PINA IFIDA 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., 1960Spina Bifida: 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: 0-597-84223-X 1. Spina Bifida-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on spina bifida. 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 SPINA BIFIDA ............................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Spina Bifida................................................................................... 6 E-Journals: PubMed Central ....................................................................................................... 24 The National Library of Medicine: PubMed ................................................................................ 25 CHAPTER 2. NUTRITION AND SPINA BIFIDA .................................................................................. 71 Overview...................................................................................................................................... 71 Finding Nutrition Studies on Spina Bifida ................................................................................. 71 Federal Resources on Nutrition ................................................................................................... 79 Additional Web Resources ........................................................................................................... 79 CHAPTER 3. ALTERNATIVE MEDICINE AND SPINA BIFIDA ............................................................ 81 Overview...................................................................................................................................... 81 National Center for Complementary and Alternative Medicine.................................................. 81 Additional Web Resources ........................................................................................................... 87 General References ....................................................................................................................... 88 CHAPTER 4. DISSERTATIONS ON SPINA BIFIDA .............................................................................. 89 Overview...................................................................................................................................... 89 Dissertations on Spina Bifida ...................................................................................................... 89 Keeping Current .......................................................................................................................... 92 CHAPTER 5. CLINICAL TRIALS AND SPINA BIFIDA ......................................................................... 93 Overview...................................................................................................................................... 93 Recent Trials on Spina Bifida ...................................................................................................... 93 Keeping Current on Clinical Trials ............................................................................................. 95 CHAPTER 6. PATENTS ON SPINA BIFIDA ......................................................................................... 97 Overview...................................................................................................................................... 97 Patents on Spina Bifida................................................................................................................ 97 Patent Applications on Spina Bifida .......................................................................................... 101 Keeping Current ........................................................................................................................ 102 CHAPTER 7. BOOKS ON SPINA BIFIDA........................................................................................... 105 Overview.................................................................................................................................... 105 Book Summaries: Federal Agencies............................................................................................ 105 Book Summaries: Online Booksellers......................................................................................... 106 Chapters on Spina Bifida ........................................................................................................... 109 Directories.................................................................................................................................. 113 CHAPTER 8. MULTIMEDIA ON SPINA BIFIDA ................................................................................ 115 Overview.................................................................................................................................... 115 Video Recordings ....................................................................................................................... 115 CHAPTER 9. PERIODICALS AND NEWS ON SPINA BIFIDA ............................................................. 117 Overview.................................................................................................................................... 117 News Services and Press Releases.............................................................................................. 117 Newsletter Articles .................................................................................................................... 119 Academic Periodicals covering Spina Bifida .............................................................................. 120 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 121 Overview.................................................................................................................................... 121 U.S. Pharmacopeia..................................................................................................................... 121 Commercial Databases ............................................................................................................... 122 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 125 Overview.................................................................................................................................... 125 NIH Guidelines.......................................................................................................................... 125
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NIH Databases........................................................................................................................... 127 Other Commercial Databases..................................................................................................... 129 The Genome Project and Spina Bifida........................................................................................ 129 APPENDIX B. PATIENT RESOURCES ............................................................................................... 135 Overview.................................................................................................................................... 135 Patient Guideline Sources.......................................................................................................... 135 Associations and Spina Bifida.................................................................................................... 140 Finding Associations.................................................................................................................. 142 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 145 Overview.................................................................................................................................... 145 Preparation................................................................................................................................. 145 Finding a Local Medical Library................................................................................................ 145 Medical Libraries in the U.S. and Canada ................................................................................. 145 ONLINE GLOSSARIES................................................................................................................ 151 Online Dictionary Directories ................................................................................................... 151 SPINA BIFIDA DICTIONARY ................................................................................................... 153 INDEX .............................................................................................................................................. 203
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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 spina bifida 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 spina bifida, 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 spina bifida, 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 spina bifida. 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 spina bifida, 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 spina bifida. 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 SPINA BIFIDA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on spina bifida.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and spina bifida, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “spina bifida” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Good Start to a Full Life: Managing Continence in Children with Spina Bifida and Hydrocephalus Source: Professional Nurse. 7(7): 474-477. April 1992. Summary: Maintaining full continence control is an essential first-step for children living with spina bifida and hydrocephalus. This article presents a multidisciplinary approach to ensure that continence training takes into account all aspects of the child's lifestyle. Topics covered include integration or mainstreaming, education, continence management, the importance of establishing a daily routine, and helping children with these conditions to reach their full potential. The authors stress that adequate social, medical, and education management will then equip these children for independent living. 8 references.
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Spina Bifida
Integrating the Spina Bifida Patient Into the General Dental Practice Source: Journal of Practical Hygiene. 10(3): 27-31. May-June 2001. Contact: Available from Montage Media Corporation. 1000 Wyckoff Avenue, Mahwah, NJ 07430-3164. (201) 891-3200. Summary: Neural tube (the embryonic tube that develops into the spinal cord, brain, and central nervous system) defects, including spina bifida, affect one out of every 1,000 newborns each year. Due to advances in medical technology, the life expectancy of these patients is rising annually, and the dental community should be prepared to treat them. This article discusses how, with proper precautions and a little effort, patients with spina bifida can be treated in the general dental practice. The authors review neural tube defects (NTD), the different types of spina bifida (a type of NTD in which the neural tube and posterior vertebrae do not completely close), medical complications, nutrition and growth complications, dermatological disorders, patient management, and radiation exposure. The authors then present a case report of a seven year old white male patient who presented for a routine oral prophylaxis; the authors describe the accommodations that were used to care for this patient. Latex avoidance precautions, wheelchair access, limited radiation exposure, and accommodations for comfort in the dental chair are further examples of ways to integrate spina bifida patients into the dental practice with safety and comfort. 5 figures. 21 references.
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Erectile Dysfunction in Patients with Spina Bifida Is a Treatable Condition Source: Journal of Urology. 164(3, Part 2): 958-961. September 2000. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2334. Fax (301) 824-7290. Summary: Now that many individuals with spina bifida live well into adulthood, erectile dysfunction (ED) has become a recognized associated medical disorder. This article reports on a study undertaken to determine the ability to use sildenafil citrate (Viagra) to treat ED in men with spina bifida. ED was diagnosed in 15 men (19 to 35 years old) with spina bifida who were assigned to take 4 sets of tablets, 5 tablets per set, in a random order. All patients took 25 and 50 mg of sildenafil and 2 identical looking sets of corresponding placebos 1 hour before planned sexual activity. Improved erectile function was reported while on sildenafil by 12 (80 percent) men compared to baseline and placebos. There was a significant dose dependent improvement of erectile function with both 25 and 50 mg sildenafil compared to baseline, as mean erectile score increased by 50 percent and 88 percent, mean duration of erections increased by 192 percent and 266 percent, mean frequency of erections increased by 61 percent and 96 percent, and mean level of confidence increased by 33 percent and 63 percent, respectively. Furthermore, 50 mg sildenafil provided greater improvement in all 4 parameters compared to 25 mg. The placebo results were not significantly different compared to baseline for any of the parameters. The authors conclude that ED in patients with spina bifida is a medically treatable condition. Sildenafil is effective in this patient population and improves level of sexual confidence. 4 figures. 7 references.
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Spina Bifida Source: Family Urology. 4(1): 8, 12. 1999. Contact: Available from American Foundation for Urologic Disease. 1126 North Charles Street, Baltimore, MD 21201. (800) 242-2383 or (410) 468-1800. Fax (410) 468-1808. Website: www.afud.org.
Studies
5
Summary: Spina bifida (myelomeningocele) is a defect found in the developing spinal cord of some infants before birth. It is most often characterized as a hole in the spinal cord that produces neurological, musculoskeletal, and urologic difficulties. This brief article reviews the urologic care of children with spina bifida. The author notes that because of the severity of the neurological and orthopedic problems, urinary tract problems are often neglected. However, today most children with spina bifida can be rendered socially continent, urinary infections can be minimized, and renal failure usually prevented. This is primarily because of the introduction of multidisciplinary clinics for the treatment of these children. During the first few years, the urologist assists patients with spina bifida to prevent or treat hydronephrosis (dilation of the urinary tract which can lead to kidney damage) through regular examinations, and interventions such as medications, catheterizations, or surgery. At some point (usually in the preschool years) the concern shifts to providing urinary continence for the patient. In adolescence, concerns about sexual function and fertility emerge. •
Urological Issues with the Spina Bifida Population Source: Journal of Urological Nursing. 12(1): 333-344. January/February/March 1993. Summary: Spina bifida, or myelomeningocele, is one of the most common birth defects in the United States, affecting approximately one in every thousand births. This article addresses urological issues that occur within the spina bifida population. Topics include urological issues for the newborn, assessment of bladder function, treatment of urinary tract infections (UTI), issues of care across the lifespan, controlling UTIs and bladder pressure to prevent kidney damage, the use of continent ostomies and indwelling catheters in this population, the use of clean intermittent catheterization (CIC), surgical methods used to enhance urinary continence, problems with latex allergy, and the importance of skin care. The author focuses on the nursing interventions necessary to help with the urological concerns of the spina bifida population. A detailed nursing care plan is included. 1 table. 19 references.
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Dentist's Role: The Unnecessary Epidemic of Folic Acid-Preventable Birth Defects, Spina Bifida and Anencephaly Source: Virginia Dental Journal. 79(3): 24-25. July-September 2002. Contact: Available from Virginia Dental Association. 7525 Staples Mill Road, Richmond, VA 23228. (804) 261-1610 or, in Virginia, (800) 552-3886. Summary: This article familiarizes dentists and dental care professionals with folic acidpreventable birth defects, notably the neural tube defects (NTDs), spina bifida and anencephaly. Prevention of most NTDs is possible if all women in the perioconceptional period have high enough body content of folic acid (a B vitamin). The author reviews neural tube formation and prevention of NTDs, and the role of health care providers in reducing the risk of NTDs. The author notes that many women of childbearing age, who may not yet be pregnant, visit dentists on a regular basis for preventive dental exams. Thus, dentists are in a unique position to provide information about folic acid and the prevention of NTDs, as it is most effective if taken before and during early pregnancy. 7 references.
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Management of Chronic Complex Urinary Problems in Children: Urinary Incontinence Associated with Spina Bifida and Spinal Cord Injury Source: Family Urology. 5(1): 9-11. 2000.
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Spina Bifida
Contact: Available from American Foundation for Urologic Disease. 1126 North Charles Street, Baltimore, MD 21201. (800) 242-2383 or (410) 468-1800. Fax (410) 468-1808. Website: www.afud.org. Summary: This article on the management of chronic complex urinary problems in children focuses on urinary incontinence (UI) associated with spina bifida and spinal cord injury. The author addresses several of the complex problems that have a lifelong impact on the child and family. These problems include UI associated with the birth defect spina bifida and the acquired problem of UI associated with spinal cord injury. The author reviews the medical conditions involved, diagnostic considerations, basic management strategies, and the emotional impact of chronic illness. The author notes that regular physician visits with comprehensive evaluation of the function and structure of the bladder and kidneys are only one step in managing urinary incontinence. The emotional and developmental considerations of each individual child and family situation may impact a medical or surgical decision. The author also briefly considers the importance of a multidisciplinary care team for these children with complex medical concerns. 1 figure.
Federally Funded Research on Spina Bifida The U.S. Government supports a variety of research studies relating to spina bifida. 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 spina bifida. 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 spina bifida. The following is typical of the type of information found when searching the CRISP database for spina bifida: •
Project Title: ANALYSIS DROSOPHILA
OF
RHOA
MEDIATED
MORPHOGENESIS
IN
Principal Investigator & Institution: Halsell, Susan R.; Biology; James Madison University Harrisonburg, Va 22801 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2005 Summary: (provided by applicant) Morphogenesis remodels the shape of the embryo, generating the myriad of complex forms and structures that characterize the mature organism. Defects in morphogenesis give rise to birth defects such as spina bifida and anencephaly. While the outcome of such morphogenetic defects is very apparent, the underlying cellular and molecular mechanisms of normal morphogenesis remain unclear. Investigating and characterizing morphogenesis is an important step 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
Studies
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understanding how to overcome birth defects. The studies proposed here focus on key a cellular aspect of morphogenesis, the generation of cell shape changes; signal transduction via the small GTPase molecular switch, RhoA, is critical for these cell shape changes. This proposal will extend previous studies, directly investigating the role of RhoA signal transduction during morphogenesis of Drosophila melanogaster. This allows exploitation of the powerful molecular and classical genetic techniques afforded by the model organism. This research will examine the precise nature of the defects in RhoA and RhoGEF2 mutant animals. This will be accomplished by utilizing fixed preparations of mutant embryos that have been stained with antibodies directed against the cytoskeleton. New mutant alleles of RhoA and its positive regulator, Rho Guanine Exchange Factor 2, will be generated in order to further define the morphogenetic processes that require Rho signal transduction. This will include standard chemical mutagenesis techniques and the generation of a conditional RhoA mutation. The relationship between Rho signal transduction and Myosin activation will be explored. This will be accomplished by molecularly engineering a myosin transgene and then expressing it in RhoA mutant embryos. Finally, powerful genetic strategies will be used to identify molecules that function upstream and downstream of Rho signal transduction. Tissue culture and biochemical studies have suggested a number of players in this process, but their biological relevance in the intact organism remains unclear. We will test these candidate loci directly in genetic interaction tests with RhoA mutations. Further, we will perform mutagenesis screens to identify novel gene products that collaborate in the Rho signal transduction pathway. Together, these studies will extend understanding of the fundamental role and pathways Rho signal transduction plays in morphogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CAMP-DEPENDENT PROTEIN KINASE A IN NEURAL TUBE FORMATION Principal Investigator & Institution: Huang, Yongzhao; Pharmacology; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-JAN-2002 Summary: (Applicant's abstract reproduced verbatim): The aim of this research application is to study functional consequences of a decreased PKA activity in early mouse development. It involves analyzing a PKA-deficient mouse generated with only one functional catalytic allele left in the PKA system. This PKA-deficient mouse develops severe neural tube defects leading to spina bifida and this suggests a specific requirement for PKA in neural tube formation. The proposed project includes examination of gene expression, cell proliferation and cell death in the defective neural tube. Rescue experiments will be performed to further determine the molecular basis for the neural tube defects in the PKA-deficient mice. This research will increase our understanding of the function of PKA in embryonic development, and the molecular and cellular basis of neurulation, which may lead to improved treatment for human neural tube defects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CELL NEURULATION
MOTILITY
AND
CELL
INTERACTIONS
DURING
Principal Investigator & Institution: Keller, Raymond E.; Professor; Biology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904
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Timing: Fiscal Year 2002; Project Start 01-APR-1989; Project End 31-MAR-2007 Summary: (provided by applicant): The broad aim is to determine the tissue interactions and signaling pathways that control a specific type of polarized cell motility that occurs during "convergence and extension" (narrowing and elongation) movements of the embryonic nervous system of the frog, Xenopus laevis, and to test the role of this motility in forming the neural tube. Past work identified a monopolar, medially-directed cell motility that causes neural cells to intercalate between one another, thus narrowing and elongating the neural plate. Previously unknown signals from the midline tissues of notochord/notoplate were discovered to control this polarized motility, and a model of how this motility is regulated by the midline was developed. The proposed research uses state of the art fluorescent cell labeling, fluorescence microscopy, and digital imaging methods to describe cell movements in cultured explants, and in recombinations of embryonic tissues, designed to test the specific tissue interactions hypothesized to control the polarized cell motility. Molecular perturbations of molecules thought to control this motility will be targeted to specific cells at specific times, using transgenic lines of X. laevis and the Ga14/UAS system from Drosophila. The specific aims are to: 1. further characterize the polarized and oriented motility of deep neural plate cells and the signals from the midline tissues that induce this motility, using our model as a guide for experiments; 2) determine the role of the planar cell polarity pathway in regulating this polarized and oriented cell behavior; 3) determine the role of small GTPases in controlling cell motility in neural plate morphogenesis. This work will provide a deeper understanding of the cell motility that forms the neural tube in vertebrates, and how this motility is controlled by specific tissue interactions and signaling pathways. These findings will contribute to understanding the failure of human birth defects, such as spina bifida, in which the neural does not form and close properly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CEREBELLAR AND MIDBRAIN FUNCTION IN CHILDREN WITH SPINA BIFIDA Principal Investigator & Institution: Dennis, Maureen F.; Senior Scientist; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORE--DATABASE, COMPUTER, AND STATISTICS Principal Investigator & Institution: Francis, David J.; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CORPUS CALLOSUM FUNCTION IN CHILDREN WITH SPINA BIFIDA Principal Investigator & Institution: Hannay, Julia H.; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002
Studies
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Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIFFERENTIAL DEVELOPMENT
ACTIN
REGULATION
IN
ZEBRAFISH
Principal Investigator & Institution: Daggett, David F.; Molecular and Cell Biology; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2004; Project Start 02-AUG-2004 Summary: (provided by applicant): The proposed research seeks to understand how the spatial and temporal control of actin dynamics is regulated differentially across the developing vertebrate embryo. This will be investigated within the specific context of mesodermal cell behaviors during gastrulation and segmentation in the zebrafish embryo. The potential role of actin regulatory molecules (ARMs) that are expressed in specific areas of developing mesoderm will be investigated by loss of function analysis, using confocal imaging and a transgenic line of reporter fish expressing actin-GFP fusion protein that reveals cellular actin distribution. The signaling pathways controlling these ARMs will be characterized using mutagenesis screening and proteinprotein interaction assays. The misregulation of actin and cell movements has been implicated in multiple human conditions such as Wiskott- Aldrich syndrome and Spina Bifida, in which compromised cell polarity causes a failure of neural tube closure in early development. An understanding of actin regulation during vertebrate development in the zebrafish may thus provide insights into the causes and treatment of certain human diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISCOURSE AND ACADEMIC SKILLS IN CHILDREN WITH SPINA BIFIDA Principal Investigator & Institution: Barnes, Marcia A.; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: E. COLI FOR PREVENTION OF CATHETER UTI IN SCI PATIENTS Principal Investigator & Institution: Trautner, Barbara W.; Medicine; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: Urinary tract infection (UTI) is a major cause of morbidity and mortality in persons with spinal cord injury (SCI). Frequent use of anti-microbial agents in patients with recurrent UTI creates selection pressure for te development of resistant bacteria. Therefore, there exists a pressing need to design and evaluate new approaches for prevention of UTI. The overall goal of this project is to develop a new approach for prevention of UTI in persons who rely in indwelling catheters for bladder drainage. The concept of using benign bacteria to prevent symptomatic infection, such as UTI, is known as bacterial interference. We previously demonstrated that intentional colonization of the bladders of patients with spinal cord injury with a non-pathogenic strain of Escherichia coli (83972) reduced the frequency of symptomatic UTI. We now propose to extend this principle of bacterial interference by inoculating urinary catheters
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Spina Bifida
with E. coli 83972 prior to insertion into patients' bladders. It is our hypothesis that colonization of bladder catheters with E. coli 83972 prior to insertion into patients may delay attachment of pathogenic bacteria to the catheter and thereby prevent UTI. Our preliminary studies show that this may be feasible. We found in vitro that incubation of urinary catheters with E. coli 83972 inhibited subsequent attachment by Enterococcus faecalis, a uropathogenic bacterium. In the current application we propose to examine the capacity of both wild-type and genetically enhanced E. coli 83972 to inhibit catheter adherence by various uropathogens and to clinically evaluate bladder catheters with pre-formed coating of E. coli 83972 in human subjects who experience recurrent UTI as a result of long-term catheterization. The results of the proposed studies may eventually benefit many types of people with mobility disorders who require indwelling bladder catheters for urinary drainage, including persons with SCI, children with spina bifida, stroke victims, and many nursing home residents. The research will be done in the Spinal Cord Injury Laboratory at the Houston Veterans' Affairs Medical Center and at Baylor College of Medicine. The candidate plans to combine her clinical background in infectious diseases with the mentored research preformed under this award in order to reduce the secondary infectious complications of mobility disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EPITHELIAL CELL STRUCTURE IN VERTEBRATE DEVELOPMENT Principal Investigator & Institution: Hildebrand, Jeffrey D.; Biological Sciences; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Many human birth defects, diseases, and cancers arise when epithelial cells either acquire or lose specific behavioral characteristics. The long-term aims of this proposal are to understand the pathways that determine epithelial cell behavior in general and will focus specifically on the role Shrm-family proteins play in this process. These proteins are conserved in vertebrates and exhibit the modular nature suggestive of multi-functional adapters. Of the five predicted family members, only Shrm and Apx have been characterized to any extent. Both are expressed in epithelial cells and localize to apical membrane domains in vivo. In addition, the function of both Apx and Shrm appears linked to the actin cytoskeleton, as Shrm directly binds F-actin and Apx function seems to be regulated by the cytoskeleton. Finally, mouse embryonic development requires the Shrm protein, as Shrm-deficient embryos exhibit severe neural tube defects that resemble many seen in human conditions such as spina bifida, anencephaly, and facial clefting. Alteration in cytoskeletal organization or polarity appears to be the underlying defect. These data support the hypothesis that these proteins utilize their modular nature to regulate architectural characteristics of epithelial cells. Therefore the goal of the research proposed here is to elucidate the functions of Shrm/Apx proteins and determine what set of epithelial behaviors require these activities. The specific aims are 1) Identify the nature and ramifications of Shrm protein-protein interactions and 2) Characterize the role of Shrm in epithelial cell biological pathways. Accomplishing these goals will require rigorous biochemical and cell biological analysis of Shrm and Shrm related proteins. Data obtained from this line of questioning will compliment a thorough analysis of the epithelial character of Shrm-null neuroepithelialcells. Together, these avenues of research should shed new light on pathways that control epithelial biology during the course of normal and adult life. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FOLATE RECEPTORS IN CRANIOFACIAL MALFORMATIONS Principal Investigator & Institution: Finnell, Richard H.; Professor & Director; None; Texas A&M University Health Science Ctr College Station, Tx 778433578 Timing: Fiscal Year 2002; Project Start 01-MAY-1999; Project End 30-APR-2004 Summary: (adapted from the Investigator's abstract): Over the past two decades, the accumulated literature suggests that periconceptional folic acid supplementation can reduce both the occurrence and recurrence of orofacial clefts and neural tube defects in humans by about 50%. This has major public health implications, as about 10,000 pregnancies per year in the United States are complicated by either neural tube defects or orofacial clefts. These malformations are among the most common of all human birth defects, yet their etiologic basis and underlying embryology remain poorly understood. The epidemiological evidence suggests that the protective effects of folic acid are unlikely to simply be maternal folate deficiency. Rather it may be deficient fetal folate metabolism, as well as the teratogenic effects of the elevated homocysteine levels that accompany folate deficiency. The applicant has developed a transgenic "knockout" mouse model lacking functional folate binding protein (FBP-1 and FBP-2). Homozygous null embryos for the FBP-1 have lethal neural tube defects. The general hypothesis is that an abnormal maternal and/or fetal folate receptor increases the risk for orofacial clefts and/or neural tube defects due to an inability to adequately bind and transport folate to both the oral and neural epithelia of the developing embryo. Experiments are proposed to determine the function of the FBPs during palatal and neural tube closure in the offspring of dams whose genes have been inactivated by homologous recombination in embryonic stem cells. The experimental model uses manipulation of folate and homocysteine levels of the dams and embryos by genetic or dietary means, with a number of morphological, molecular and biochemical endpoints. The conclusion of these studies have the potential to lead to a greater mechanistic appreciation for the protective effect of folic acid supplementation on embryonic development, the relative importance of folate and homocysteine metabolites and a better understanding regarding the role of cellular proliferation and/or cell death in craniofacial and neural tube development under conditions of variable folate and homocysteine availability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HEREDITARY BASIS OF NEURAL TUBE DEFECTS Principal Investigator & Institution: Speer, Marcy C.; Associate Research Professor; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-AUG-1999; Project End 30-JUN-2004 Summary: (Adapted from investigator's abstract) The goal of this revised application is to illuminate the hereditary factors predisposing to neural tube defects (NTDs) and the interactions of these genes with one another and with the environment, eventually leading to mechanisms for the prevention of these frequent birth defects. Failed closure of the neural tube, the embryonic structure from which the brain and spinal cord are formed, leads to NTDs. The NTD complex includes the two most common forms of NTDs, spina bifida and anecephaly, as well as other less frequent manifestations. The frequency of NTD births in the US is approximately 1/1000. Multiple lines of evidence in humans and studies in experimental organisms provide compelling evidence that the predisposition to the development of NTDs includes a hereditary component. The increased risk to siblings over the general population rate is estimated at 25-50. The applicants propose to identify genetic factors involved in NTD development. We will collect both simplex and multiplex pedigrees in which the affected member(s) have a
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NTD. Extensive family history data and blood for DNA extraction will be obtained from these pedigrees. In addition, these pedigrees will be exhaustively characterized clinically, including radiographic assessment of facial dysmorphology, and cytogenetic assessments. In addition, the applicants will collect and database information on key environmental risk factors such as folic acid supplementation, maternal weight, and paternal military exposures to allow assessment of gene/environment interactions. These studies are aided by the plethora of well characterized murine models for NTDs, the human homologies for which have been identified in many cases. In the first two years of the study, specific candidate genes will be examined with SSCP analysis in available families. In year three, genomic screening of multiplex families will be performed, with follow-up investigations in years 4-5. These multiplex pedigrees will allow investigation of regions of interest unrelated to known candidate genes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMMUNOTHERAPY FOR LATEX RUBBER ALLERGY Principal Investigator & Institution: Adkinson, N Franklin.; Professor of Medicine; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-SEP-1998; Project End 30-NOV-2007 Summary: (provided by applicant): Allergic sensitivity to natural rubber latex has become a major occupational hazard of healthcare workers and some patients with frequent latex rubber exposures. Between 2.2 and 10.7% of healthcare workers and up to 50% of children with spina bifida are at risk for systemic reactions to rubber products, mainly latex gloves. Since complete avoidance is difficult in most medical environments, latex allergy can necessitate involuntary career changes with substantial economic and emotional consequences. Using a latex allergen extract now under FDA review as a proposed diagnostic reagent, this project will continue development of a natural exposure model of respiratory latex allergy in clinical studies to demonstrate the safety and efficacy of immunotherapy for IgE-dependent latex allergy. The specific aims are: (1) to complete a Phase I clinical trial of immunotherapy with a candidate extract of nonammoniated latex. This study is currently in progress with three of six latex-allergic healthcare workers enrolled. Safety, IgG and IgE antibody responses) and evidence of desensitization (skin test titrations) are being studied. (2) to determine in a randomized, placebo-controlled clinical trial the safety and clinical efficacy of immunotherapy in patients with l disabling occupational allergy to latex proteins. Subjects will be health professionals with clinically significant respiratory or anaphylactic reactions to latex and documented failure of attempts at avoidance. The primary endpoint will be sensitivity to latex as determined by the hooded chamber graded exposure technique. Secondary endpoints for the clinical trial will include immunologic changes (IgG and IgE fluxes), skin test sensitivity, adverse reaction rates, and where possible assessment of workrelated symptoms. In parallel we propose (3) to prospectively evaluate cohorts of new nursing students and children with spina bifida in order to determine the initial prevalence rates, the rate of new sensitization over a five-year period, and the risk factors related to the development of sensitivity. Enrolled cohorts will be followed annually to assess latex exposure, clinical reactivity, and skin test reactivity. The purpose is to evaluate clinical effectiveness of latex avoidance policies currently in use. The long-term objective of this research plan is to develop a useful therapeutic alternative for latex sensitive healthcare workers and selected patients who have failed avoidance, and to document prospectively the effectiveness of current latex containment policies on the incidence of new sensitization. Potential benefits of successful immunotherapy include a reduction in professional disability, prevention of chronic
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disease, expanded occupational choices and increased work productivity for those affected. Knowledge of the effectiveness of containment practices will help shape future occupational health polices. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFANT VISUAL INFORMATION PROCESSING Principal Investigator & Institution: Cohen, Leslie B.; Professor; Psychology; University of Texas Austin 101 E. 27Th/Po Box 7726 Austin, Tx 78712 Timing: Fiscal Year 2002; Project Start 01-SEP-1987; Project End 30-JUN-2004 Summary: The research described in this proposal will continue our examination of developmental changes in infants' visual information-processing. For more than two decades we have been investigating how infants perceive, organize, and understand visual information in their environment. Based upon our findings, as well as those from many other laboratories, we have discovered a number of general informationprocessing principles that seem to apply repeatedly over the first two years of life. In many respects these principles resemble those that characterize children and adults as they become proficient, or expert, in specific domains. It is just that for infants the domain is the immediate world around them, and during the first two years of life they are becoming proficient in perceiving, predicting, and understanding objects, people, and events in that world. By using experimental designs capitalizing on infant visual habituation, we plan to examine the development of normal infant visual information processing in four specific research areas: the perception of objects, faces, simple causal events, and other more complex events. In each case we will by examining local versus global processing. Specific predictions in each area, based upon our informationprocessing principles will be tested. We also plan to attempt some computational modeling of the developmental process. The normal developmental progressions we discover can be used as baselines to assess infants with aberrant developmental patterns. In fact, although not a formal part of this proposal, we already have established collaborations with other laboratories and jointly plan to use our discoveries about normal perceptual development to assist in those projects' assessments of infants with spina bifida or with brain lesions in either the left or right hemisphere. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LONGITUDINAL EFFECTS OF SPINA BIFIDA ON EARLY LEARNING Principal Investigator & Institution: Landry, Susan H.; Professor; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOLECULAR GENETIC STUDIES OF NEURAL TUBE DEFECTS Principal Investigator & Institution: Northrup, Hope; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MULTICENTER TRIAL OF FETAL MYELOMENINGOCELE REPAIR Principal Investigator & Institution: Adzick, N. Scott.; Surgeon-In-Chief; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 15-MAR-2002; Project End 28-FEB-2007 Summary: (provided by applicant): Since 1997, 180 fetuses have had in utero closure of myelomeningocele (MMC) by open fetal surgery. Preliminary clinical evidence suggests that this procedure reduces the incidence of shunt-dependent hydrocephalus and restores the cerebellum and brainstem to more normal configuration. However, clinical results of fetal surgery for MMC are based on comparisons with historical controls and examine only efficacy and not safety. The Myelomeningocele Repair Randomized Trial is a multi-center unblinded randomized clinical trial of 200 patients that will be conducted at three Fetal Surgery Units (FSUs), the University of California-San Francisco, Children s Hospital of Philadelphia, and Vanderbilt University Medical Center, along with an independent Data and Study Coordinating Center (DSCC), the George Washington University Biostatistics Center. The primary objective of the trial is to determine if intrauterine repair of fetal myelomeningocele at 18 to 25 weeks gestation improves outcome, as measured by (1) death or the need for ventricular decompressive shunting by one year of life and (2) death or Bayley Mental Development Index, as compared to standard postnatal repair. Consenting patients who satisfy eligibility criteria will be centrally randomized to either intrauterine or standard postnatal repair of the MMC. Patients assigned to the fetal surgery group will be discharged to nearby accommodation following surgery, unless unfeasible, in which case they will return to their assigned FSU at 32 weeks gestation for delivery at 37 weeks gestation by cesarean section. Patients assigned to the postnatal surgery group will return home and at 37 weeks, return to their assigned FSU for delivery by cesarean section. Magnetic resonance imaging will be conducted at enrollment, discharge or term gestation, and one year of age to determine if intrauterine repair improves the degree of the Chiari II malformation. Neonatal morbidity will be recorded as will the number of surgical procedures for conditions related to the MMC, muscle strength, ambulation status and urinary and fecal continence. Infants will make follow-up visits at twelve and thirty months corrected age for detailed neuromotor function analysis, cognitive testing and evaluation of neurodevelopmental status. In addition, the long term psychosocial and reproductive consequences in mothers will be evaluated. In summary, the proposed trial is expected to demonstrate whether fetal intervention offers improved outcome with a reasonable quality of life for spina bifida children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MYELOMENINGOCELE REPAIR RANDOMIZED TRIAL-DSCC Principal Investigator & Institution: Thom, Elizabeth A.; Associate Research Professor of Statisti; Statistics; George Washington University 2121 I St Nw Washington, Dc 20052 Timing: Fiscal Year 2002; Project Start 11-APR-2002; Project End 31-MAR-2007 Summary: Since 1997, 180 fetuses have had in utero closure of myelomeningocele (MMC) by open fetal surgery. Preliminary clinical evidence suggests that this procedure reduces the incidence of shunt-dependent hydrocephalus and restores the cerebellum and brainstem to more normal configuration. However, clinical results of fetal surgery for MMC are based on comparisons with historical controls and examine only efficacy and not safety. The Myelomeningocele Repair Randomized Trial is a multi-center unblinded randomized clinical trial of 200 patients that will be conducted at three Fetal Surgery Units (FSU), the University of California-San Francisco, Children's Hospital of
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Philadelphia, and Vanderbilt University Medical Center. The primary objective of the trial is to determine if intrauterine repair of fetal myelomeningocele at 18(0) to 25(6) weeks gestation improves outcome, as measured by 1) death or the need for ventricular decompressive shunting by one year of life and 2) death or Bayley Mental Development Index, as compared to standard postnatal repair This proposal is for the George Washington University Biostatistics Center to serve as the Data and Study Coordinating Center (DSCC) for the MMC Repair Trial. The purpose of the DSCC, an important but independent member of the multi-center collaborative study group, is to provide expertise and support in study design, study conduct and statistical analysis. We will provide scientific leadership in the design of the study and prepare the final study documents including the protocol, manual of operations and case report forms. The DSCC will be responsible for all publicity for the MMC Repair Trial such as establishing a central web site, mailing of physician brochures, presenting trial information at appropriate professional meetings and placing print advertisements in medical journals and patient oriented publications. We will also serve as the central referral site for patients to learn more about the trial, conduct preliminary review of patient eligibility and assign the patient to a Fetal Surgery Unit for final evaluation. The DSCC will maintain an Internet randomization system and web-based data entry system for the patient eligibility data. We will provide a comprehensive data processing system including central data entry, data base management and data quality control. The DSCC will use appropriate statistical techniques to conduct interim and final analyses. We will assist the investigators in preparation of manuscripts and abstracts from study results. In summary, we will participate in cooperation with the FSUs on the proposed trial with the goal of demonstrating whether fetal intervention offers improved outcome with a reasonable quality of life for spina bifida children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURAL TUBE DEFECTS IN DISHEVELED MUTANT MICE Principal Investigator & Institution: Wynshaw-Boris, Anthony J.; Associate Professor; Pediatrics; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2009 Summary: (provided by applicant): Neural tube defects (NTDs) are common birth defects in humans. Although it is known that genetic susceptibility factors are associated with NTDs in humans, they have yet to be identified. The mouse can be used as a model system to study genetic factors associated with NTDs and the mechanism of neural tube closure. In the course of studying mice with inactivation of each of the three mouse Disheveled (Dvl) genes, we discovered that Dvl2 -/- and Dvl1 -/- Dvl2 -/- display NTDs. Disheveled is an important gene in the evolutionarily conserved Wnt/wingless signal transduction pathway and the planar cell polarity (PCP) pathways. All eukaryotic Dvl proteins contain three highly conserved domains: DIX, PDZ and DEP. Studies in Drosophila and Xenopus indicate that while the DIX and N-terminal portion of the DEP domain are required for Wnt pathway signaling, the PDZ and C-terminal DEP domain are essential for the PCP/convergent extension pathway. Disruption of either the Wnt or PCP pathways may result in NTDs. We propose to determine the spatial and temporal requirements for Dvl proteins during neural tube closure, and whether the NTDs displayed by Dvl mutant mice are caused by Writ signaling defects and/or PCP pathway defects. We will use the following specific aims. 1) To further characterize Dvldependent pathways responsible for the NTDs in Dvl 1/2 mutants, we will examine Wnt and PCP/convergent extension pathway signaling in cells and in vivo during
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neural tube closure in wild-type and Dvl 1/2 double mutants. 2) We will test for genetic interactions between Loop tail/strabismus (Stbm) and fused/axin with Dvl1 and Dvl2 in neural tube closure, to genetically distinguish PCP and Wnt pathway effects, respectively. 3) To determine the sites in neural tube that require Dvl2 function for normal closure, we will produce mice with specific loss-of-function of Dvl2 or specific expression of Dvl2 in spatially and temporally restricted patterns. The effect of these mutations on neural tube closure in wild type and Dvl mutants will be assessed. 4) To determine the domains of the Dvl2 protein that are required for neural tube closure, we will produce an allele series of Dvl2 mutants in mice using a BAC transgenic strategy. Precise mutations in Dvl2 will be engineered using homologous recombination of BACs in bacteria, and the resultant mutant Dvl2 BACs will be used to produce transgenic mice. The effect of these mutations on neural tube closure in Dvl -/-Dvl2 -/- mutants will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEW DHFR DELETION POLYMORPHISM - A RISK FACTOR FOR SB? Principal Investigator & Institution: Johnson, William G.; Professor of Neurology; Neurology; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 30-JUN-2004 Summary: (provided by applicant): Spinal bifida (SB) is a common birth defect that is determined by multiple genetic and environmental factors. Up to 72% of SB is preventable by periconceptual maternal folate supplementation. The C677T polymorphism of the methylenetetrahydrofolate reductase gene and some other functional polymorphisms appear to be risk factors for SB in some populations but not others. However, despite extensive study, the genetic risk factors for SB are poorly understood. We hypothesize that genetic factors which diminish bioavailability of reduced foliate in the mother during pregnancy may contribute to SB in her fetus. We recently discovered a new 1 9bp deletion of dihydrofolate reductase (DHFR) that is a common polymorphism (allele frequency 0.44) and is a good candidate for such a genetic factor. We found that homozygosity for this deletion allele was significantly more frequent in SB mothers compared with controls, SB fathers, and SB patients, as predicted by the hypothesis.We propose to confirm and extend this finding in a replication series of SB families. We will use a new method devised by the PI to test for transmission/disequilibrium in SIB maternal trios (SB mother, maternal grandmother and maternal grandfather) to document the action of the DHFR deletion allele as a teratogenic locus, that is, one that acts in a mother to affect the development of her fetus. We will also document whether the deletion allele decreases DHFR transcription or affects DHFR activity by another mechanism.If this hypothesis is confirmed, it will shed light on how foliate supplements prevent SB and may lead to improved forms of foliate supplementation for pregnancy. About half of dietary foliates and all of folic acid supplements are unreduced and must be reduced by DHFR to be available for mother and fetus. Forms of foliate that are already reduced could be preferable as foliate supplements during pregnancy for prevention of SB. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PARTICIPATION OF CHILDREN WITH PHYSICAL DISABILITIES Principal Investigator & Institution: Law, Mary C.; Professor; Mc Master University Hamilton L8s 4L8, Canada Hamilton,
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Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 31-MAY-2004 Summary: (adapted from investigator's abstract): Childhood physical disability refers to intrinsic biological or acquired conditions (e.g., cerebral palsy, spina bifida, traumatic brain injury, spinal cord injury, amputation) that cause impairments which result in disability and limited participation in day-to-day activities. As children grow and develop, there are many factors within the child, his or her family and the environment that have the potential to influence participation in the everyday activities of childhood. It is difficult to plan interventions to enhance participation without knowledge about which factors are the most important in what is, undoubtedly, a complex set of relationships. The proposed project, from the Neurodevelopmental Clinical Research Unit (NCRU) at McMaster University, is a longitudinal study of children with physical disabilities aged 5- 13 years to determine the child, family and environmental factors that enhance participation in the formal and informal activities of childhood. Innovative methodologies (structural equation modeling and a cross-sequential design) will be used to evaluate the relative contribution of child, family and environmental factors in determining participation of children with long-term, non-progressive physical conditions associated with physical functional limitations in day-to-day activities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF GEMININ EXPRESSION IN EMBRYONIC ECTODERM Principal Investigator & Institution: Kroll, Kristen L.; Molecular Biol & Pharmacology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Our long-term objective is to dissect the molecular circuitry that underlies cell fate determination in the neurectoderm during early vertebrate embryogenesis. Information obtained in these studies may ultimately impact multiple human health issues, including our ability to manipulate embryonic stem cells for human therapies in the nervous system, and our understanding of the molecular basis of birth defects, including holoprosencephaly and spina bifida. These birth defects are among the most common congenital malformations in humans. Our general strategy is to focus upon a group of genes that act as primary effectors of neural fate during early embryogenesis. Expression of these genes in the future neural plate represents the earliest transcriptional response of ectoderm to neural-inducing signals from adjacent cells. This expression demarcates the embryonic ectoderm into neural versus non-neural territories. It is not known how this transcription arises or which molecular determinants and signaling pathways are direct regulators. Here, we have used a manipulatable transgenic Xenopus embryo system to reconstitute cis-regulatory controls underlying the early neural expression of one such gene, geminin. We show that 5' regulatory sequences from geminin recapitulate its expression and respond to inductive signals in the same manner as the endogenous gene. We propose use of several approaches to identify discrete cis-elements and protein complexes that directly control the onset of geminin's initial neural-specific transcriptional program, including injection and transgenic methodologies in vivo and various molecular methodologies in vitro. These studies should fill a critical gap in our understanding of the molecular basis of neural cell fate determination. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ROLE OF CHROMOSOME 13Q GENES IN NEURAL TUBE DEFECTS Principal Investigator & Institution: Kessler, John A.; Professor and Chair; Mol Pharm & Biol Chemistry; Northwestern University Office of Sponsored Research Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 31-MAY-2005 Summary: Adapted from the Applicant's Description) Neural tube defects represent a common, heterogeneous set of congenital malformations whose etiology is poorly understood. Although some environmental factors have been implicated, a significant genetic contribution is implied by the analysis of murmne lines with NTDs and the familial clustering in humans. Additionally, numerous syndromes and chromosomal anomalies are associated with NTDs. Both deletions and trisomies of chromosome 13 have been associated with neural tube defects raising the possibility that certain genes on chromosome 13 contribute to the etiology of NTDs when their dosage is altered. Nested sets of deletions of chromosome 1 3q, including one recently identified in the investigators clinic, implicate a fairly small region on chromosome 1 3q33-34. Although the exact genes required for producing an NTD in a 13q deletion are not known, several genes found in this region are important for early neural development in murine models, making them excellent candidates to test for involvement in human NTDs. The investigators propose to test the hypothesis that candidate genes in the chromosome 1 3g critical region are associated with NTDs in patients who lack chromosomal deletions. They will map the chromosome 1 3q critical region using patients with deletions and NTDs to narrow further the number of candidate genes. They will then choose genes to screen in detail based upon evidence of their involvement in early neural development or evidence of linkage disequilibrium. The candidates will be screened for mutations in a large set of individuals with NTDs using the resources of the NTD collaborative group. The investigators will test for linkage disequilibrium of all available candidate genes in the 1 3q critical region with the transmission disequilibrium test. These studies are likely to define mutations or polymorphisms associated with NTDs. The ability to identify genetic factors that place families at risk might help reduce the incidence of NTDs or make early intervention more feasible. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SPINA BIFIDA RESEARCH RESOURCE Principal Investigator & Institution: Mitchell, Laure; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 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: VARIABILITY
SPINA
BIFIDA:
COGNITIVE
AND
NEUROBIOLOGICAL
Principal Investigator & Institution: Fletcher, Jack M.; Professor; Pediatrics; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 20-MAR-1998; Project End 29-FEB-2004 Summary: Spina bifida meningomyelocele is the major severely disabling birth defect in North America, but our knowledge of the factors responsible for neurobehavioral outcome is fragmentary. The program project aims to make these fragments coherent. The overall objective of this program project is to identify sources of variability-genetic,
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environmental, and CNS-that explain variations in the neurobehavioral outcomes of children with spina bifida meningomyelocele and hydrocephalus (SBH). To accomplish this objective, we propose to evaluate 583 children with spina bifida and 159 controls in five projects and three cores at two primary data collection sites: the University of Texas-Houston Medical School and the Hospital for Sick Children, Toronto. Project 1 (Genetics; Northrup, P.I.) evaluates genetic factors associated with spina bifida and related neural tube defects in Hispanic and Caucasian cohorts. Approximately 100 candidate genes will be tested and a genome-wide search will be initiated that permits testing of 150 of 330 possible markers. Projects 2 (Early Learning; Landry, P.I.) is a longitudinal study of infants with SBH from 7-36 months of age. This study addresses the relationship of core neurobiological deficits and the environment in producing early learning deficits in children with SBH. Project 3 (Cerebellum; Dennis, P.I.) evaluates the role of cerebellum/midbrain dysmorphology in producing the motor, spatial, and attentional deficits associated with SBH. Project 4 (Corpus Callosum; Hannay, P.I.) examines the corpus callosum anomalies characteristic of SBH in relationship to interhemispheric transmission and hemispheric specialization. Project 5 (Discourse and Academic Skills; Barnes, P.I. evaluates factors producing deficits in discourse, reading comprehension, and math in children with SBH. These 5 projects are supported by an Administrative Services Core (A; Fletcher, P.I.), Subject Recruitment and Evaluation Core (B; Fletcher, P.I.), and Database, Computer, and Statistics Core (C; Francis, P.I.) Core B provides for comprehensive medical, neuroimaging and psychometric evaluations of each child. Core C provides databases, project-specific data analyses, and overall data analyses. Altogether, this comprehensive program project should facilitate an integrated, multi-disciplinary understanding of spina bifida, a common and significantly handicapping disability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE BIOAVILAIBILITY OF FOLATE IN HUMANS Principal Investigator & Institution: Van Breemen, Richard B.; Professor of Medicinal Chemistry; Medicinal Chem & Pharmacognosy; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): The active metabolites of the B vitamin folic acid are essential cofactors for many biochemical reactions involving one-carbon transfers. Folate deficiency has been associated with an increased incidence of several forms of cancer and recent studies with the human colon cancer cell lines suggest that only certain forms of folate might inhibit colon cancer cell proliferation. In addition, maternal folate has been shown to prevent neural tube defects such as spina bifida and anencephalus. Since folic acid fortification of enriched cereal was initiated in the US, the incidence of spina bifida has declined 20 percent, but the incidence of anencephaly remains unchanged, which supports the need for alternate types or higher levels of dietary folates. Since folic acid must be metabolized to its reduced forms for biological activity, perhaps one of these pre-formed active metabolites of folic acid would be more effective for the prevention of cancer and birth defects. Furthermore, a greater understanding of the bioavailability of dietary folates including polyglutamyl forms of folate is essential for establishing dietary guidelines for specific population groups and for making accurate decisions with respect to food fortification. To address these issues, new highly sensitive and selective analytical methods are needed to simultaneously measure multiple forms of folates in blood and cells. We have reported a new HPLC-tandem mass spectrometry (LC-MS-MS) assay based on hydrophilic interaction chromatography coupled with
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negative ion tandem mass spectrometry for the analysis of 5'-methyl-tetrahydrofolate in human plasma. As Specific Aim 1 of our investigation, we propose to expand this assay to include the simultaneous measurement of multiple forms of folate including folic acid, tetrahydrofolate (THF), 5-methyl-THF, and 5'-formyl THF in human plasma and human cells grown in culture. To the best of our knowledge, no other laboratory has reported the measurement of all of these folates in human plasma or tissues. Then as Specific Aim 2, we will apply our new LC-MS-MS assay to the quantitative analysis of multiple forms of labeled and unlabeled folates in human plasma in support of an ongoing clinical study of the bioavailability of intrinsically labeled [13C11]-folic acid and [13C6]-hexaglutamyl folic acid. These studies will open a wide range of clinical and basic science research opportunities for nutrition-based cancer chemoprevention, which will become the basis of subsequent R01-type grant applications. Finally as Specific Aim 3, the transport and metabolism of labeled folic acid, hexaglutamyl folic acid, 5-methylTHF, 5-formyl-THF, and THF will be investigated using Caco-2, which form a highly differentiated monolayer in cell culture that is a standard model for the human instestinal uptake of orally administered compounds. Our new LC-MS-MS assay and the use of 13C-labeled folate species will provide new and more detailed information on the uptake, metabolism, and bioavailability of folates than has been possible previously. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE GENETICS OF SPINA BIFIDA Principal Investigator & Institution: Mitchell, Laura E.; Professor; Biomedical Sciences; Texas A&M University Health Science Ctr College Station, Tx 778433578 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-MAY-2004 Summary: (Adapted from investigator's abstract): The goal of the proposed project is to delineate the genetic architecture of spina bifida (SB), a developmental malformation resulting from abnormal or incomplete closure of the caudal end of the neural tube. A comprehensive program, integrating molecular, statistical and epidemiological methods will be used to evaluate the potential genetic determinants of SB in a large, wellcharacterized sample of families drawn from a defined geographic region. A data resource will be created including approximately 500 families consisting (minimally) of a proband affected with SB, along with the biological parents and an unaffected sibling should one or both of the parents be unavailable. Extended relatives to be studied come primarily from the material side, such as the grandmother of the proband and maternal aunts; these data will be used to attempt to tease apart maternal from fetal genotypic effects. This data resource will be useful for testing of presently identified candidate loci as well as future evaluation of putative susceptibility loci. There is also the potential to interact with other scientists, such as Dr. Marcy Speer at Duke University, also studying SB to provide replication opportunities for each other. Recent studies in humans as well as animal models suggest the biochemical and developmental pathways that control neural tube development and provide several excellent candidate susceptibility loci. These highly motivated and prioritized loci will be evaluated using an approach that detects association using a transmission disequilibrium test. Data will also be collected on several environmental factors, chosen on the basis of previous evidence of their potential involvement, to evaluate any interactions with a specific variant in the 5,10methylenetetrahydrofolate reductase (MTHFR) gene. Finally, any variants found to be associated with SB will be evaluated with respect to several criteria in an attempt to determine whether they have direct functional significance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE DEVELOPMENT
ROLE
OF
TWISTED
GASTRULATION
IN
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MOUSE
Principal Investigator & Institution: Petryk, Anna; Pediatrics; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2003; Project Start 15-JAN-2003; Project End 14-JAN-2006 Summary: (provided by applicant): Dr. Petryk is a pediatric endocrinologist at the University of Minnesota. The candidate's long-term goal is to pursue an academic career devoted primarily to basic research. As a pediatric resident and an endocrinology fellow, Dr. Petryk was involved in the care of a significant number of patients with congenital malformations and growth disorders. Her interest in the molecular basis of these health problems led her to pursue research training in developmental biology in order to gain understanding of their pathogenesis as a basis for possible therapeutic interventions in the future. Dr. Petryk has generated twisted gastrulation (tsg) deficient mice that will serve as a model to study molecular and cellular mechanisms of skeletal and neural tube development. This work will be carried out under the mentorship of Dr. Michael O'Connor. Dr. Petryk has also established key collaborations that will be instrumental in her career development plan. Tsg has recently been recognized as a new bone morphogenetic protein (BMP) antagonist that is required for normal embryonic development of invertebrate and lower vertebrate species. Tsg is thought to act synergistically with another extracellular protein Chordin (Chd) to inhibit BMP2 and BMP4 signaling by preventing their binding to the receptors. The role of Tsg in mammalian development is currently unknown. Preliminary phenotypic analysis indicates that Tsg-deficient mice have reduced growth and skeletal defects similar to those that occur in spina bifida. Chd-deficient mice also have skeletal defects and abnormal neural tube patterning. The comparison of the phenotypes of mice deficient in Chd versus those deficient in Tsg, and generation of Tsg;Chd double mutants, will offer new insight into the molecular mechanisms of congenital malformations. The candidate will pursue the following specific aims: 1) Characterize the mechanisms underlying the skeletal defects and growth deficiency in Tsg-deficient mice; 2) Understand the interactions between Tsg and Chd in mouse embryonic development by generating and characterizing Tsg;Chd double mutants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT OF OSTEOPENIA IN CHILDREN WITH CEREBRAL PALSY Principal Investigator & Institution: Henderson, Richard C.; Professor; Orthopaedics; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 29-SEP-2004 Summary: (provided by applicant): Osteopenia resulting in fractures with minimal trauma is a common problem in many pediatric conditions such as osteogenesis imperfecta, juvenile idiopathic osteoporosis, muscular dystrophy, and myelodysplasia (spina bifida). As part of the North American Growth in Cerebral Palsy Project (NAGCePP) we have extensively studied one such group of children, those with cerebral palsy (CP), to better define the prevalence, causes, and consequences of osteopenia in this condition. Bisphosphonates are a group of medications utilized to treat osteoporosis in elderly adults. There are published reports of these agents used in assorted pediatric conditions, but with rare exception these are anecdotal, uncontrolled case reports involving at most a few children. We have recently completed a small
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Spina Bifida
placebo-controlled Pilot Trial to assess the safety and efficacy of intravenous bisphosphonates to treat low bone density in children with severe CP. At the conclusion of the 18-month study period bone density in the distal femur had increased 89% + 21% (mean + SE) compared to 9% + 6% in controls. No clinically significant adverse effects were identified. The Pilot Trial raises many questions with regards to dosing (frequency, duration, amount, route of administration), indications for treatment, long-term risks and benefits including the effect on fracture rate. The results of the Pilot Trial provide the justification for a larger scale Future Clinical Trial to answer these many questions. The purpose of this application is to support the Clinical Trial Planning Project, a process critical to the successful implementation and completion of the Future Clinical Trial. The Clinical Trial Planning Project will focus on building from both the Pilot Trial and the existing NAGCeP collaboration in several areas. Subjects: Develop additional recruiting strategies for larger numbers of subjects and further refine criteria for inclusion based on analysis of fracture risk data. Intervention: Select alternative drugs and dosing regimens that are more practical. Outcomes: Further evaluate and adapt DXA technology to this population with contractures, scoliosis, metallic implants, involuntary muscle spasms, retardation, and other characteristics that present unique challenges. Collaborative Resources & Infrastructure: Adapt and expand our existing NAGCePP network (eg database, safety monitoring) to incorporate the Future Clinical Trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: UROPATHOGEN DETECTION USING DNA BIOSENSORS Principal Investigator & Institution: Churchill, Bernard M.; Urology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 30-JUN-2007 Summary: (provided by the applicant): Urinary tract infection is the most common urological disease in the United States and is a major cause of patient morbidity and health-care expenditure. This Bioengineering Research Partnership proposal involves development of a microelectromechanical system for the genotypic detection and species-specific identification of uropathogens within a time frame (5-10 minutes from sample collection to readout) that would enable point-of-care diagnosis and treatment. The focus of this proposal is to produce a self-contained microbial pathogen detection device and to examine its performance using clinical urine samples. Research at UCLA has provided two key technological advances that make development of a uropathogen sensor feasible. The first is microfluidics for sample processing. The second is an electrochemical microsensor which allows ultrasensitive detection of specific DNA-RNA or DNA-DNA hybridization events, without the need for target amplification. This project has been in development for over a year involving a multidisciplinary effort including leaders in the fields of microfluidics and microsensor technology, molecular microbiology, pediatrics and biomathematics. Specific Aim 1 describes how microfluidics studies will be applied to development of a crossflow filter for uropathogen concentration, micromixing for processing of uropathogen nucleic acids, and washing of the sensor surface. Specific Aim 2 involves fabrication of the microsensor array, development of a streptavidin self-assembled monolayer, and testing of oligonucleotide probes for electrochemical detection of uropathogen rRNA and mRNA on the microsensor surface. Specific Aim 3 will involve integration of the microfluidics and sensor components and testing of its analytic validity on simulated and actual urine specimens. Specific Aim 4 will involve batch fabrication of the device
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and clinical examination of the association between urosensor results and clinical correlates of urinary tract infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSITIONS
VIDEO
INTERVENTION/PREVENTION
ASSESSMENT-
Principal Investigator & Institution: Rich, Michael O.; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2002; Project Start 01-MAR-2000; Project End 28-FEB-2005 Summary: Michael Rich, MD, MPJ, is an Adolescent Medicine physician with special clinical expertise and research interest in chronic diseases. He is particularly interested in investigating the patient's illness experience in order to develop health care delivery that is effective and sensitive to patient needs. In 1998 , he was awarded the 1998 New Investigator Award of the Society for Adolescent Medicine for his innovative patientcentered research method, Video Intervention/Prevention Assessment (VIA). Derived from established social science research methods, VIA is a qualitative technique which analyzes "video diaries" created by patients of their "real life" experiences with illness and health care to teach clinicians about disease and disability as it exists in the contexts of their lives, environments, and psychosocial features of asthma which had previously been inaccessible to traditional investigative techniques. A K23 award would allow Dr. Rich to advance this research career and further develop the VIA methodology through formal course work in the underlying research methods and analytical techniques, by integrating quantitative measures of clinical effectiveness under the sponsoring mentorship of Donald Goldmann, MD, and by working under the guidance of comentors who are leading experts in the research fields which inform VIA, including visual anthropology, qualitative research methods, and quantitative and qualitative health services research. The Research Plan applies VIA to the examination of the transition from pediatric to adult health care systems by young people with chronic, function-limiting conditions and special health care needs. Focusing on patients with myelodysplasia/spina bifida and sickle cell disease, the VIA Transitions study will use clinical, qualitative, and quantitative means to investigate: 1) What is the patient's health-related quality of life (HRQL) before, during, and after transition from pediatric to adult care? 2) What are the patient's needs at each stage of transition and how well are they being met? 3) What is the experience of transitioning care for a patient with complex needs and a function-limiting condition? Study participants will be assessed with clinical interviews and standardized HRQL instruments before making visual narratives of their illness experience at three points: 1) while they are under the care of the pediatric medical system, 2) when they leave pediatrics and initiate care in the adult health care system, and 3) after they have established their adult care for approximately one year. The visual narratives will be coded and triangulated with the data derived from clinical interviews and HRQL instruments for areas of congruence and dissonance. The finding swill be applied to the design of more patient-sensitive transition programs and management strategies. Applying VIA to a new clinical problem and analyzing the data from the original asthma pilot and the Transitions study. Dr. Rich will refine and modify this investigative methodology so that it is flexible enough to be applied to a broad range of clinical questions while retaining the richness of the data derived. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “spina bifida” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for spina bifida in the PubMed Central database: •
Altered regulation of platelet-derived growth factor receptor-[alpha] genetranscription in vitro by spina bifida-associated mutant Pax1 proteins. by Joosten PH, Hol FA, van Beersum SE, Peters H, Hamel BC, Afink GB, van Zoelen EJ, Mariman EC.; 1998 Nov 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=24395
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Incidence of neural tube defects in Ontario, 1986 --1999. by Gucciardi E, Pietrusiak MA, Reynolds DL, Rouleau J.; 2002 Aug 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117467
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Incidence of open neural tube defects in Nova Scotia after folic acid fortification. by Persad VL, Hof M, Dube JM, Zimmer P.; 2002 Aug 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117468
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Is there a familial link between Down's syndrome and neural tube defects? Population and familial survey. by Amorim MR, Castilla EE, Orioli IM.; 2004 Jan 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=314048
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Neural Tube Defects and Abnormal Brain Development in F52-Deficient Mice. by Wu M, Chen DF, Sasaoka T, Tonegawa S.; 1996 Mar 5; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=39918
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Neural tube defects and periconceptional folic acid in England and Wales: retrospective study. by Kadir RA, Sabin C, Whitlow B, Brockbank E, Economides D.; 1999 Jul 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28158
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Outcome in people with open spina bifida at age 35: prospective community based cohort study. by Hunt GM, Oakeshott P.; 2003 Jun 21; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=162127
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Rescue of neural tube defects in Pax-3-deficient embryos by p53 loss of function: implications for Pax-3- dependent development and tumorigenesis. by Pani L, Horal M, Loeken MR.; 2002 Mar 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=155364
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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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The effect of GABA receptor ligands in experimental spina bifida occulta. by Briner W.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=48147
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Unpredicted spontaneous extrusion of a renal calculus in an adult male with spina bifida and paraplegia: report of a misdiagnosis. Measures to be taken to reduce urological errors in spinal cord injury patients. by Vaidyanathan S, Hughes PL, Soni BM, Singh G, Mansour P, Sett P.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64578
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with spina bifida, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “spina bifida” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for spina bifida (hyperlinks lead to article summaries): •
A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis: rehabilitation challenge. Author(s): Esenyel M, Currie DM. Source: Disability and Rehabilitation. 2002 June 15; 24(9): 499-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097219&dopt=Abstract
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A cluster of anaphylactic reactions in children with spina bifida during general anesthesia: epidemiologic features, risk factors, and latex hypersensitivity. Author(s): Kelly KJ, Pearson ML, Kurup VP, Havens PL, Byrd RS, Setlock MA, Butler JC, Slater JE, Grammer LC, Resnick A, et al. Source: The Journal of Allergy and Clinical Immunology. 1994 July; 94(1): 53-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8027499&dopt=Abstract
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A comprehensive ethical framework for fetal research and its application to fetal surgery for spina bifida. Author(s): Chervenak FA, McCullough LB. Source: American Journal of Obstetrics and Gynecology. 2002 July; 187(1): 10-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12114882&dopt=Abstract
6
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A diagnostic approach for the evaluation of spina bifida by three-dimensional ultrasonography. Author(s): Lee W, Chaiworapongsa T, Romero R, Williams R, McNie B, Johnson A, Treadwell M, Comstock CH. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 2002 June; 21(6): 619-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12054297&dopt=Abstract
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A longitudinal study of pubertal timing, parent-child conflict, and cohesion in families of young adolescents with spina bifida. Author(s): Coakley RM, Holmbeck GN, Friedman D, Greenley RN, Thill AW. Source: Journal of Pediatric Psychology. 2002 July-August; 27(5): 461-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058010&dopt=Abstract
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A long-term review of severely disabled spina bifida patients using a reciprocal walking system. Author(s): Roussos N, Patrick JH, Hodnett C, Stallard J. Source: Disability and Rehabilitation. 2001 April 15; 23(6): 239-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11336096&dopt=Abstract
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A multimethod, multi-informant, and multidimensional perspective on psychosocial adjustment in preadolescents with spina bifida. Author(s): Holmbeck GN, Westhoven VC, Phillips WS, Bowers R, Gruse C, Nikolopoulos T, Totura CM, Davison K. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 782-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924683&dopt=Abstract
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A proposed grading and scoring system for spina bifida: Spina Bifida Neurological Scale (SBNS) Author(s): Aranda G. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 1994 March; 10(2): 77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8033164&dopt=Abstract
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A quantitative study of a spina bifida foetus. Author(s): Brocklehurst G. Source: The Journal of Pathology. 1969 November; 99(3): 205-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4917707&dopt=Abstract
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Abnormal US appearance of the cerebellum (banana sign): indirect sign of spina bifida. Author(s): Benacerraf BR, Stryker J, Frigoletto FD Jr. Source: Radiology. 1989 April; 171(1): 151-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2648467&dopt=Abstract
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Acute abdominal symptoms and signs in children and young adults with spina bifida: ten years' experience. Author(s): Worley G, Wiener JS, George TM, Fuchs HE, Mackey JF, Fitch RD, Oldham KT. Source: Journal of Pediatric Surgery. 2001 September; 36(9): 1381-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11528610&dopt=Abstract
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An examination of polymorphic genes and folate metabolism in mothers affected by a spina bifida pregnancy. Author(s): Lucock M, Daskalakis I, Hinkins M, Yates Z. Source: Molecular Genetics and Metabolism. 2001 August; 73(4): 322-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11509014&dopt=Abstract
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Anencephaly and spina bifida: a possible example of cytoplasmic inheritance in man. Author(s): Nance WE. Source: Nature. 1969 October 25; 224(217): 373-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4898927&dopt=Abstract
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Apolipoprotein E and apolipoprotein B genotypes and risk for spina bifida. Author(s): Volcik KA, Zhu H, Shaw GM, Lammer EJ, Finnell RH. Source: Teratology. 2002 November; 66(5): 257-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397634&dopt=Abstract
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Are myo-inositol, glucose and zinc concentrations in amniotic fluid of fetuses with spina bifida different from controls? Author(s): Groenen PM, Wevers RA, Janssen FS, Tuerlings JH, Merkus JM, SteegersTheunissen RP. Source: Early Human Development. 2003 February; 71(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614945&dopt=Abstract
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Arterial vascular properties in individuals with spina bifida. Author(s): Boot CR, van Langen H, Hopman MT. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2003 April; 41(4): 242-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669089&dopt=Abstract
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Assessing the factorial invariance of Harter's self-concept measures: comparing preadolescents with and without spina bifida using child, parent, and teacher report. Author(s): Thill AD, Holmbeck GN, Bryant FB, Nelson C, Skocic A, Uli N. Source: Journal of Personality Assessment. 2003 October; 81(2): 111-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12946918&dopt=Abstract
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Association between prenatal sonographic findings and post-natal outcomes in 30 cases of isolated spina bifida aperta. Author(s): Peralta CF, Bunduki V, Plese JP, Figueiredo EG, Miguelez J, Zugaib M. Source: Prenatal Diagnosis. 2003 April; 23(4): 311-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12673636&dopt=Abstract
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Audit of prenatal and postnatal diagnosis of isolated open spina bifida in three university hospitals in The Netherlands. Author(s): Olde Scholtenhuis MA, Cohen-Overbeek TE, Offringa M, Barth PG, Stoutenbeek P, Gooskens RH, Wladimiroff JW, Bilardo CM. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2003 January; 21(1): 48-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528161&dopt=Abstract
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Augmentation ileocystoplasty in patients with neurogenic bladder due to spinal cord injury or spina bifida. Author(s): Nomura S, Ishido T, Tanaka K, Komiya A. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2002 January; 40(1): 30-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821967&dopt=Abstract
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Babies with spina bifida treated without surgery: parents' views on home versus hospital care. Author(s): Delight E, Goodall J. Source: Bmj (Clinical Research Ed.). 1988 November 12; 297(6658): 1230-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2462949&dopt=Abstract
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Bacterial colonisation and infection in spina bifida babies. Author(s): Moorhouse EC, Farrell W, Archer M, Hart-Barry M. Source: Ir J Med Sci. 1976 February; 145(2): 51-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=770391&dopt=Abstract
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Basic physiotherapy of spina bifida. Author(s): Hewson JE. Source: Dev Med Child Neurol Suppl. 1976; (37): 117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=797604&dopt=Abstract
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Beecham backs out of spina bifida trial. Author(s): Bryan J. Source: New Scientist (1971). 1982 December 16; 96(1336): 709. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11655513&dopt=Abstract
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Behavioral physical therapy and spina bifida: a case study. Author(s): Rapport MD, Bailey JS. Source: Journal of Pediatric Psychology. 1985 March; 10(1): 87-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3886870&dopt=Abstract
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Beyond multidisciplinary care: a new conceptual model for spina bifida services. Author(s): Kinsman SL, Levey E, Ruffing V, Stone J, Warren L. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2000 December; 10 Suppl 1: 35-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11214831&dopt=Abstract
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Bilateral dislocation of the hip in spina bifida: a long-term follow-up study. Author(s): Heeg M, Broughton NS, Menelaus MB. Source: Journal of Pediatric Orthopedics. 1998 July-August; 18(4): 434-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9661846&dopt=Abstract
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Bilateral distal tibial and fibular epiphyseal separation associated with spina bifida. A case report. Author(s): Stern MB, Grant SS, Isaacson AS. Source: Clinical Orthopaedics and Related Research. 1967 January-February; 50: 191-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5339470&dopt=Abstract
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Birth ranks of spontaneous abortions in sibships of children affected by anencephaly or spina bifida. Author(s): James WH. Source: British Medical Journal. 1978 January 14; 1(6105): 72-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=620202&dopt=Abstract
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Birth weight of infants with spina bifida cystica. Author(s): Wald NJ, Cuckle HS, Boreham J, Althouse R. Source: British Journal of Obstetrics and Gynaecology. 1980 July; 87(7): 578-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7426511&dopt=Abstract
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Birth-weight distribution patterns in relation to estimated duration of pregnancy in normal infants, spina bifida and Down's syndrome. Author(s): Burns JK. Source: The Journal of Physiology. 1973 April; 230(1): 50P-51P. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4267241&dopt=Abstract
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Bladder cancer arising in a spina bifida patient. Author(s): Game X, Villers A, Malavaud B, Sarramon J. Source: Urology. 1999 November; 54(5): 923. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10754152&dopt=Abstract
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Bladder dysfunction and neurological disability at presentation in closed spina bifida. Author(s): Johnston LB, Borzyskowski M. Source: Archives of Disease in Childhood. 1998 July; 79(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9771249&dopt=Abstract
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Bowel control of children with spina bifida. Author(s): Forsythe WI, Kinley JG. Source: Developmental Medicine and Child Neurology. 1970 February; 12(1): 27-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4907699&dopt=Abstract
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Bowel dysfunction in spina bifida--an American experience with the ACE procedure. Author(s): Webb HW, Barraza MA, Stevens PS, Crump JM, Erhard M. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 37-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926323&dopt=Abstract
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Bowel management in spina bifida patients. Author(s): Nash DF. Source: Proc R Soc Med. 1972 January; 65(1): 70-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4552521&dopt=Abstract
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Bowel training for children with spina bifida. Author(s): Rogers J. Source: Prof Nurse. 1988 November; 4(2): 87-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3059360&dopt=Abstract
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Bowel training in spina bifida: importance of education, patient compliance, age, and anal reflexes. Author(s): King JC, Currie DM, Wright E. Source: Archives of Physical Medicine and Rehabilitation. 1994 March; 75(3): 243-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8129572&dopt=Abstract
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Brief communication: possible X-linked anencephaly and spina bifida--report of a kindred. Author(s): Toriello HV, Warren ST, Lindstrom JA. Source: American Journal of Medical Genetics. 1980; 6(2): 119-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7004185&dopt=Abstract
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Campaign to safeguard spina bifida babies. Author(s): Nicholson-Lord D. Source: Times (Lond). 1977 December 29; : 2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11648944&dopt=Abstract
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Can prenatal ultrasound findings predict ambulatory status in fetuses with open spina bifida? Author(s): Biggio JR Jr, Owen J, Wenstrom KD, Oakes WJ. Source: American Journal of Obstetrics and Gynecology. 2001 November; 185(5): 101620. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11717624&dopt=Abstract
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Caring for a child with spina bifida: understanding the child and carer. Author(s): Zipitis CS, Paschalides C. Source: Journal of Child Health Care : for Professionals Working with Children in the Hospital and Community. 2003 June; 7(2): 101-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841528&dopt=Abstract
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Case report: human neonatus with spina bifida, clubfoot, situs inversus totalis and cerebral deformities: sequence or accident? Author(s): Piegger J, Gruber H, Fritsch H. Source: Ann Anat. 2000 November; 182(6): 577-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11125811&dopt=Abstract
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Catecholamine metabolite excretion in spina bifida. Author(s): McKibbin B, O'Gorman L, Duckworth T. Source: Journal of Clinical Pathology. 1969 November; 22(6): 687-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4903899&dopt=Abstract
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Change in spinal curvature following release of tethered spinal cord associated with spina bifida. Author(s): Reigel DH, Tchernoukha K, Bazmi B, Kortyna R, Rotenstein D. Source: Pediatric Neurosurgery. 1994; 20(1): 30-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8142280&dopt=Abstract
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Changes of the lumbar spinal canal proximal to spina bifida occulta. An archaeologic study with clinical significance. Author(s): Papp T, Porter RW. Source: Spine. 1994 July 1; 19(13): 1508-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7939984&dopt=Abstract
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Characterization of T cell responses to Hev b 3, an allergen associated with latex allergy in spina bifida patients. Author(s): Bohle B, Wagner B, Vollmann U, Buck D, Niggemann B, Szepfalusi Z, Fischer G, Scheiner O, Breiteneder H, Ebner C. Source: Journal of Immunology (Baltimore, Md. : 1950). 2000 April 15; 164(8): 4393-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10754340&dopt=Abstract
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Charcot arthropathy in spina bifida. Author(s): Nagarkatti DG, Banta JV, Thomson JD. Source: Journal of Pediatric Orthopedics. 2000 January-February; 20(1): 82-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10641695&dopt=Abstract
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Children with spina bifida perceive visual illusions but not multistable figures. Author(s): Dennis M, Rogers T, Barnes MA. Source: Brain and Cognition. 2001 June-July; 46(1-2): 108-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11527307&dopt=Abstract
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Clinical risk: identifying latex allergy in adults with spina bifida. Author(s): Wright LE, Alderson JD, Ash D, Short JA. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S47-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11848050&dopt=Abstract
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Cognitive changes after cerebrospinal fluid shunting in young adults with spina bifida and assumed arrested hydrocephalus. Author(s): Mataro M, Poca MA, Sahuquillo J, Cuxart A, Iborra J, de la Calzada MD, Junque C. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 May; 68(5): 615-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10766893&dopt=Abstract
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Cognitive status of young adults with spina bifida. Author(s): Barf HA, Verhoef M, Jennekens-Schinkel A, Post MW, Gooskens RH, Prevo AJ. Source: Developmental Medicine and Child Neurology. 2003 December; 45(12): 813-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14667073&dopt=Abstract
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Common variant in betaine-homocysteine methyltransferase (BHMT) and risk for spina bifida. Author(s): Morin I, Platt R, Weisberg I, Sabbaghian N, Wu Q, Garrow TA, Rozen R. Source: American Journal of Medical Genetics. 2003 June 1; 119A(2): 172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749058&dopt=Abstract
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Communication of the diagnosis of Down's syndrome and spina bifida in Scotland, 1971-1981. Author(s): Murdoch JC. Source: J Ment Defic Res. 1983 December; 27(4): 247-53. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11653727&dopt=Abstract
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Coning in a patient with spina bifida following general anaesthesia for cystoscopy. Author(s): Radhakrishna S. Source: Anaesthesia. 2000 March; 55(3): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10744567&dopt=Abstract
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Constipation and spina bifida occulta: is there an association? Author(s): Thorpe AC, Evans RE, Williams NS. Source: Journal of the Royal College of Surgeons of Edinburgh. 1994 August; 39(4): 2214. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7807452&dopt=Abstract
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Continence in patients with spina bifida: long term results. Author(s): Malone PS, Wheeler RA, Williams JE. Source: Archives of Disease in Childhood. 1994 February; 70(2): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8129429&dopt=Abstract
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Correlates of functional status, self-management, and developmental competence outcomes in adolescents with spina bifida. Author(s): Sawin KJ, Buran CF, Brei TJ, Fastenau PS. Source: Sci Nurs. 2003 Summer; 20(2): 72-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14626030&dopt=Abstract
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Current status of prenatal management of fetal spina bifida in the world: worldwide cooperative survey on the medico-ethical issue. Author(s): Oi S. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2003 August; 19(7-8): 596-9. Epub 2003 August 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12905004&dopt=Abstract
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Decreased methylene tetrahydrofolate reductase activity due to the 677C-->T mutation in families with spina bifida offspring. Author(s): van der Put NM, van den Heuvel LP, Steegers-Theunissen RP, Trijbels FJ, Eskes TK, Mariman EC, den Heyer M, Blom HJ. Source: Journal of Molecular Medicine (Berlin, Germany). 1996 November; 74(11): 691-4. Erratum In: J Mol Med 1997 January; 75(1): 69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8956155&dopt=Abstract
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Deep venous thrombosis in individuals with spina bifida. Author(s): Levey EB, Kinsman KF, Kinsman SL. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S35-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585254&dopt=Abstract
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Dental surgery in pediatric patients with spina bifida and latex allergy. Author(s): Hudson ME. Source: Aorn Journal. 2001 July; 74(1): 57-63, 65-6, 69-70 Passim; Quiz 73-8. Review. Erratum In: Aorn J 2002 February; 75(2): 267. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11460784&dopt=Abstract
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Dependence and perceived difficulty in activities of daily living in adults with cerebral palsy and spina bifida. Author(s): Andren E, Grimby G. Source: Disability and Rehabilitation. 2000 May 10; 22(7): 299-307. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10877483&dopt=Abstract
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Depressive symptoms and self-concept in young people with spina bifida. Author(s): Appleton PL, Ellis NC, Minchom PE, Lawson V, Boll V, Jones P. Source: Journal of Pediatric Psychology. 1997 October; 22(5): 707-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9383931&dopt=Abstract
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Desmopressin for nocturnal incontinence in the spina bifida population. Author(s): Horowitz M, Combs AJ, Gerdes D. Source: The Journal of Urology. 1997 December; 158(6): 2267-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9366373&dopt=Abstract
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Detection efficiency of different bone SPECT processing protocols for the diagnosis of “spina bifida”. Author(s): Gunes I, Sarikaya I, Ozkan T, Akbunar T. Source: J Nucl Biol Med. 1993 June; 37(2): 49-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8373832&dopt=Abstract
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Detection of open spina bifida by the lemon sign: pathologic correlation. Author(s): Gabbe SG, Mintz MC, Mennuti MT, McDonnell AE. Source: Journal of Clinical Ultrasound : Jcu. 1988 July-August; 16(6): 399-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3152259&dopt=Abstract
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Detection of skin over cysts with Spina bifida may be useful not only for preventing neurological damage during labor but also for predicting fetal prognosis. Author(s): Oya N, Suzuki Y, Tanemura M, Kojima K, Kajiura S, Murakami I, Yamashita N, Suzumori K. Source: Fetal Diagnosis and Therapy. 2000 May-June; 15(3): 156-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782000&dopt=Abstract
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Determination of independent risk factors and comparative analysis of diagnostic methods for immediate type latex allergy in spina bifida patients. Author(s): De Swert LF, Van Laer KM, Verpoorten CM, Van Hoeyveld EM, Cadot P, Stevens EA. Source: Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology. 1997 September; 27(9): 1067-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9678839&dopt=Abstract
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Development of a health-related quality of life instrument for use in children with spina bifida. Author(s): Parkin PC, Kirpalani HM, Rosenbaum PL, Fehlings DL, Van Nie A, Willan AR, King D. Source: Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 1997 March; 6(2): 123-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9161112&dopt=Abstract
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Development of lumbosacral spina bifida: three-dimensional computer graphic study of human embryos at Carnegie stage twelve. Author(s): Haque M, Ohata K, Takami T, Soares SB Jr, Aree SN, Hakuba A, Hara M. Source: Pediatric Neurosurgery. 2001 November; 35(5): 247-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11741118&dopt=Abstract
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Disability and quality of life in spina bifida and hydrocephalus. Author(s): Cate IM, Kennedy C, Stevenson J. Source: Developmental Medicine and Child Neurology. 2002 May; 44(5): 317-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12033717&dopt=Abstract
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Dislocation and deformity of the hip in children with spina bifida cystica. Author(s): Menelaus MB. Source: The Journal of Bone and Joint Surgery. British Volume. 1969 May; 51(2): 238-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4890318&dopt=Abstract
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Distribution of alleles of the methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in familial spina bifida. Author(s): Johnson WG, Stenroos ES, Heath SC, Chen Y, Carroll R, McKoy VV, Chatkupt S, Lehner T. Source: American Journal of Medical Genetics. 1999 December 22; 87(5): 407-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10594879&dopt=Abstract
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Dizygotic twinning in mothers of spina bifida. Author(s): Journel H, Le Marec B. Source: American Journal of Medical Genetics. 1989 February; 32(2): 257-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2648828&dopt=Abstract
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Doctors split on screening pregnant women to detect spina bifida babies. Author(s): Yanchinski S. Source: New Scientist (1971). 1978 January 12; 77(1085): 68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11663823&dopt=Abstract
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Does bladder capacity assessment by frequency/volume chart correlate well with urodynamic estimation in children with spina bifida? Author(s): Marshall DF, Boston VE. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S24-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11813130&dopt=Abstract
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Does the absence of anal reflexes guarantee a “safe bladder” in children with spina bifida? Author(s): Marshall DF, Boston VE. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S21-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11813129&dopt=Abstract
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Driver education: the needs of the learner driver with spina bifida and hydrocephalus. Author(s): Simms B. Source: Z Kinderchir. 1989 December; 44 Suppl 1: 35-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2623960&dopt=Abstract
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Eating disorders in adolescents and young women with spina bifida. Author(s): Silber TJ, Shaer C, Atkins D. Source: The International Journal of Eating Disorders. 1999 May; 25(4): 457-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10202657&dopt=Abstract
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Effects of prophylaxis on latex sensitization in children with spina bifida. Author(s): Cremer R, Hoppe A, Kleine-Diepenbruck U, Blaker F. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926329&dopt=Abstract
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Efficacy of latex avoidance for primary prevention of latex sensitization in children with spina bifida. Author(s): Nieto A, Mazon A, Pamies R, Lanuza A, Munoz A, Estornell F, Garcia-Ibarra F. Source: The Journal of Pediatrics. 2002 March; 140(3): 370-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11953738&dopt=Abstract
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Electromyographic assessment of neurological function in patients with myelomeningocele caused by spina bifida. Author(s): Hong CZ. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2001 September; 64(9): 516-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11768281&dopt=Abstract
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Electromyographic evaluation in children with spina bifida. Author(s): Tsai PY, Cha RC, Yang TF, Wong TT, Huang PH, Pan PJ. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2001 September; 64(9): 509-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11768280&dopt=Abstract
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Elevated plasma total homocysteine and C677T mutation of the methylenetetrahydrofolate reductase gene in patients with spina bifida. Author(s): Bjorke-Monsen AL, Ueland PM, Schneede J, Vollset SE, Refsum H. Source: Qjm : Monthly Journal of the Association of Physicians. 1997 September; 90(9): 593-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9349452&dopt=Abstract
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Embryogenesis. Why do we need a new explanation for the emergence of spina bifida with lipoma? Author(s): Catala M. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 1997 June; 13(6): 336-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9272286&dopt=Abstract
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Energy consumption in children with spina bifida and cerebral palsy: a comparative study. Author(s): Duffy CM, Hill AE, Cosgrove AP, Corry IS, Graham HK. Source: Developmental Medicine and Child Neurology. 1996 March; 38(3): 238-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8631520&dopt=Abstract
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Enzyme defect as a risk factor for spina bifida. Author(s): Lucock MD, Wild J, Levene MI. Source: Lancet. 1995 December 2; 346(8988): 1495-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7491024&dopt=Abstract
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Epidemiology of spina bifida in Tottori Prefecture, Japan, 1976-1995. Author(s): Ehara H, Ohno K, Ohtani K, Koeda T, Takeshita K. Source: Pediatric Neurology. 1998 September; 19(3): 199-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9806137&dopt=Abstract
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Erectile dysfunction in patients with spina bifida is a treatable condition. Author(s): Palmer JS, Kaplan WE, Firlit CF. Source: The Journal of Urology. 2000 September; 164(3 Pt 2): 958-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10958716&dopt=Abstract
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Erectile dysfunction in spina bifida is treatable. Author(s): Palmer JS, Kaplan WE, Firlit CF. Source: Lancet. 1999 July 10; 354(9173): 125-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10408490&dopt=Abstract
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Ethics: “life before birth” and moral complexity in maternal-fetal surgery for spina bifida. Author(s): Bliton MJ. Source: Clin Perinatol. 2003 September; 30(3): 449-64, V-Vi. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14533888&dopt=Abstract
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Ethylene oxide allergy in children with spina bifida. Author(s): Pittman T, Kiburz J, Steinhardt G, Krock J, Gabriel K. Source: The Journal of Allergy and Clinical Immunology. 1995 October; 96(4): 486-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7560659&dopt=Abstract
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Evaluation and risk factors of latex allergy in spina bifida patients: is it preventable? Author(s): Ellsworth PI, Merguerian PA, Klein RB, Rozycki AA. Source: The Journal of Urology. 1993 August; 150(2 Pt 2): 691-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8326624&dopt=Abstract
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Evaluation of infant methylenetetrahydrofolate reductase genotype, maternal vitamin use, and risk of high versus low level spina bifida defects. Author(s): Volcik KA, Shaw GM, Lammer EJ, Zhu H, Finnell RH. Source: Birth Defects Research. Part A, Clinical and Molecular Teratology. 2003 March; 67(3): 154-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12797455&dopt=Abstract
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Evaluation of the MTHFR C677T allele and the MTHFR gene locus in a German spina bifida population. Author(s): Koch MC, Stegmann K, Ziegler A, Schroter B, Ermert A. Source: European Journal of Pediatrics. 1998 June; 157(6): 487-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9667406&dopt=Abstract
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Examination of deficits in conceptual reasoning abilities associated with spina bifida. Author(s): Dise JE, Lohr ME. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 1998 May-June; 77(3): 247-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9635560&dopt=Abstract
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Exploring causes of paralysis in spina bifida. Author(s): Marwick C. Source: Jama : the Journal of the American Medical Association. 1989 June 2; 261(21): 3069, 3074. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2716140&dopt=Abstract
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Extensive cervical intradural and intramedullary lipoma and spina bifida occulta of C1: a case report. Author(s): Crols R, Appel B, Klaes R. Source: Clinical Neurology and Neurosurgery. 1993 March; 95(1): 39-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8453814&dopt=Abstract
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Factors affecting mortality and morbidity in adult spina bifida. Author(s): Singhal B, Mathew KM. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1999 December; 9 Suppl 1: 31-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10661789&dopt=Abstract
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Factors associated with quality of life in adolescents with spina bifida. Author(s): Sawin KJ, Brei TJ, Buran CF, Fastenau PS. Source: Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association. 2002 September; 20(3): 279-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240958&dopt=Abstract
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Factors limiting the effectiveness of prenatal screening for anencephaly and spina bifida in a high-risk area. Author(s): Omran M, McLoone P, Stone D, Aitken D, Crossley J. Source: Paediatric and Perinatal Epidemiology. 1993 October; 7(4): 461-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8290385&dopt=Abstract
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Factors that influence the presence of symptoms caused by latex allergy in children with spina bifida. Author(s): Mazon A, Nieto A, Estornell F, Nieto A, Reig C, Garcia-Ibarra F. Source: The Journal of Allergy and Clinical Immunology. 1997 May; 99(5): 600-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9155824&dopt=Abstract
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Faecal incontinence in children with spina bifida: the best conservative treatment. Author(s): Eire PF, Cives RV, Gago MC. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 1998 November; 36(11): 774-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9848485&dopt=Abstract
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False-positive diagnosis of spina bifida in a fetus with triploidy. Author(s): Johnson DD, Nager CW, Budorick NE. Source: Obstetrics and Gynecology. 1997 May; 89(5 Pt 2): 809-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9166329&dopt=Abstract
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Fetal surgery for spina bifida aperta: to be or not to be? Author(s): Patricolo M, Noia G, Pomini F, Perilli L, Lannace E, Catesini C, Mancuso S, Caione P. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S22-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12541210&dopt=Abstract
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Fetal surgery for spina bifida. Author(s): Sobkowiak CA. Source: Lancet. 1999 January 30; 353(9150): 406-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9950465&dopt=Abstract
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Fetal surgery for spina bifida. Author(s): Magram G. Source: Lancet. 1999 January 30; 353(9150): 406; Author Reply 407. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9950464&dopt=Abstract
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Fetal surgery for spina bifida. Author(s): Tulipan N, Bruner JP. Source: Lancet. 1999 January 30; 353(9150): 406; Author Reply 407. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9950463&dopt=Abstract
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Folic acid and prevention of neural tube defects: a study of Canadian mothers of infants with spina bifida. Author(s): Forman R, Singal N, Perelman V, Chou S, Hoffman L, Parkin P, Koren G. Source: Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 1996 June; 19(3): 195-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8724823&dopt=Abstract
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Folic acid and prevention of spina bifida and anencephaly. 10 years after the U.S. Public Health Service recommendation. Author(s): Erickson JD. Source: Mmwr. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports / Centers for Disease Control. 2002 September 13; 51(Rr-13): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353506&dopt=Abstract
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Folic acid and prevention of spina bifida. Author(s): Klein NW. Source: Jama : the Journal of the American Medical Association. 1996 June 5; 275(21): 1636. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8637132&dopt=Abstract
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Folic-acid-preventable spina bifida and anencephaly. Author(s): Oakley GP Jr. Source: Bulletin of the World Health Organization. 1998; 76 Suppl 2: 116-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10063685&dopt=Abstract
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Follow-up study after treatment of knee flexion contractures in spina bifida patients. Author(s): Snela S, Parsch K. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2000 June; 9(3): 154-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10904901&dopt=Abstract
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Foot deformities in adolescents and young adults with spina bifida. Author(s): Frischhut B, Stockl B, Landauer F, Krismer M, Menardi G. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2000 June; 9(3): 161-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10904902&dopt=Abstract
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Frankie's story--spina bifida from the parents' perspective. Author(s): Cerniglia FR Jr. Source: The Journal of Urology. 1997 September; 158(3 Pt 2): 1291. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9258197&dopt=Abstract
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From anemia to spina bifida - the story of folic acid. A tribute to Professor Richard Smithells. Author(s): Eskes TK. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2000 June; 90(2): 119-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10825628&dopt=Abstract
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Function of dislocated hips in children with lower level spina bifida. Author(s): Alman BA, Bhandari M, Wright JG. Source: The Journal of Bone and Joint Surgery. British Volume. 1996 March; 78(2): 294-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8666645&dopt=Abstract
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Functional investigation in children with spina bifida -- measured by the Pediatric Evaluation of Disability Inventory (PEDI). Author(s): Tsai PY, Yang TF, Chan RC, Huang PH, Wong TT. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2002 February; 18(1-2): 48-53. Epub 2002 January 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11935244&dopt=Abstract
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Gamma globulin levels in newborn with spina bifida cystica. Author(s): Chadd MA, Gray OP, Keyser JW. Source: Acta Paediatr Scand. 1970 March; 59(2): 134-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4986104&dopt=Abstract
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Gender and spina bifida--some misconceptions. Author(s): Lonton AP. Source: Z Kinderchir. 1985 December; 40 Suppl 1: 34-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3911641&dopt=Abstract
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Genetic mapping of the human homologue (T) of mouse T(Brachyury) and a search for allele association between human T and spina bifida. Author(s): Morrison K, Papapetrou C, Attwood J, Hol F, Lynch SA, Sampath A, Hamel B, Burn J, Sowden J, Stott D, Mariman E, Edwards YH. Source: Human Molecular Genetics. 1996 May; 5(5): 669-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8733136&dopt=Abstract
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Genetics of anencephaly and spina bifida? Author(s): Yen S, MacMahon B. Source: Lancet. 1968 September 14; 2(7568): 623-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4175169&dopt=Abstract
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Goal-directed behavior and perception of self-competence in children with spina bifida. Author(s): Landry SH, Robinson SS, Copeland D, Garner PW. Source: Journal of Pediatric Psychology. 1993 June; 18(3): 389-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8340846&dopt=Abstract
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Goal-directed behavior in children with spina bifida. Author(s): Landry SH, Copeland D, Lee A, Robinson S. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1990 December; 11(6): 306-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2149725&dopt=Abstract
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Hand function in patients with spina bifida cystica. Author(s): Mazur JM, Menelaus MB, Hudson I, Stillwell A. Source: Journal of Pediatric Orthopedics. 1986 July-August; 6(4): 442-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3734068&dopt=Abstract
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Hand function in subjects with spina bifida. Author(s): Muen WJ, Bannister CM. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1997 December; 7 Suppl 1: 18-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9497111&dopt=Abstract
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Hand positioning sense in children with spina bifida myelomeningocele. Author(s): Hwang R, Kentish M, Burns Y. Source: The Australian Journal of Physiotherapy. 2002; 48(1): 17-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869161&dopt=Abstract
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Handedness and progressive hydrocephalus in spina bifida patients. Author(s): Wassing HE, Siebelink BM, Luyendijk W. Source: Developmental Medicine and Child Neurology. 1993 September; 35(9): 788-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8354430&dopt=Abstract
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Health-related quality of life and disability in young patients with spina bifida. Author(s): Padua L, Rendeli C, Rabini A, Girardi E, Tonali P, Salvaggio E. Source: Archives of Physical Medicine and Rehabilitation. 2002 October; 83(10): 1384-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370873&dopt=Abstract
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Helping to solve problems associated with spina bifida: 1. Presentation of the TRS Project: organizing services for low frequency diagnostic groups and 2. Cognitive deficits often seen in young adults with spina bifida: effects in the school and work place. Author(s): West M, Fjeldvik L, Rand-Hendriksen S. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1995 December; 5 Suppl 1: 12-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8770570&dopt=Abstract
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Heterogeneity of spina bifida. Author(s): Blatter BM, Lafeber AB, Peters PW, Roeleveld N, Verbeek AL, Gabreels FJ. Source: Teratology. 1997 April; 55(4): 224-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9216039&dopt=Abstract
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Hev b 7 is a Hevea brasiliensis protein associated with latex allergy in children with spina bifida. Author(s): Wagner B, Buck D, Hafner C, Sowka S, Niggemann B, Scheiner O, Breiteneder H. Source: The Journal of Allergy and Clinical Immunology. 2001 October; 108(4): 621-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11590391&dopt=Abstract
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High risk of anaphylactic shock during surgery for spina bifida. Author(s): Moneret-Vautrin DA, Mata E, Gueant JL, Turgeman D, Laxenaire MC. Source: Lancet. 1990 April 7; 335(8693): 865-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1969598&dopt=Abstract
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High risk of sensitization to latex in children with spina bifida. Author(s): Beaudouin E, Prestat F, Schmitt M, Kanny G, Laxenaire MC, Moneret-Vautrin DA. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1994 April; 4(2): 90-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8025101&dopt=Abstract
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HLA gene and haplotype frequencies in spina bifida. Population and family studies. Author(s): De Bruyere M, Kulakowski S, Malchaire J, Delire M, Sokal G. Source: Tissue Antigens. 1977 November; 10(5): 399-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=605436&dopt=Abstract
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HLA, Pi, Gm and Km phenotypes in a spina bifida population with myelomeningocele. Author(s): Vannier JP, Cavelier B, Martin JP, Lefort J, Rivat L, Feingold J. Source: Tissue Antigens. 1980 May; 15(5): 501-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6969471&dopt=Abstract
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Homocysteine metabolism and effects of folic acid supplementation in patients affected with spina bifida. Author(s): Brouwer IA, van Dusseldorp M, Thomas CM, van der Put NM, Gaytant MA, Eskes TK, Hautvast JG, Steegers-Theunissen RP. Source: Neuropediatrics. 2000 December; 31(6): 298-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11508548&dopt=Abstract
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Hospital service for young adults with spina bifida and hydrocephalus. Author(s): Holland MB, Gilbertson MP. Source: Z Kinderchir. 1983 December; 38 Suppl 2: 113-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6372299&dopt=Abstract
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How adequate are hospital records?--The first report of the North West Spina Bifida Registry. Author(s): Shaw J, Lewis MA. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1997 December; 7 Suppl 1: 28-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9497113&dopt=Abstract
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How much value is muscle charting? A study of the relation between neonatal assessment of muscle power and later mobility in children with spina bifida defects. Author(s): Murdoch A, Young DG. Source: Z Kinderchir Grenzgeb. 1979 December; 28(4): 387-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=399413&dopt=Abstract
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How valuable is muscle charting? A study of the relationship between neonatal assessment of muscle power and later mobility in children with spina bifida defects. Author(s): Murdoch A. Source: Physiotherapy. 1980 July; 66(7): 221-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7005919&dopt=Abstract
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Hyperacusis in children with spina bifida; a pilot-study. Author(s): Oen JM, Begeer JH, Staal-Schreinemachers AI, Tijmstra T. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1997 December; 7 Suppl 1: 46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9497120&dopt=Abstract
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Hyperzincemia in anencephaly and spina bifida: a clue to the pathogenesis of neural tube defects? Author(s): Zimmerman AW. Source: Neurology. 1984 April; 34(4): 443-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6366610&dopt=Abstract
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Hypothyroidism secondary to topical iodine treatment in infants with spina bifida. Author(s): Barakat M, Carson D, Hetherton AM, Smyth P, Leslie H. Source: Acta Paediatrica (Oslo, Norway : 1992). 1994 July; 83(7): 741-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7949805&dopt=Abstract
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Identification and characterization of an Xq26-q27 duplication in a family with spina bifida and panhypopituitarism suggests the involvement of two distinct genes. Author(s): Hol FA, Schepens MT, van Beersum SE, Redolfi E, Affer M, Vezzoni P, Hamel BC, Karnes PS, Mariman EC, Zucchi I. Source: Genomics. 2000 October 15; 69(2): 174-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11031100&dopt=Abstract
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IgE reactivity to 14-kD and 27-kD natural rubber proteins in latex-allergic children with spina bifida and other congenital anomalies. Author(s): Alenius H, Palosuo T, Kelly K, Kurup V, Reunala T, Makinen-Kiljunen S, Turjanmaa K, Fink J. Source: International Archives of Allergy and Immunology. 1993; 102(1): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8400886&dopt=Abstract
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Impact of functional severity on self concept in young people with spina bifida. Author(s): Minchom PE, Ellis NC, Appleton PL, Lawson V, Boll V, Jones P, Elliott CE. Source: Archives of Disease in Childhood. 1995 July; 73(1): 48-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7639550&dopt=Abstract
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Impaired regeneration of monoglutamyl tetrahydrofolate leads to cellular folate depletion in mothers affected by a spina bifida pregnancy. Author(s): Lucock MD, Daskalakis I, Lumb CH, Schorah CJ, Levene MI. Source: Molecular Genetics and Metabolism. 1998 September; 65(1): 18-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9787091&dopt=Abstract
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In vitro high-field magnetic resonance imaging-documented anatomy of a fetal myelomeningocele at 20 weeks' gestation. A contribution to the rationale of intrauterine surgical repair of spina bifida. Author(s): Beuls EA, Vanormelingen L, van Aalst J, Vandersteen M, Adriaensen P, Cornips EM, Vles HJ, Gelan J. Source: Journal of Neurosurgery. 2003 March; 98(2 Suppl): 210-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650407&dopt=Abstract
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Incidence and type of hindfoot deformities in patients with low-level spina bifida. Author(s): Frawley PA, Broughton NS, Menelaus MB. Source: Journal of Pediatric Orthopedics. 1998 May-June; 18(3): 312-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9600554&dopt=Abstract
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Incidental spina bifida occulta in functional enuresis observed during laser reflexo therapy. Author(s): Kalra V, Palaksha HK. Source: Journal of Child Neurology. 1999 August; 14(8): 541-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10456767&dopt=Abstract
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Increased incidence of spina bifida occulta in fluorosis prone areas. Author(s): Gupta SK, Gupta RC, Seth AK, Chaturvedi CS. Source: Acta Paediatr Jpn. 1995 August; 37(4): 503-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7572153&dopt=Abstract
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Infant methionine synthase variants and risk for spina bifida. Author(s): Shaw GM, Todoroff K, Finnell RH, Lammer EJ, Leclerc D, Gravel RA, Rozen R. Source: Journal of Medical Genetics. 1999 January; 36(1): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9950377&dopt=Abstract
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Infantile arachnoid cyst compressing the sacral nerve root associated with spina bifida and lipoma--case report. Author(s): Tsutsumi S, Wachi A, Uto A, Koike J, Arai H, Sato K. Source: Neurol Med Chir (Tokyo). 2000 August; 40(8): 435-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10979269&dopt=Abstract
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Injury risk for research subjects with spina bifida occulta in a repeated impact study: a case review. Author(s): Albano JP, Shannon SG, Alem NM, Mason KT. Source: Aviation, Space, and Environmental Medicine. 1996 August; 67(8): 767-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8853834&dopt=Abstract
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Interaction between undulated and Patch leads to an extreme form of spina bifida in double-mutant mice. Author(s): Helwig U, Imai K, Schmahl W, Thomas BE, Varnum DS, Nadeau JH, Balling R. Source: Nature Genetics. 1995 September; 11(1): 60-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7550316&dopt=Abstract
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Intramedullary spinal teratoma with spina bifida. Author(s): Hamada H, Kurimoto M, Hayashi N, Hirashima Y, Matsumura N, Endo S. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2001 January; 17(1-2): 109-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11219616&dopt=Abstract
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Is an artificial sphincter the best choice for incontinent boys with Spina Bifida? Review of our long term experience with the AS-800 artificial sphincter. Author(s): Spiess PE, Capolicchio JP, Kiruluta G, Salle JP, Berardinucci G, Corcos J. Source: Can J Urol. 2002 April; 9(2): 1486-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12010593&dopt=Abstract
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Is antenatal selection for spina bifida possible? Author(s): Boydell LR, Nevin NC. Source: Bmj (Clinical Research Ed.). 1990 September 22; 301(6752): 608. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2242465&dopt=Abstract
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Is maternal obesity a risk factor for anencephaly and spina bifida? Author(s): Watkins ML, Scanlon KS, Mulinare J, Khoury MJ. Source: Epidemiology (Cambridge, Mass.). 1996 September; 7(5): 507-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8862982&dopt=Abstract
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Is Sonic hedgehog (SHH) a candidate gene for spina bifida? A pilot study. Author(s): Zhu H, Barber R, Shaw GM, Lammer EJ, Finnell RH. Source: American Journal of Medical Genetics. 2003 February 15; 117A(1): 87-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12548748&dopt=Abstract
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Is there a role for immunoblots in the diagnosis of latex allergy? Intermethod comparison of in vitro and in vivo IgE assays in spina bifida patients. Author(s): Gruber C, Buck D, Wahn U, Niggemann B. Source: Allergy. 2000 May; 55(5): 476-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10843429&dopt=Abstract
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Issues in the prevention of spina bifida. Author(s): Bower C, Stanley FJ. Source: Journal of the Royal Society of Medicine. 1996 August; 89(8): 436-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8795496&dopt=Abstract
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Issues of medical management in adults with spina bifida. Author(s): McDonnell GV, McCann JP. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2000 April; 16(4): 222-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10855520&dopt=Abstract
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Language development in children with spina bifida. Author(s): Fletcher JM, Barnes M, Dennis M. Source: Semin Pediatr Neurol. 2002 September; 9(3): 201-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12350041&dopt=Abstract
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Laparoscopic antegrade continence enema in situ appendix procedure for refractory constipation and overflow fecal incontinence in children with spina bifida. Author(s): Van Savage JG, Yohannes P. Source: The Journal of Urology. 2000 September; 164(3 Pt 2): 1084-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10958747&dopt=Abstract
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Laparoscopic antegrade continence enema procedure for fecal incontinence in a patient with spina bifida. Author(s): Ameda K, Kakizaki H, Machino R, Tanaka H, Shibata T, Koyanagi T. Source: International Journal of Urology : Official Journal of the Japanese Urological Association. 2003 July; 10(7): 401-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823697&dopt=Abstract
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Latex allergies in children with spina bifida: relevance for the pediatric dentist. Author(s): Nelson LP, Soporowski NJ, Shusterman S. Source: Pediatr Dent. 1994 January-February; 16(1): 18-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8015937&dopt=Abstract
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Latex allergy and sensitization in children with spina bifida. Author(s): Obojski A, Chodorski J, Barg W, Medrala W, Fal AM, Malolepszy J. Source: Pediatric Neurosurgery. 2002 November; 37(5): 262-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411719&dopt=Abstract
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Latex allergy and spina bifida. Author(s): Peters HC. Source: Journal (Canadian Dental Association). 1994 March; 60(3): 177. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8156451&dopt=Abstract
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Latex allergy in patients with spina bifida. Author(s): Robinson JL. Source: The Journal of Pediatrics. 2000 February; 136(2): 270-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10657842&dopt=Abstract
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Latex allergy in Saudi children with spina bifida. Author(s): Kattan H, Harfi HA, Tipirneni P. Source: Allergy. 1999 January; 54(1): 70-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195360&dopt=Abstract
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Latex allergy in spina bifida: at the turning point? Author(s): Niggemann B, Buck D, Michael T, Haberl H, Wahn U. Source: The Journal of Allergy and Clinical Immunology. 2000 December; 106(6): 1201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11112908&dopt=Abstract
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Latex allergy: frequent occurrence of IgE antibodies to a cluster of 11 latex proteins in patients with spina bifida and histories of anaphylaxis. Author(s): Alenius H, Kurup V, Kelly K, Palosuo T, Turjanmaa K, Fink J. Source: The Journal of Laboratory and Clinical Medicine. 1994 May; 123(5): 712-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8195677&dopt=Abstract
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Latex sensitization in children with spina bifida: follow-up comparative study after two years. Author(s): Mazon A, Nieto A, Linana JJ, Montoro J, Estornell F, Garcia-Ibarra F. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2000 February; 84(2): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10719778&dopt=Abstract
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Latex sensitization in spina bifida appears disease-associated. Author(s): Szepfalusi Z, Seidl R, Bernert G, Dietrich W, Spitzauer S, Urbanek R. Source: The Journal of Pediatrics. 1999 March; 134(3): 344-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10064673&dopt=Abstract
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Link between the CSF shunt and achievement in adults with spina bifida. Author(s): McDonnell GV, McCann JP. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 June; 68(6): 800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10877634&dopt=Abstract
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Link between the CSF shunt and achievement in adults with spina bifida. Author(s): Hunt GM, Oakeshott P, Kerry S. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1999 November; 67(5): 591-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10519863&dopt=Abstract
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Longitudinal study of observed and perceived family influences on problem-focused coping behaviors of preadolescents with spina bifida. Author(s): McKernon WL, Holmbeck GN, Colder CR, Hommeyer JS, Shapera W, Westhoven V. Source: Journal of Pediatric Psychology. 2001 January-February; 26(1): 41-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11145731&dopt=Abstract
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Long-term evaluation of rectus fascial wrap in patients with spina bifida. Author(s): Walker RD, Erhard M, Starling J. Source: The Journal of Urology. 2000 August; 164(2): 485-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10893629&dopt=Abstract
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Long-term followup of cadaveric renal transplantation in patients with spina bifida. Author(s): Power RE, O'Malley KJ, Little DM, Donovan MG, Creagh TA, Murphy DM, Hickey DP. Source: The Journal of Urology. 2002 February; 167(2 Pt 1): 477-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792900&dopt=Abstract
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Long-term outcome in open spina bifida. Author(s): Oakeshott P, Hunt GM. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 August; 53(493): 632-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14601340&dopt=Abstract
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Lumbar canal stenosis: a cause of late neurological deterioration in patients with spina bifida. Author(s): Martinez-Lage JF, Piqueras C, Poza M. Source: Surgical Neurology. 2001 May; 55(5): 256-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11516459&dopt=Abstract
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Lumbar rhabdomyosarcoma in a patient with spina bifida. Author(s): Oguz KK, Cila A, Soylemezoglu F, Yakupoglu H, Firat MM, Akalan N. Source: Pediatric Radiology. 2001 December; 31(12): 895. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11727032&dopt=Abstract
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Malaysian children with spina bifida: relationship between functional outcome and level of lesion. Author(s): Ong LC, Lim YN, Sofiah A. Source: Singapore Med J. 2002 January; 43(1): 012-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12008770&dopt=Abstract
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Marital quality of parents of children with spina bifida: a case-comparison study. Author(s): Cappelli M, McGarth PJ, Daniels T, Manion I, Schillinger J. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1994 October; 15(5): 320-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7868699&dopt=Abstract
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Mass screening for open spina bifida needs careful consideration. Author(s): Check W. Source: Jama : the Journal of the American Medical Association. 1977 October 3; 238(14): 1441-1443+. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11643516&dopt=Abstract
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Maternal carbamazepine and infant spina bifida. Author(s): Kallen AJ. Source: Reproductive Toxicology (Elmsford, N.Y.). 1994 May-June; 8(3): 203-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8075508&dopt=Abstract
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Maternal myo-inositol, glucose, and zinc status is associated with the risk of offspring with spina bifida. Author(s): Groenen PM, Peer PG, Wevers RA, Swinkels DW, Franke B, Mariman EC, Steegers-Theunissen RP. Source: American Journal of Obstetrics and Gynecology. 2003 December; 189(6): 1713-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14710103&dopt=Abstract
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Maternal occupational exposure during pregnancy and the risk of spina bifida. Author(s): Blatter BM, Roeleveld N, Zielhuis GA, Gabreels FJ, Verbeek AL. Source: Occupational and Environmental Medicine. 1996 February; 53(2): 80-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8777455&dopt=Abstract
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Maternal periconceptional vitamin use, genetic variation of infant reduced folate carrier (A80G), and risk of spina bifida. Author(s): Shaw GM, Lammer EJ, Zhu H, Baker MW, Neri E, Finnell RH. Source: American Journal of Medical Genetics. 2002 February 15; 108(1): 1-6. Erratum In: Am J Med Genet 2002 December 15; 113(4): 392. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11857541&dopt=Abstract
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Maternal vitamin use, genetic variation of infant methylenetetrahydrofolate reductase, and risk for spina bifida. Author(s): Shaw GM, Rozen R, Finnell RH, Wasserman CR, Lammer EJ. Source: American Journal of Epidemiology. 1998 July 1; 148(1): 30-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9663401&dopt=Abstract
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Maternal, paternal, and marital functioning in families of preadolescents with spina bifida. Author(s): Holmbeck GN, Gorey-Ferguson L, Hudson T, Seefeldt T, Shapera W, Turner T, Uhler J. Source: Journal of Pediatric Psychology. 1997 April; 22(2): 167-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9114641&dopt=Abstract
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Maternal-fetal surgery for spina bifida: on the brink of a new era? Author(s): Moise KJ Jr. Source: American Journal of Obstetrics and Gynecology. 2003 August; 189(2): 311. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14520183&dopt=Abstract
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Math and numeracy in young adults with spina bifida and hydrocephalus. Author(s): Dennis M, Barnes M. Source: Developmental Neuropsychology. 2002; 21(2): 141-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12139196&dopt=Abstract
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Measuring glomerular filtration rate with cystatin C and beta-trace protein in children with spina bifida. Author(s): Pham-Huy A, Leonard M, Lepage N, Halton J, Filler G. Source: The Journal of Urology. 2003 June; 169(6): 2312-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771788&dopt=Abstract
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Methylenetetrahydrofolate reductase (MTHFR): incidence of mutations C677T and A1298C in Brazilian population and its correlation with plasma homocysteine levels in spina bifida. Author(s): Perez AB, D'Almeida V, Vergani N, de Oliveira AC, de Lima FT, Brunoni D. Source: American Journal of Medical Genetics. 2003 May 15; 119A(1): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707953&dopt=Abstract
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Methylenetetrahydrofolate reductase and spina bifida: evaluation of level of defect and maternal genotypic risk in Hispanics. Author(s): Volcik KA, Blanton SH, Tyerman GH, Jong ST, Rott EJ, Page TZ, Romaine NK, Northrup H. Source: American Journal of Medical Genetics. 2000 November 6; 95(1): 21-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11074490&dopt=Abstract
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Microdeletion 22q11.2, Kousseff syndrome and spina bifida. Author(s): Seller MJ, Mohammed S, Russell J, Ogilvie C. Source: Clinical Dysmorphology. 2002 April; 11(2): 113-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12002140&dopt=Abstract
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Microsatellites proximal to leptin and leptin receptor as risk factors for spina bifida. Author(s): Shaw GM, Barber R, Todoroff K, Lammer EJ, Finnell RH. Source: Teratology. 2000 March; 61(3): 231-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10661913&dopt=Abstract
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Molecular analysis of DRB and DQB1 alleles in German spina bifida patients with and without IgE responsiveness to the latex major allergen Hev b 1. Author(s): Rihs HP, Cremer R, Chen Z, Baur X. Source: Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology. 1998 February; 28(2): 175-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9515590&dopt=Abstract
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Mothers' experiences of living worried when parenting children with spina bifida. Author(s): Monsen RB. Source: Journal of Pediatric Nursing. 1999 June; 14(3): 157-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10394219&dopt=Abstract
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MRI morphometric study and correlation with cognitive functions in young adults shunted for congenital hydrocephalus related to spina bifida. Author(s): Hommet C, Cottier JP, Billard C, Perrier D, Gillet P, De Toffol B, Sirinelli D, Bertrand P, Autret A. Source: European Neurology. 2002; 47(3): 169-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11914556&dopt=Abstract
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Mutated methylenetetrahydrofolate reductase as a risk factor for spina bifida. Author(s): van der Put NM, Steegers-Theunissen RP, Frosst P, Trijbels FJ, Eskes TK, van den Heuvel LP, Mariman EC, den Heyer M, Rozen R, Blom HJ. Source: Lancet. 1995 October 21; 346(8982): 1070-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7564788&dopt=Abstract
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National survey on hydrocephalus & spina bifida (IAPS members): need for consensus conference. Author(s): Bajpai M. Source: Indian J Pediatr. 1997 November-December; 64(6 Suppl): 86-94. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11129887&dopt=Abstract
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Natural rubber latex allergy: prevalence and risk factors in patients with spina bifida compared with atopic children and controls. Author(s): Cremer R, Hoppe A, Korsch E, Kleine-Diepenbruck U, Blaker F. Source: European Journal of Pediatrics. 1998 January; 157(1): 13-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9461356&dopt=Abstract
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Needs assessment in a spina bifida program: a comparison of the perceptions by adolescents with spina bifida and their parents. Author(s): Buran CF, McDaniel AM, Brei TJ. Source: Clinical Nurse Specialist Cns. 2002 September; 16(5): 256-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394114&dopt=Abstract
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Neural crest anomaly syndromes in children with spina bifida. Author(s): Nye JS, McLone DG, Charrow J, Hayes EA. Source: Teratology. 1999 October; 60(4): 179-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10508971&dopt=Abstract
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Neurological and medico-social problems of spina bifida patients in adolescence and adulthood. Author(s): Oi S, Sato O, Matsumoto S. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 1996 April; 12(4): 181-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739403&dopt=Abstract
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Neurological dysfunction above cele level in children with spina bifida cystica. Author(s): Dahl M, Silander HC, Norrlin S, Olsen L, Thuomas KA. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 64-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926334&dopt=Abstract
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Neuromotor speech deficits in children and adults with spina bifida and hydrocephalus. Author(s): Huber-Okrainec J, Dennis M, Brettschneider J, Spiegler BJ. Source: Brain and Language. 2002 March; 80(3): 592-602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11896659&dopt=Abstract
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Neurophysiological analysis of leg movements in infants with spina bifida aperta in the early postnatal period. Author(s): Sival DA, van Weerden TW, den Dunnen WF, Timmer A, StaalSchreinemachers AL, Sollie KM, Hoving EW, Sauer PJ, Brouwer OF. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S29-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585251&dopt=Abstract
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Neuroradiological assessment of visuoperceptual disturbance in children with spina bifida and hydrocephalus. Author(s): Ito J, Saijo H, Araki A, Tanaka H, Tasaki T, Cho K, Miyamoto A. Source: Developmental Medicine and Child Neurology. 1997 June; 39(6): 385-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9233363&dopt=Abstract
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Neurosurgical management of patients with spina bifida and myelomeningocele. Author(s): Ransohoff J, Mathews ES. Source: The Medical Clinics of North America. 1969 May; 53(3): 493-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4888922&dopt=Abstract
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Next steps: the Oregon Spina Bifida Project: community based services for children with chronic health conditions. Author(s): Merkens MJ. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1996 December; 6 Suppl 1: 36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9008820&dopt=Abstract
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Object-based and action-based visual perception in children with spina bifida and hydrocephalus. Author(s): Dennis M, Fletcher JM, Rogers T, Hetherington R, Francis DJ. Source: Journal of the International Neuropsychological Society : Jins. 2002 January; 8(1): 95-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11843078&dopt=Abstract
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Observed and perceived dyadic and systemic functioning in families of preadolescents with spina bifida. Author(s): Holmbeck GN, Coakley RM, Hommeyer JS, Shapera WE, Westhoven VC. Source: Journal of Pediatric Psychology. 2002 March; 27(2): 177-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821501&dopt=Abstract
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Occurrence of split cord malformation in meningomyelocele: complex spina bifida. Author(s): Kumar R, Bansal KK, Chhabra DK. Source: Pediatric Neurosurgery. 2002 March; 36(3): 119-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11919445&dopt=Abstract
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Orofacial clefts and spina bifida: N-acetyltransferase phenotype, maternal smoking, and medication use. Author(s): van Rooij IA, Groenen PM, van Drongelen M, Te Morsche RH, Peters WH, Steegers-Theunissen RP. Source: Teratology. 2002 November; 66(5): 260-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397635&dopt=Abstract
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Orthopaedic care of children with spina bifida: you've come a long way, baby! Author(s): Brown JP. Source: Orthopaedic Nursing / National Association of Orthopaedic Nurses. 2001 JulyAugust; 20(4): 51-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12025673&dopt=Abstract
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Orthopaedic Management of High-Level Spina Bifida. Early Walking Compared With Early Use of a Wheelchair. Author(s): Lynn MD. Source: The Journal of Bone and Joint Surgery. American Volume. 1989 July; 71(6): 953. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2663871&dopt=Abstract
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Orthopedic and habilitation management of patients with spina bifida and myelomeningocele. Author(s): Tzimas NA, Badell-Ribera A. Source: The Medical Clinics of North America. 1969 May; 53(3): 502-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4888924&dopt=Abstract
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Outcome in people with open spina bifida at age 35: prospective community based cohort study. Author(s): Hunt GM, Oakeshott P. Source: Bmj (Clinical Research Ed.). 2003 June 21; 326(7403): 1365-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12816823&dopt=Abstract
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Outcome of hydrocephalus and spina bifida surgery in a referral hospital without neurosurgical services in Tanzania. Author(s): Oneko M, Lyamuya S, Mhando S. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S39-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585257&dopt=Abstract
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Over the cutting edge: how ethics consultation illuminates the moral complexity of open-uterine fetal repair of spina bifida and patients' decision making. Author(s): Bliton MJ, Zaner RM. Source: J Clin Ethics. 2001 Winter; 12(4): 346-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12026740&dopt=Abstract
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Parent and school perceptions of language abilities in children with spina bifida and shunted hydrocephalus. Author(s): Vachha B, Adams RC. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S31-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585252&dopt=Abstract
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Perceived benefits of word prediction intervention on written productivity in children with spina bifida and hydrocephalus. Author(s): Tam C, Reid D, Naumann S, O' Keefe B. Source: Occupational Therapy International. 2002; 9(3): 237-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12374999&dopt=Abstract
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Plasma antidiuretic hormone levels in children with spina bifida. Author(s): Ferrara P, D'Aleo C, Ruggiero A, Paoletti FP, Chiozza ML, Plebani M, Caione P, Del Gado R, Salvaggio E. Source: Urologia Internationalis. 2002; 68(3): 144-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11919457&dopt=Abstract
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Polymorphisms of the 5,10-methylenetetrahydrofolate and the methionine synthase reductase genes as independent risk factors for spina bifida. Author(s): Pietrzyk JJ, Bik-Multanowski M, Sanak M, Twardowska M. Source: Journal of Applied Genetics. 2003; 44(1): 111-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590188&dopt=Abstract
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Predicting ambulation by checking leg withdrawal in fetuses with spina bifida. Author(s): Petrikovsky BM. Source: American Journal of Obstetrics and Gynecology. 2002 July; 187(1): 256; Author Reply 256. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12114925&dopt=Abstract
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Pregnancy in patients with spina bifida and urinary diversion. Author(s): Natarajan V, Kapur D, Sharma S, Singh G. Source: International Urogynecology Journal and Pelvic Floor Dysfunction. 2002 November; 13(6): 383-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466911&dopt=Abstract
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Prevalence of spina bifida and anencephaly during the transition to mandatory folic acid fortification in the United States. Author(s): Williams LJ, Mai CT, Edmonds LD, Shaw GM, Kirby RS, Hobbs CA, Sever LE, Miller LA, Meaney FJ, Levitt M. Source: Teratology. 2002 July; 66(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12115778&dopt=Abstract
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Problems posed by spina bifida. Author(s): Edwards JH, Laurance BM. Source: Times (Lond). 1978 January 13; : 15. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11648880&dopt=Abstract
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Progression of terminal syrinx in occult spina bifida after untethering. Author(s): Sade B, Beni-Adani L, Ben-Sira L, Constantini S. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2003 February; 19(2): 106-8. Epub 2002 November 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607029&dopt=Abstract
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Progression of terminal syrinx in occult spina bifida. Author(s): Vandertop WP. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2003 June; 19(5-6): 267; Author Reply 268. Epub 2003 May 20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756599&dopt=Abstract
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Quality of life in spina bifida: importance of parental hope. Author(s): Kirpalani HM, Parkin PC, Willan AR, Fehlings DL, Rosenbaum PL, King D, Van Nie AJ. Source: Archives of Disease in Childhood. 2000 October; 83(4): 293-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10999858&dopt=Abstract
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Re: “Maternal vitamin use, genetic variation of infant methylenetetrahydrofolate reductase, and risk for spina bifida”. Author(s): Botto LD, Mulinare J. Source: American Journal of Epidemiology. 1999 August 1; 150(3): 323-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10430239&dopt=Abstract
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Reduction of latex sensitisation in spina bifida patients by a primary prophylaxis programme (five years experience). Author(s): Cremer R, Kleine-Diepenbruck U, Hering F, Holschneider AM. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S19-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12541209&dopt=Abstract
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Rehabilitation of patients with spina bifida. Author(s): Singh U, Gogia VS. Source: Indian J Pediatr. 1997 November-December; 64(6 Suppl): 77-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11129885&dopt=Abstract
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Relations between family environment and adjustment outcomes in young adults with spina bifida. Author(s): Loomis JW, Javornisky JG, Monahan JJ, Burke G, Lindsay A. Source: Developmental Medicine and Child Neurology. 1997 September; 39(9): 620-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9344055&dopt=Abstract
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Relationships among life stress, perceived family environment, and the psychological distress of spina bifida adolescents. Author(s): Murch RL, Cohen LH. Source: Journal of Pediatric Psychology. 1989 June; 14(2): 193-214. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2666629&dopt=Abstract
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Renal transplantation in patients with spina bifida. Author(s): Little DM, Gleeson MJ, Hickey DP, Donovan MG, Murphy DM. Source: Urology. 1994 September; 44(3): 319-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8073546&dopt=Abstract
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Risk factors for latex allergy in patients with spina bifida and latex sensitization. Author(s): Bernardini R, Novembre E, Lombardi E, Mezzetti P, Cianferoni A, Danti DA, Mercurella A, Vierucci A. Source: Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology. 1999 May; 29(5): 681-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10231329&dopt=Abstract
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Risk factors for latex sensitization in children with spina bifida. Author(s): Pires G, Morais-Almeida M, Gaspar A, Godinho N, Calado E, AbreuNogueira J, Rosado-Pinto J. Source: Allergologia Et Immunopathologia. 2002 January-February; 30(1): 5-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888486&dopt=Abstract
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Risk factors for neural tube defects: associations between uncoupling protein 2 polymorphisms and spina bifida. Author(s): Volcik KA, Shaw GM, Zhu H, Lammer EJ, Finnell RH. Source: Birth Defects Research. Part A, Clinical and Molecular Teratology. 2003 March; 67(3): 158-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12797456&dopt=Abstract
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Role of urologic evaluation in the adult spina bifida patient. Author(s): Persun ML, Ginsberg PC, Harmon JD, Harkaway RC. Source: Urologia Internationalis. 1999; 62(4): 205-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10567883&dopt=Abstract
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Second trimester sonography and fetal spina bifida screening. Author(s): Strigini FA, Carmignani A, Genazzani AR. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 April; 81(1): 59-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676399&dopt=Abstract
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Secondary conditions in children with disabilities: spina bifida as a case example. Author(s): Simeonsson RJ, McMillen JS, Huntington GS. Source: Mental Retardation and Developmental Disabilities Research Reviews. 2002; 8(3): 198-205. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12216064&dopt=Abstract
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Sociodemographic patterns in spina bifida birth prevalence trends--North Carolina, 1995-1999. Author(s): Meyer RE, Siega-Riz AM. Source: Mmwr. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports / Centers for Disease Control. 2002 September 13; 51(Rr-13): 12-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353507&dopt=Abstract
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Sonographic diagnosis of spina bifida at 12 weeks: heading towards indirect signs. Author(s): Buisson O, De Keersmaecker B, Senat MV, Bernard JP, Moscoso G, Ville Y. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 March; 19(3): 290-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11896954&dopt=Abstract
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Spina bifida and anencephaly prevalence--United States, 1991-2001. Author(s): Mathews TJ, Honein MA, Erickson JD. Source: Mmwr. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports / Centers for Disease Control. 2002 September 13; 51(Rr-13): 9-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353510&dopt=Abstract
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Spina bifida and folate-related genes: a study of gene-gene interactions. Author(s): de Franchis R, Botto LD, Sebastio G, Ricci R, Iolascon A, Capra V, Andria G, Mastroiacovo P. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. 2002 May-June; 4(3): 126-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12180146&dopt=Abstract
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Spina bifida occulta in isthmic spondylolisthesis: a surgical trap. Author(s): Kumar R, Niall D, Walsh A, Khalilullah K, McCormack D. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2002 April; 11(2): 159-61. Epub 2001 December 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11956923&dopt=Abstract
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Spina bifida, folate metabolism, and dietary folate intake in a Northern Canadian aboriginal population. Author(s): Arbour L, Christensen B, Delormier T, Platt R, Gilfix B, Forbes P, Kovitch I, Morel J, Rozen R. Source: Int J Circumpolar Health. 2002 November; 61(4): 341-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546192&dopt=Abstract
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Spina bifida, somitic count and carnegie stage twelve. Author(s): O'Rahilly R, Muller F. Source: Pediatric Neurosurgery. 2003 March; 38(3): 165. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601244&dopt=Abstract
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Spina bifida. Author(s): Barker E, Saulino M, Caristo AM. Source: Rn. 2002 December; 65(12): 33-8; Quiz 39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12567828&dopt=Abstract
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Testing for genetic associations in a spina bifida population: analysis of the HOX gene family and human candidate gene regions implicated by mouse models of neural tube defects. Author(s): Volcik KA, Blanton SH, Kruzel MC, Townsend IT, Tyerman GH, Mier RJ, Northrup H. Source: American Journal of Medical Genetics. 2002 July 1; 110(3): 203-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12116226&dopt=Abstract
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Testing for genetic associations with the PAX gene family in a spina bifida population. Author(s): Volcik KA, Blanton SH, Kruzel MC, Townsend IT, Tyerman GH, Mier RJ, Northrup H. Source: American Journal of Medical Genetics. 2002 July 1; 110(3): 195-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12116225&dopt=Abstract
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The “failures” of spina bifida transdisciplinary care. Author(s): Calado E, Loff C. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S51-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585262&dopt=Abstract
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The efficacy of bowel management in the adult with spina bifida. Author(s): Wright L. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S41-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585258&dopt=Abstract
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The experience of parenting an adolescent with spina bifida. Author(s): Sawin KJ, Bellin MH, Roux G, Buran C, Brei TJ, Fastenau PS. Source: Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses. 2003 November-December; 28(6): 173-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14649165&dopt=Abstract
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The incidence of cleft lip, cleft palate, hydrocephalus and spina bifida at Queen Elizabeth Central Hospital, Blantyre, Malawi. Author(s): Msamati BC, Igbigbi PS, Chisi JE. Source: Cent Afr J Med. 2000 November; 46(11): 292-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12002118&dopt=Abstract
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The management of the failed bladder neck procedure in patients with spina bifida. Author(s): Walker RD. Source: Bju International. 2003 October; 92 Suppl 1: 35-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12969007&dopt=Abstract
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The neuropathic bowel in spina bifida--a cross-sectional study in 226 patients. Author(s): Knab K, Langhans B, Behrens R, Strehl AE. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S41-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11848046&dopt=Abstract
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The significance of the percentage of the defect size in spina bifida cystica in determination of the surgical technique. Author(s): Ozveren MF, Erol FS, Topsakal C, Tiftikci MT, Akdemir I. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2002 November; 18(11): 614-20. Epub 2002 October 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420121&dopt=Abstract
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The unnecessary epidemic of folic acid-preventable spina bifida and anencephaly. Author(s): Campbell RK. Source: Pediatrics. 2001 October; 108(4): 1048-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589212&dopt=Abstract
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Ultrasound evaluation of prenatal and neonatal spina bifida. Author(s): Babcook CJ. Source: Neurosurg Clin N Am. 1995 April; 6(2): 203-18. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7620348&dopt=Abstract
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Unilateral dislocation of the hip in spina bifida. A long-term follow-up. Author(s): Fraser RK, Bourke HM, Broughton NS, Menelaus MB. Source: The Journal of Bone and Joint Surgery. British Volume. 1995 July; 77(4): 615-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7615608&dopt=Abstract
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Unilateral spondylolysis associated with spina bifida occulta and nerve root compression. Author(s): Burkus JK. Source: Spine. 1990 June; 15(6): 555-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2205929&dopt=Abstract
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Unpredicted spontaneous extrusion of a renal calculus in an adult male with spina bifida and paraplegia: report of a misdiagnosis. Measures to be taken to reduce urological errors in spinal cord injury patients. Author(s): Vaidyanathan S, Hughes PL, Soni BM, Singh G, Mansour P, Sett P. Source: Bmc Urology [electronic Resource]. 2001; 1(1): 3. Epub 2001 December 20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11801198&dopt=Abstract
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Up-slanting palpebral fissures and oblique astigmatism associated with A-pattern strabismus and overdepression in adduction in spina bifida. Author(s): Paysse EA, Khokhar A, McCreery KM, Morris MC, Coats DK. Source: J Aapos. 2002 December; 6(6): 354-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12506275&dopt=Abstract
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Urinary findings in asymptomatic subjects with spina bifida treated with intermittent catheterization. Author(s): Szucs K, O'Neil KM, Faden H. Source: The Pediatric Infectious Disease Journal. 2001 June; 20(6): 638-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11419515&dopt=Abstract
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Urinary incontinence in children with spina bifida. Author(s): Willis C. Source: Nurs Times. 1989 November 1-7; 85(44): 48-51. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2687800&dopt=Abstract
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Urinary problems of spina bifida. Author(s): Nash DF. Source: Developmental Medicine and Child Neurology. 1969 February; 11(1): 106-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4977651&dopt=Abstract
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Urolithiasis in spina bifida. Author(s): Gros DA, Thakkar RN, Lakshmanan Y, Ruffing V, Kinsman SL, Docimo SG. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 68-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926338&dopt=Abstract
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Uroneurological assessment of spina bifida cystica and occulta. Author(s): Sakakibara R, Hattori T, Uchiyama T, Kamura K, Yamanishi T. Source: Neurourology and Urodynamics. 2003; 22(4): 328-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12808708&dopt=Abstract
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Valgus deformity of the ankle in children with spina bifida aperta. Author(s): Malhotra D, Puri R, Owen R. Source: The Journal of Bone and Joint Surgery. British Volume. 1984 May; 66(3): 381-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6373777&dopt=Abstract
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Valproate and spina bifida. Author(s): Robert E, Lofkvist E, Mauguiere F. Source: Lancet. 1984 December 15; 2(8416): 1392. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6150384&dopt=Abstract
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Valproate and spina bifida. Author(s): Oakeshott P. Source: The Practitioner. 1989 September 8; 233(1474): 1129. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2515531&dopt=Abstract
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Valproate and spina bifida. Author(s): Oakeshott P, Hunt GM. Source: Bmj (Clinical Research Ed.). 1989 May 13; 298(6683): 1300-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2500206&dopt=Abstract
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Valproate, spina bifida, and birth defect registries. Author(s): Staunton H. Source: Lancet. 1989 February 18; 1(8634): 381. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2563529&dopt=Abstract
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Ventricular shunts and the prevalence of sensitization and clinically relevant allergy to latex in patients with spina bifida. Author(s): Buck D, Michael T, Wahn U, Niggemann B. Source: Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology. 2000 May; 11(2): 111-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10893014&dopt=Abstract
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Ventriculo-cardiac shunts in the first week of life. Results of a controlled trial in the treatment of hydrocephalus in infants born with spina bifida cystica or cranium bifidum. Author(s): Lorber J. Source: Dev Med Child Neurol Suppl. 1969; 20: 13-22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4905059&dopt=Abstract
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Very low frequency of latex and fruit allergy in patients with spina bifida from Venezuela: influence of socioeconomic factors. Author(s): Capriles-Hulett A, Sanchez-Borges M, Von-Scanzoni C, Medina JR. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 1995 July; 75(1): 62-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7621063&dopt=Abstract
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Visual but not spatial working memory deficit in children with spina bifida. Author(s): Mammarella N, Cornoldi C, Donadello E. Source: Brain and Cognition. 2003 November; 53(2): 311-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14607170&dopt=Abstract
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Vocal-cord paralysis and brainstem dysfunction in children with spina bifida. Author(s): Hesz N, Wolraich M. Source: Developmental Medicine and Child Neurology. 1985 August; 27(4): 528-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4029525&dopt=Abstract
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Waardenburg syndrome and spina bifida. Author(s): Kromberg JG, Krause A. Source: American Journal of Medical Genetics. 1993 February 15; 45(4): 536-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8465867&dopt=Abstract
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Walking ability in mature patients with spina bifida. Author(s): Stillwell A, Menelaus MB. Source: Journal of Pediatric Orthopedics. 1983 May; 3(2): 184-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6345583&dopt=Abstract
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Walking ability in spina bifida patients: a model for predicting future ambulatory status based on sitting balance and motor level. Author(s): Swank M, Dias LS. Source: Journal of Pediatric Orthopedics. 1994 November-December; 14(6): 715-8. Erratum In: J Pediatr Orthop 1995 March-April; 15(2): 278. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7814582&dopt=Abstract
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What's new in the genetics of hydrocephalus and spina bifida? The Casey Holter Memorial Lecture 1993. Author(s): Donnai D. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1993 December; 3 Suppl 1: 5-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8130156&dopt=Abstract
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Where have all the spina bifida gone? Author(s): Lorber J. Source: Midwife Health Visit Community Nurse. 1986 March; 22(3): 94-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3534525&dopt=Abstract
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Where should spina bifida children go to school? Author(s): Dodd KD. Source: Z Kinderchir. 1984 December; 39 Suppl 2: 129-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6240849&dopt=Abstract
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Why do adults with spina bifida and hydrocephalus die? A clinic-based study. Author(s): McDonnell GV, McCann JP. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2000 December; 10 Suppl 1: 31-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11214829&dopt=Abstract
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Why is the occurrence of open spina bifida so relevant? The recent experience of a Portuguese spina bifida center. Author(s): Calado E, Loff C, Castelo L. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S48-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11848052&dopt=Abstract
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Wound healing in trophic ulcers in spina bifida patients. Author(s): Srivastava VK. Source: Journal of Neurosurgery. 1995 January; 82(1): 40-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7815132&dopt=Abstract
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X chromosome genes involved in the regulation of facial clefting and spina bifida. Author(s): Moore GE, Ivens A, Newton R, Balacs MA, Henderson DJ, Jensson O. Source: Cleft Palate J. 1990 April; 27(2): 131-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2187632&dopt=Abstract
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X-linked hydrocephalus masquerading as spina bifida and destructive porencephaly in successive generations in one family. Author(s): Brewer CM, Fredericks BJ, Pont JM, Stephenson JB, Tolmie JL. Source: Developmental Medicine and Child Neurology. 1996 July; 38(7): 632-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8674913&dopt=Abstract
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X-linked hydrocephalus masquerading as spina bifida and destructive porencephaly in successive generations in one family. Author(s): Brewer CM, Fredericks BJ, Pont JM, Stephenson JB, Tolmie JL. Source: Developmental Medicine and Child Neurology. 1996 April; 38(4): 359-63. Erratum In: Dev Med Child Neurol 1996 June; 38(6): 472. Corrected and Republished In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8641541&dopt=Abstract
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Yale-New Haven Hospital Spina Bifida Center: introduction of the pediatric nurse practitioner in a program of comprehensive management. Author(s): Venes JL, Rodgers B. Source: Conn Med. 1975 December; 39(12): 801-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1106943&dopt=Abstract
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CHAPTER 2. NUTRITION AND SPINA BIFIDA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and spina bifida.
Finding Nutrition Studies on Spina Bifida The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “spina bifida” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
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Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “spina bifida” (or a synonym): •
A Common variant in methionine synthase reductase combined low cobalamin (vitamin B12) increases risk for spina bifida. Source: Wilson, A. Platt, R. Qu, Q. Leclerc, D. Christensen, B. Yang, H. Gravel, R.A. Rozen, R. Mol-genet-metab. Orlando, FL : Academic Press, c1998-. August 1999. volume 67 (4) page 317-323. 1096-7192
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Absorption of dietary and supplemental folate in women with prior pregnancies with neural tube defects and controls. Author(s): Interdisciplinary Graduate Program in Nutritional Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. Source: Neuhouser, M L Beresford, S A Hickok, D E Monsen, E R J-Am-Coll-Nutr. 1998 December; 17(6): 625-30 0731-5724
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Altered folate and vitamin B12 metabolism in families with spina bifida offspring. Author(s): Department of Pediatrics, University Hospital Nijmegen, The Netherlands. Source: van der Put, N M Thomas, C M Eskes, T K Trijbels, F J Steegers Theunissen, R P Mariman, E C De Graaf Hess, A Smeitink, J A Blom, H J QJM. 1997 August; 90(8): 505-10 1460-2725
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Altered folate metabolism and disposition in mothers affected by a spina bifida pregnancy: influence of 677c --> t methylenetetrahydrofolate reductase and 2756a --> g methionine synthase genotypes. Author(s): Research School of Medicine, Centre for Reproduction, Growth and Development, Division of Paediatrics and Child Health, University of Leeds, West Yorkshire, UK. Source: Lucock, M Daskalakis, I Briggs, D Yates, Z Levene, M Mol-Genet-Metab. 2000 May; 70(1): 27-44 1096-7192
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An examination of polymorphic genes and folate metabolism in mothers affected by a spina bifida pregnancy. Author(s): Academic Unit of Paediatrics, D Floor, Clarendon Wing, Leeds General Infirmary, University of Leeds, Leeds, West Yorkshire LS2 9NS, UK.
[email protected] Source: Lucock, M Daskalakis, I Hinkins, M Yates, Z Mol-Genet-Metab. 2001 August; 73(4): 322-32 1096-7192
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Awareness of folic acid for neural tube defect prevention among Israeli women. Author(s): Department of Pediatrics, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel-Aviv University, Zerifin, Israel. Source: Ringel, S Lahat, E Elizov, T Greenberg, R Arieli, S Afriat, R Berkovitch, M Teratology. 1999 July; 60(1): 29-32 0040-3709
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Curly tail: a 50-year history of the mouse spina bifida model. Author(s): Department of Anatomy and Embryology, Maastricht University, The Netherlands.
[email protected] Source: van Straaten, H W Copp, A J Anat-Embryol-(Berl). 2001 April; 203(4): 225-37 0340-2061
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D-chiro-inositol is more effective than myo-inositol in preventing folate-resistant mouse neural tube defects. Author(s): Neural Development Unit, Institute of Child Health, University College London, UK.
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Source: Cogram, P Tesh, S Tesh, J Wade, A Allan, G Greene, N D Copp, A J HumReprod. 2002 September; 17(9): 2451-8 0268-1161 •
Decreased methylene tetrahydrofolate reductase activity due to the 677C-->T mutation in families with spina bifida offspring. Author(s): Department of Pediatrics, University Hospital Nijmegen, The Netherlands. Source: van der Put, N M van den Heuvel, L P Steegers Theunissen, R P Trijbels, F J Eskes, T K Mariman, E C den Heyer, M Blom, H J J-Mol-Med. 1996 November; 74(11): 691-4 0946-2716
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Distribution of alleles of the methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in familial spina bifida. Author(s): Department of Neurology, UMDNJ-Robert Wood Johnson Medical School, Piscataway, New Jersey 08854, USA. Source: Johnson, W G Stenroos, E S Heath, S C Chen, Y Carroll, R McKoy, V V Chatkupt, S Lehner, T Am-J-Med-Genet. 1999 December 22; 87(5): 407-12 0148-7299
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East Ireland 1980-1994: epidemiology of neural tube defects. Author(s): Health Information Unit, Dr Steeven's Hospital, Dublin. Source: McDonnell, R J Johnson, Z Delaney, V Dack, P J-Epidemiol-Community-Health. 1999 December; 53(12): 782-8 0143-005X
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Eating disorders in adolescents and young women with spina bifida. Author(s): Department of General Pediatrics and Adolescent Medicine, Children's National Medical Center, Washington, D.C. 20010-2970, USA. Source: Silber, T J Shaer, C Atkins, D Int-J-Eat-Disord. 1999 May; 25(4): 457-61 0276-3478
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Elevated plasma total homocysteine and C677T mutation of the methylenetetrahydrofolate reductase gene in patients with spina bifida. Author(s): Department of Pharmacology, University of Bergen, Norway. Source: Bjorke Monsen, A L Ueland, P M Schneede, J Vollset, S E Refsum, H QJM. 1997 September; 90(9): 593-6 1460-2725
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Evaluation of the MTHFR C677T allele and the MTHFR gene locus in a German spina bifida population. Author(s): Medizinisches Zentrum fur Humangenetik, Marburg, Germany.
[email protected] Source: Koch, M C Stegmann, K Ziegler, A Schroter, B Ermert, A Eur-J-Pediatr. 1998 June; 157(6): 487-92 0340-6199
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Folate status and neural tube defects. Author(s): Department of Clinical Medicine, Trinity College Dublin, Ireland. Source: Molloy, A M Mills, J L Kirke, P N Weir, D G Scott, J M Biofactors. 1999; 10(2-3): 291-4 0951-6433
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Folic acid and prevention of spina bifida and anencephaly. 10 years after the U.S. Public Health Service recommendation. Source: Erickson, J D MMWR-Recomm-Repage 2002 September 13; 51(RR-13): 1-3 10575987
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Folic acid for the prevention of neural tube defects. American Academy of Pediatrics. Committee on Genetics. Source: Anonymous Pediatrics. 1999 August; 104(2 Pt 1): 325-7 0031-4005
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Folic acid to prevent neural tube defects. Source: Anonymous Drug-Ther-Bull. 1994 April 21; 32(4): 31-2 0012-6543
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From anemia to spina bifida - the story of folic acid. A tribute to Professor Richard Smithells. Author(s): Department of Obstetrics and Gynecology, University of Nijmegen, The Netherlands. Source: Eskes, T K Eur-J-Obstet-Gynecol-Reprod-Biol. 2000 June; 90(2): 119-23 0301-2115
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From the Centers for Disease Control. Use of folic acid for prevention of spina bifida and other neural tube defects--1983-1991. Source: Anonymous JAMA. 1991 September 4; 266(9): 1190-1 0098-7484
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Genetic polymorphisms in methylenetetrahydrofolate reductase and methionine synthase, folate levels in red blood cells, and risk of neural tube defects. Author(s): Department of Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada. Source: Christensen, B Arbour, L Tran, P Leclerc, D Sabbaghian, N Platt, R Gilfix, B M Rosenblatt, D S Gravel, R A Forbes, P Rozen, R Am-J-Med-Genet. 1999 May 21; 84(2): 151-7 0148-7299
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Health promotion strategies an other clinical issues in spina bifida. Source: Anonymous Aust-Fam-Physician. 2002 January; 31(1): 100-1 0300-8495
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Homocysteine metabolism and effects of folic acid supplementation in patients affected with spina bifida. Author(s): Department of Obstetrics and Gynaecology, University Hospital St. Radboud, Nijmegen, The Netherlands. Source: Brouwer, I A van Dusseldorp, M Thomas, C M van der Put, N M Gaytant, M A Eskes, T K Hautvast, J G Steegers Theunissen, R P Neuropediatrics. 2000 December; 31(6): 298-302 0174-304X
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Immunohistochemical localization of chondroitin and heparan sulfate proteoglycans in pre-spina bifida splotch mouse embryos. Author(s): Department of Biology, McGill University, Montreal, Quebec, Canada. Source: Trasler, D G Morriss Kay, G Teratology. 1991 November; 44(5): 571-9 0040-3709
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Impaired regeneration of monoglutamyl tetrahydrofolate leads to cellular folate depletion in mothers affected by a spina bifida pregnancy. Author(s): University of Leeds, Leeds, West Yorkshire, UK. Source: Lucock, M.D. Daskalakis, I. Lumb, C.H. Schorah, C.J. Levene, M.I. Moleculargenetics-and-metabolism,-Print (USA). (September 1998). volume 65(1) page 18-30. folic acid vitamin deficiencies vitamins supplements 1096-7192
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Incidence of open neural tube defects in Nova Scotia after folic acid fortification. Author(s): Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS. Source: Persad, Vidia L Van den Hof, Michiel C Dube, Johanne M Zimmer, Pamela CMAJ. 2002 August 6; 167(3): 241-5 0820-3946
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Interaction between selenium and zinc in the pathogenesis of anencephaly and spina bifida. Author(s): Knoxville Neurology Clinic, TN. Source: Zimmerman, A W Lozzio, C B Z-Kinderchir. 1989 December; 44 Suppl 148-50 0174-3082
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Is spina bifida in man linked to a genetic defect of cellular zinc uptake in children. Source: Favier, A. Dardelet, B. Richard, M.J. Arnaud, J. Trace elements in man and animals 6 / edited by Lucille S. Hurley,. [et al.]. New York : Plenum Press, c1988. page 609-610. ISBN: 0306430045
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Lack of association between mutations in the folate receptor-alpha gene and spina bifida. Author(s): Department of Veterinary Anatomy and Public Health, Texas A&M University, College Station 77843-4458, USA. Source: Barber, R C Shaw, G M Lammer, E J Greer, K A Biela, T A Lacey, S W Wasserman, C R Finnell, R H Am-J-Med-Genet. 1998 April 1; 76(4): 310-7 0148-7299
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Lowered weight gain during pregnancy and risk of neural tube defects among offspring. Author(s): March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Emeryville, CA 94608, USA. Source: Shaw, G M Todoroff, K Carmichael, S L Schaffer, D M Selvin, S Int-J-Epidemiol. 2001 February; 30(1): 60-5 0300-5771
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Maternal periconceptional vitamin use, genetic variation of infant reduced folate carrier (A80G), and risk of spina bifida. Author(s): March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Oakland, California 94606, USA. Source: Shaw, Gary M Lammer, Edward J Zhu, Huiping Baker, Mei Wang Neri, Eric Finnell, Richard H Am-J-Med-Genet. 2002 February 15; 108(1): 1-6 0148-7299
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Maternal vitamin use, genetic variation of infant methylenetetrahydrofolate reductase, and risk for spina bifida. Author(s): March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Emeryville 94608, USA. Source: Shaw, G M Rozen, R Finnell, R H Wasserman, C R Lammer, E J Am-J-Epidemiol. 1998 July 1; 148(1): 30-7 0002-9262
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Microsatellites proximal to leptin and leptin receptor as risk factors for spina bifida. Author(s): March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Emeryville, California 94608, USA. Source: Shaw, G M Barber, R Todoroff, K Lammer, E J Finnell, R H Teratology. 2000 March; 61(3): 231-5 0040-3709
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Molecular genetic analysis of the gene encoding the trifunctional enzyme MTHFD (methylenetetrahydrofolate-dehydrogenase, methenyltetrahydrofolatecyclohydrolase, formyltetrahydrofolate synthetase) in patients with neural tube defects. Author(s): Department of Human Genetics, University Hospital Nijmegen, The Netherlands.
[email protected] Source: Hol, F A van der Put, N M Geurds, M P Heil, S G Trijbels, F J Hamel, B C Mariman, E C Blom, H J Clin-Genet. 1998 February; 53(2): 119-25 0009-9163
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National Health and Medical Research Council. Revised statement on the relationship between dietary folic acid and neural tube defects such as spina bifida. Source: Anonymous J-Aust-Coll-Midwives. 1995 December; 8(4): 50-1 1031-170X
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Neural tube defect surveillance and folic acid intervention--Texas-Mexico border, 1993-1998. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 2000 January 14; 49(1): 1-4 0149-2195
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Periconceptional use of multivitamins and the occurrence of anencephaly and spina bifida. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 1988 December 2; 37(47): 72730 0149-2195
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Plasma antidiuretic hormone levels in children with spina bifida. Author(s): Department of Paediatrics, Catholic University of Rome, Italy.
[email protected] Source: Ferrara, Pietro D'Aleo, Carmen Ruggiero, Antonio Paoletti, Fabrizia Paolini Chiozza, Mario Laura Plebani, Mario Caione, Paolo Del Gado, Roberto Salvaggio, Elio Urol-Int. 2002; 68(3): 144-7 0042-1138
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Possible prevention of neural tube defects by vitamin supplementation. Source: Wald, N. Prevention of spina bifida and other neural tube defects / edited by John Dobbing. London : Academic Press, c1983. page 231-239. charts. ISBN: 0122188608
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Prevalence of spina bifida and anencephaly during the transition to mandatory folic acid fortification in the United States. Author(s): National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
[email protected] Source: Williams, L J Mai, C T Edmonds, L D Shaw, G M Kirby, R S Hobbs, C A Sever, L E Miller, L A Meaney, F J Levitt, M Teratology. 2002 July; 66(1): 33-9 0040-3709
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Prevention of folic acid-preventable spina bifida and anencephaly. Author(s): Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724. Source: Oakley, G P Erickson, J D James, L M Mulinare, J Cordero, J F Ciba-FoundSympage 1994; 181212-23; discussion 223-31 0300-5208
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Prevention of neural tube defects by vitamin supplements. Source: Smithells, R.W. Prevention of spina bifida and other neural tube defects / edited by John Dobbing. London : Academic Press, c1983. page 53-84. charts. ISBN: 0122188608
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Prevention of recurrence of neural tube defects by vitamin prophylaxis. Source: Lowry, R.B. J-Can-Diet-Assoc. Toronto, Ont. : The Association. October 1984. volume 45 (4) page 330-335. 0008-3399
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Prevention program for reducing risk for neural tube defects--South Carolina, 19921994. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 1995 March 3; 44(8): 141-2 0149-2195
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Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 1992 September 11; 41(RR-14): 1-7 0149-2195
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Retinoic acid-induced spina bifida: evidence for a pathogenetic mechanism. Author(s): Department of Cell Biology and Anatomy, University of North Carolina Chapel Hill 27599. Source: Alles, A J Sulik, K K Development. 1990 January; 108(1): 73-81 0950-1991
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Risk of neural tube defects in the offspring of thalassaemia carriers in Hong Kong Chinese. Author(s): Department of Obstetrics and Gynaecology, The University of Hong Kong, Tsan Yuk Hospital, Hong Kong, China.
[email protected] Source: Lam, Y H Tang, M H Prenat-Diagn. 1999 December; 19(12): 1135-7 0197-3851
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Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida. Author(s): Department of Paediatrics, Catholic University, Rome, and Bassini Hospital, Milan-Bicocca University, Cinisello Balsamo, Milan, Italy.
[email protected]
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Source: Ferrara, P D'Aleo, C M Tarquini, E Salvatore, S Salvaggio, E BJU-Int. 2001 May; 87(7): 674-8 1464-4096 •
Sodium valproate and spina bifida. Source: Anonymous Drug-Ther-Bull. 1990 July 23; 28(15): 59-60 0012-6543
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Spina bifida and other neural tube defects. Author(s): Department of Pediatrics, Division of Medical Genetics, University of Texas Medical School, Houston, Texas, USA. Source: Northrup, H Volcik, K A Curr-Probl-Pediatr. 2000 Nov-December; 30(10): 313-32 0045-9380
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Spina bifida phenotypes in infants or fetuses of obese mothers. Author(s): March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Emeryville, California 94608, USA. Source: Shaw, G M Todoroff, K Finnell, R H Lammer, E J Teratology. 2000 May; 61(5): 376-81 0040-3709
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Spina bifida, anencephaly, and folic acid: what do they have to do with neurosurgery? Source: Ausman, J I Slavin, K V Surg-Neurol. 1995 February; 43(2): 120-1 0090-3019
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Spina bifida, folate metabolism, and dietary folate intake in a Northern Canadian aboriginal population. Author(s): Department of Human Genetics, School of Dietetics and Human Nutrition, McGill University Montreal, Quebec Canada.
[email protected] Source: Arbour, L Christensen, B Delormier, T Platt, R Gilfix, B Forbes, P Kovitch, I Morel, J Rozen, R Int-J-Circumpolar-Health. 2002 November; 61(4): 341-51 1239-9736
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Spina bifida. Source: Nutr-and-M.D. Van Nuys : PM, Inc. November 1983. volume 9 (11) page 3-4.
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Suspended judgment. Does taking extra vitamins prevent spina bifida? Author(s): Department of Environmental and Preventive Medicine, Medical College of St. Bartholomew's Hospital, London, UK. Source: Wald, N Control-Clin-Trials. 1990 October; 11(5): 309-13 0197-2456
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The C677T mutation of the 5,10-methylenetetrahydrofolate reductase gene is a moderate risk factor for spina bifida in Italy. Author(s): Department of Paediatrics, Federico II University, Napoli, Italy. Source: de Franchis, R Buoninconti, A Mandato, C Pepe, A Sperandeo, M P Del Gado, R Capra, V Salvaggio, E Andria, G Mastroiacovo, P J-Med-Genet. 1998 December; 35(12): 1009-13 0022-2593
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The disposition of valproate and its metabolites in the late first trimester and early second trimester of pregnancy in maternal serum, urine, and amniotic fluid: effect of dose, co-medication, and the presence of spina bifida. Author(s): Department of Cell Biology and Genetics, Erasmus University Rotterdam, The Netherlands. Source: Omtzigt, J G Nau, H Los, F J Pijpers, L Lindhout, D Eur-J-Clin-Pharmacol. 1992; 43(4): 381-8 0031-6970
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The risk of spina bifida aperta after first-trimester exposure to valproate in a prenatal cohort. Author(s): Department of Cell Biology and Genetics, Erasmus University, Rotterdam, The Netherlands.
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Source: Omtzigt, J G Los, F J Grobbee, D E Pijpers, L Jahoda, M G Brandenburg, H Stewart, P A Gaillard, H L Sachs, E S Wladimiroff, J W et al. Neurology. 1992 April; 42(4 Suppl 5): 119-25 0028-3878 •
The role of improvement in the maternal diet and preconceptional folic acid supplementation in the prevention of neural tube defects. Source: Laurence, K.M. Campbell, H. James, N.E. Prevention of spina bifida and other neural tube defects / edited by John Dobbing. London : Academic Press, c1983. page 85125. ill., charts. ISBN: 0122188608
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The valproic acid metabolite E-2-n-propyl-2-pentenoic acid does not induce spina bifida in the mouse. Author(s): Institute of Toxicology and Embryopharmacology, Free University of Berlin, FRG. Source: Ehlers, K Sturje, H Merker, H J Nau, H Dev-Pharmacol-Ther. 1992; 19(4): 196-204 0379-8305
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Time trends in neural tube defects prevalence in relation to preventive strategies: an international study. Author(s): International Centre for Birth Defects, Rome, Italy. Source: Rosano, A Smithells, D Cacciani, L Botting, B Castilla, E Cornel, M Erickson, D Goujard, J Irgens, L Merlob, P Robert, E Siffel, C Stoll, C Sumiyoshi, Y J-EpidemiolCommunity-Health. 1999 October; 53(10): 630-5 0143-005X
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Treatment of defecation disorders by colonic enemas in children with spina bifida. Author(s): Spina Bifida Team, University Children's Hospital, Utrecht, The Netherlands. Source: Scholler Gyure, M Nesselaar, C van Wieringen, H van Gool, J D Eur-J-PediatrSurg. 1996 December; 6 Suppl 132-4 0939-7248
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Use of folic acid for prevention of spina bifida and other neural tube defects--19831991. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 1991 August 2; 40(30): 513-6 0149-2195
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Valproate and spina bifida. Author(s): Addenbrooke's Hospital, Cambridge. Source: Oakeshott, P Hunt, G M BMJ. 1989 May 13; 298(6683): 1300-1 0959-8138
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Valproic acid sodium-induced spina bifida occulta in the rat. Author(s): Department of Histology and Embryology, Kocaeli University Medical Faculty, Turkey. Source: Ceylan, S Duru, S Ceylan, S Neurosurg-Revolume 2001 March; 24(1): 31-4 03445607
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Valproic acid-induced neural tube defects in mouse and human: aspects of chirality, alternative drug development, pharmacokinetics and possible mechanisms. Author(s): Institute of Toxicology and Embryopharmacology, Free University Berlin, Germany. Source: Nau, H Hauck, R S Ehlers, K Pharmacol-Toxicol. 1991 November; 69(5): 310-21 0901-9928
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What's new in the genetics of hydrocephalus and spina bifida? The Casey Holter Memorial Lecture 1993. Author(s): Regional Genetics Service, St. Mary's Hospital, Manchester, UK. Source: Donnai, D Eur-J-Pediatr-Surg. 1993 December; 3 Suppl 15-7 0939-7248
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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to spina bifida; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Folic Acid Source: Integrative Medicine Communications; www.drkoop.com Folic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,887,00.html Vitamin B9 (Folic Acid) Alternative names: Folate, Folic Acid Source: Integrative Medicine Communications; www.drkoop.com
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Minerals Folate Source: Integrative Medicine Communications; www.drkoop.com Folate Source: Prima Communications, Inc.www.personalhealthzone.com Gabapentin Source: Healthnotes, Inc.; www.healthnotes.com Iodine Source: Integrative Medicine Communications; www.drkoop.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND SPINA BIFIDA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to spina bifida. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to spina bifida and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “spina bifida” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to spina bifida: •
A case of congenital spina bifida: imprint of the defect of psychic development. Author(s): Parker B. Source: The International Journal of Psycho-Analysis. 1971; 52(3): 307-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4936557&dopt=Abstract
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Absorption of dietary and supplemental folate in women with prior pregnancies with neural tube defects and controls. Author(s): Neuhouser ML, Beresford SA, Hickok DE, Monsen ER. Source: Journal of the American College of Nutrition. 1998 December; 17(6): 625-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9853543&dopt=Abstract
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Altered bladder and bowel function following cutaneous electrical field stimulation in children with spina bifida--interim results of a randomized double-blind placebocontrolled trial. Author(s): Marshall DF, Boston VE.
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Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1997 December; 7 Suppl 1: 41-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9497117&dopt=Abstract •
Amelioration of sodium valproate-induced neural tube defects in mouse fetuses by maternal folic acid supplementation during gestation. Author(s): Padmanabhan R, Shafiullah MM. Source: Congenit Anom Kyoto. 2003 March; 43(1): 29-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692401&dopt=Abstract
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Clinical care of pregnant women with epilepsy: neural tube defects and folic acid supplementation. Author(s): Yerby MS. Source: Epilepsia. 2003; 44 Suppl 3: 33-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790884&dopt=Abstract
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Clinical consequences of spina bifida occulta. Author(s): Gregerson DM. Source: Journal of Manipulative and Physiological Therapeutics. 1997 October; 20(8): 546-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9345683&dopt=Abstract
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Colorectal dysfunction and faecal incontinence in children with spina bifida. Author(s): Ponticelli A, Iacobelli BD, Silveri M, Broggi G, Rivosecchi M, De Gennaro M. Source: British Journal of Urology. 1998 May; 81 Suppl 3: 117-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9634035&dopt=Abstract
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Decline of neural tube defects cases after a folic acid campaign in Nuevo Leon, Mexico. Author(s): Martinez de Villarreal L, Perez JZ, Vazquez PA, Herrera RH, Campos Mdel R, Lopez RA, Ramirez JL, Sanchez JM, Villarreal JJ, Garza MT, Limon A, Lopez AG, Barcenas M, Garcia JR, Dominguez AS, Nunez RH, Ayala JL, Martinez JG, Gonzalez MT, Alvarez CG, Castro RN. Source: Teratology. 2002 November; 66(5): 249-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397633&dopt=Abstract
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Epidemiology of neural tube defects. Author(s): Frey L, Hauser WA. Source: Epilepsia. 2003; 44 Suppl 3: 4-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790881&dopt=Abstract
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Evaluation of infant methylenetetrahydrofolate reductase genotype, maternal vitamin use, and risk of high versus low level spina bifida defects. Author(s): Volcik KA, Shaw GM, Lammer EJ, Zhu H, Finnell RH. Source: Birth Defects Research. Part A, Clinical and Molecular Teratology. 2003 March; 67(3): 154-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12797455&dopt=Abstract
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Experiences and critical comments on the temporary intravesical electrostimulation of the neurogenic bladder in spina bifida children. Author(s): Seiferth J, Heising J, Larkamp H. Source: Urologia Internationalis. 1978; 33(5): 279-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=360551&dopt=Abstract
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Factors associated with quality of life in adolescents with spina bifida. Author(s): Sawin KJ, Brei TJ, Buran CF, Fastenau PS. Source: Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association. 2002 September; 20(3): 279-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240958&dopt=Abstract
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Folate and neural tube defects. Recommendations from a Danish working group. Author(s): Rasmussen LB, Andersen NL, Andersson G, Lange AP, Rasmussen K, SkakIversen L, Skovby F, Ovesen L. Source: Dan Med Bull. 1998 April; 45(2): 213-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9587705&dopt=Abstract
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Folate status and neural tube defects. Author(s): Molloy AM, Mills JL, Kirke PN, Weir DG, Scott JM. Source: Biofactors (Oxford, England). 1999; 10(2-3): 291-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10609896&dopt=Abstract
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Folic acid and prevention of spina bifida and anencephaly. 10 years after the U.S. Public Health Service recommendation. Author(s): Erickson JD. Source: Mmwr. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports / Centers for Disease Control. 2002 September 13; 51(Rr-13): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353506&dopt=Abstract
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Homocysteine metabolism and effects of folic acid supplementation in patients affected with spina bifida. Author(s): Brouwer IA, van Dusseldorp M, Thomas CM, van der Put NM, Gaytant MA, Eskes TK, Hautvast JG, Steegers-Theunissen RP.
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Source: Neuropediatrics. 2000 December; 31(6): 298-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11508548&dopt=Abstract •
Inadequate folic acid intakes are prevalent among young women with neural tube defects. Author(s): Gross SM, Caufield LA, Kinsman SL, Ireys HT. Source: Journal of the American Dietetic Association. 2001 March; 101(3): 342-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11269615&dopt=Abstract
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Incidence of open neural tube defects in Nova Scotia after folic acid fortification. Author(s): Persad VL, Van den Hof MC, Dube JM, Zimmer P. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 August 6; 167(3): 241-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186168&dopt=Abstract
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Incidental spina bifida occulta in functional enuresis observed during laser reflexo therapy. Author(s): Kalra V, Palaksha HK. Source: Journal of Child Neurology. 1999 August; 14(8): 541-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10456767&dopt=Abstract
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Is dietary intake of methionine associated with a reduction in risk for neural tube defect-affected pregnancies? Author(s): Shaw GM, Velie EM, Schaffer DM. Source: Teratology. 1997 November; 56(5): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9451752&dopt=Abstract
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Lack of association between mutations in the folate receptor-alpha gene and spina bifida. Author(s): Barber RC, Shaw GM, Lammer EJ, Greer KA, Biela TA, Lacey SW, Wasserman CR, Finnell RH. Source: American Journal of Medical Genetics. 1998 April 1; 76(4): 310-7. Erratum In: Am J Med Genet 1998 September 23; 79(3): 231. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9545095&dopt=Abstract
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Management issues for women with epilepsy: neural tube defects and folic acid supplementation. Author(s): Yerby MS. Source: Neurology. 2003 September 1; 61(6 Suppl 2): S23-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14504306&dopt=Abstract
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Maternal vitamin use, genetic variation of infant methylenetetrahydrofolate reductase, and risk for spina bifida. Author(s): Shaw GM, Rozen R, Finnell RH, Wasserman CR, Lammer EJ. Source: American Journal of Epidemiology. 1998 July 1; 148(1): 30-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9663401&dopt=Abstract
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Neural tube defects and drinking water disinfection by-products. Author(s): Klotz JB, Pyrch LA. Source: Epidemiology (Cambridge, Mass.). 1999 July; 10(4): 383-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10401872&dopt=Abstract
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Neurogenic bladder and spina bifida occulta: a case report. Author(s): Borregard PE. Source: Journal of Manipulative and Physiological Therapeutics. 1987 June; 10(3): 122-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3302087&dopt=Abstract
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Neurogenic faecal incontinence in children with spina bifida: rectosphincteric responses and evaluation of a physiological rationale for management, including biofeedback conditioning. Author(s): Shepherd K, Hickstein R, Shepherd R. Source: Aust Paediatr J. 1983 June; 19(2): 97-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6354164&dopt=Abstract
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Over the cutting edge: how ethics consultation illuminates the moral complexity of open-uterine fetal repair of spina bifida and patients' decision making. Author(s): Bliton MJ, Zaner RM. Source: J Clin Ethics. 2001 Winter; 12(4): 346-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12026740&dopt=Abstract
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Premeditated assaults on young boys by a man with spina bifida and hydrocephalus-a cognitive-behavioural approach to treatment. Author(s): Houston JC. Source: Med Sci Law. 1992 April; 32(2): 133-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1535410&dopt=Abstract
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Promotion of folate for the prevention of neural tube defects: knowledge and use of periconceptional folic acid supplements in Western Australia, 1992 to 1995. Author(s): Bower C, Blum L, O'Daly K, Higgins C, Loutsky F, Kosky C. Source: Aust N Z J Public Health. 1997 December; 21(7): 716-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9489188&dopt=Abstract
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Psychosocial and cultural factors associated with the management of spina bifida cystica in Nigeria. Author(s): Oyewole A, Adeloye A, Adeyokunnu AA. Source: Developmental Medicine and Child Neurology. 1985 August; 27(4): 498-503. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4029520&dopt=Abstract
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Recommendations on the use of folic acid supplementation to prevent the recurrence of neural tube defects. Clinical Teratology Committee, Canadian College of Medical Geneticists. Author(s): Van Allen MI, Fraser FC, Dallaire L, Allanson J, McLeod DR, Andermann E, Friedman JM. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1993 November 1; 149(9): 1239-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8221478&dopt=Abstract
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Recurrence rates for neural tube defects and vitamin supplementation. Author(s): James WH. Source: Journal of Medical Genetics. 1981 August; 18(4): 249-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7024545&dopt=Abstract
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Severe neural tube defect syndrome from the Early Archaic of Florida. Author(s): Dickel DN, Doran GH. Source: American Journal of Physical Anthropology. 1989 November; 80(3): 325-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2686462&dopt=Abstract
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Spina bifida and folate. Author(s): Cumming FJ, Bradley S. Source: The Medical Journal of Australia. 1999 February 1; 170(3): 144. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065136&dopt=Abstract
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Spina bifida occulta mimicking a destructive lesion. Author(s): DeBono V, Marchiori DM. Source: Journal of Manipulative and Physiological Therapeutics. 1998 July-August; 21(6): 419-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9726070&dopt=Abstract
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Spina bifida: the personal and financial cost of incontinence. Author(s): White M. Source: British Journal of Nursing (Mark Allen Publishing). 1993 December 9-1994 January 12; 2(22): 1123-4, 1126-30; Discussion 1130-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8281028&dopt=Abstract
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The unnecessary epidemic of folic acid-preventable spina bifida and anencephaly. Author(s): Campbell RK. Source: Pediatrics. 2001 October; 108(4): 1048-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589212&dopt=Abstract
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Treatment of faecal incontinence in children with spina bifida by biofeedback and behavioural modification. Author(s): Pappo I, Meyer S, Winter S, Nissan S. Source: Z Kinderchir. 1988 December; 43 Suppl 2: 36-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3213249&dopt=Abstract
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Treatment of fecal incontinence in children with spina bifida: comparison of biofeedback and behavior modification. Author(s): Whitehead WE, Parker L, Bosmajian L, Morrill-Corbin ED, Middaugh S, Garwood M, Cataldo MF, Freeman J. Source: Archives of Physical Medicine and Rehabilitation. 1986 April; 67(4): 218-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3964054&dopt=Abstract
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Use of folic acid supplementation in the periconceptional period provides great promise for the primary prevention of the neural tube defects (NTDs), anencephaly, and spina bifida. Author(s): Sever LE. Source: Journal of Nurse-Midwifery. 1992 September-October; 37(5): 350. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1403181&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to spina bifida; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Anemia Source: Integrative Medicine Communications; www.drkoop.com Birth Defects Prevention Source: Healthnotes, Inc.; www.healthnotes.com Pregnancy and Postpartum Support Source: Healthnotes, Inc.; www.healthnotes.com Pyloric Stenosis Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements Anticonvulsants Source: Healthnotes, Inc.; www.healthnotes.com Methionine Source: Healthnotes, Inc.; www.healthnotes.com Valproic Acid Source: Healthnotes, Inc.; www.healthnotes.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON SPINA BIFIDA Overview In this chapter, we will give you a bibliography on recent dissertations relating to spina bifida. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “spina bifida” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on spina bifida, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Spina Bifida ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to spina bifida. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Description of Attitudes, Interests, and Knowledge about Careers and Selected Personality Characteristics in a Group of Spina Bifida Adolescents by Gobble, Eva Marie Robinson, PhD from University of Pittsburgh, 1980, 195 pages http://wwwlib.umi.com/dissertations/fullcit/8112672
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A Preliminary Study of Family Coping Behaviors and the Timing of Diagnosis of Spina Bifida by Anderson, Susan Delaine; PhD from The Florida State University, 2000, 131 pages http://wwwlib.umi.com/dissertations/fullcit/9971733
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Adults with Spina Bifida: Relational Reciprocity Within the Family (Disabled Adults, Adult Children) by Shirley, Karen J., PhD from Temple University, 1992, 206 pages http://wwwlib.umi.com/dissertations/fullcit/9227524
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An Exploratory Study of the Childhood and Adolescent Play and Fantasy of Four Adults Who Have Spina Bifida Manifesta by Carbonara, Nancy Trevorrow, PhD from University of Pittsburgh, 1983, 1002 pages http://wwwlib.umi.com/dissertations/fullcit/8411830
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An Investigation into the Effects of a Child with Spina Bifida on the Family As Perceived by Mothers by Singh, Delar Kour, PhD from University of Pittsburgh, 1990, 346 pages http://wwwlib.umi.com/dissertations/fullcit/9106785
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An Investigation of the Concept of Cardinality in Children with Spina Bifida by Bowman, James G; PhD from York University (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL35818
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Context Effects on the Intrinsic Dynamics of Infants with Spina Bifida (SB) by Chapman, David D.; PhD from Indiana University, 1997, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9942903
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Coping, Functioning, and Satisfaction in Families with a Spina Bifida Child of School Age (Chronic Illness) by Johnson-Russell, Judith Mary, EDD from East Texas State University, 1992, 196 pages http://wwwlib.umi.com/dissertations/fullcit/9235096
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Developmental Achievement in Latency-aged Spina Bifida Children by Johnson, Allen Frank, DSW from Smith College School for Social Work, 1979, 240 pages http://wwwlib.umi.com/dissertations/fullcit/8005318
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Idiom Comprehension: Typical Development, and Atypical Function and Relations with Corpus Callosum Dysmorphology in Children with Spina Bifida and Hydrocephalus by Huber Okrainec, Joelene Frieda Harder, PhD from University of Toronto (Canada), 2003, 232 pages http://wwwlib.umi.com/dissertations/fullcit/NQ78051
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Included Alone: an Exploratory Study of the Education Experiences of Students with Spina Bifida, Their Parents, and Teachers by Fine, Doris Landau; PhD from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 2001, 368 pages http://wwwlib.umi.com/dissertations/fullcit/3015036
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Increasing Compliance to Urinary Self-Care Procedures by Adolescents with Spina Bifida by Grame, Carolyn Jo (Carter), PhD from Washington University, 1984, 235 pages http://wwwlib.umi.com/dissertations/fullcit/8418737
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Locus of Control and Family Dynamics in Parents of Children with Spina Bifida by D'Arca, Rick J., PhD from The University of Toledo, 1997, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9816874
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Mathematics Achievement and Cognitive Factors in Spina Bifida Children with Hydrocephalus by Tuleya-Payne, Helena, DED from The Pennsylvania State University, 1983, 172 pages http://wwwlib.umi.com/dissertations/fullcit/8320940
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Pain in Children with Spina Bifida: The Associations with Locus of Control, Depression, and Quality of Life by Clancy, Christine Anne, PhD from University of Toronto (Canada), 2003, 112 pages http://wwwlib.umi.com/dissertations/fullcit/NQ78369
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Parent Ratings of Quality of Life in Children and Adolescents with and without Spina Bifida by Cook, Carolyn R., PhD from The University of North Carolina at Chapel Hill, 2003, 96 pages http://wwwlib.umi.com/dissertations/fullcit/3086512
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Parental Coping in Raising Children Who Have Spina Bifida Cystica. by Nevin, Robert Samuel, PhD from University of Minnesota, 1978, 184 pages http://wwwlib.umi.com/dissertations/fullcit/7912057
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Perception of Musical Rhythm and Pitch in Children and Adolescents with Spina Bifida and Hydrocephalus by Misakyan, Talar Mary, MA from University of Toronto (Canada), 2003, 33 pages http://wwwlib.umi.com/dissertations/fullcit/MQ78251
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Quality of Life of Adults with Spina Bifida: An Issue of Equality (Australia) by Bowles, Wendy Lyn, PhD from University of New South Wales (Australia), 1996 http://wwwlib.umi.com/dissertations/fullcit/f304419
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Retinoic Acid-Induced Spina Bifida Early Events by Griffith, C. May; PhD from University of Toronto (Canada), 1990 http://wwwlib.umi.com/dissertations/fullcit/NL56951
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Survival of the Fittest: Treatment Issues Involving Newborns with Mental and Physical Handicaps Especially Down Syndrome and Spina Bifida (Mental Handicaps, Medical Ethics) by Haunss, Charles Edward, EDD from Columbia University Teachers College, 1991, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9210537
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The Developmental Progression of Play Behaviors in Handicapped and NonHandicapped Children Ages 9, 13 and 18 Months (Infant, Movement, Spina Bifida) by Rakoff, Ann R., EDD from Columbia University Teachers College, 1984, 163 pages http://wwwlib.umi.com/dissertations/fullcit/8411287
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The Effect of a Child with Spina Bifida on the Family: A System's Theory Approach by Gobble, John Theodore, Jr., PhD from University of Pittsburgh, 1981, 165 pages http://wwwlib.umi.com/dissertations/fullcit/8202332
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The Effect of Frequent Computer Play on Eye-Hand Coordination Skills of Young Children with Spina Bifida by Miller, Pamela Ruth, EDD from The Johns Hopkins University, 2002, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3046518
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The Efficacy of Two Familial Models in the Prediction of Adherence in PreAdolescents with Spina Bifida by Hommeyer, Jennifer Schneider, PhD from Loyola University of Chicago, 2003, 141 pages http://wwwlib.umi.com/dissertations/fullcit/3085083
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The Problems Experienced by Children with Genetic Impairments, with Particular Reference to Spina Bifida, and by Their Parents and Teachers. (Afrikaans Text) by Urbani, Giovanni, DED from University of South Africa (South Africa), 1981 http://wwwlib.umi.com/dissertations/fullcit/f483222
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The Relationship among Severity of Illness, Functional Status, and Health-Related Quality of Life in Youth with Spina Bifida by Leger, Robin R., PhD from New York University, 2003, 164 pages http://wwwlib.umi.com/dissertations/fullcit/3086913
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The Relationship among Social Background, Family Support, Autonomy, and Life Satisfaction of Adults with Spina Bifida by Dehart, Panzy Hawk, PhD from New York University, 1999, 123 pages http://wwwlib.umi.com/dissertations/fullcit/9922544
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Upper Extremity Responses of Children with Spina Bifida Exhibiting Different Ambulatory Abilities to Visual and Auditory Stimuli (Visual Stimuli) by Evaggelinou, Christina, PhD from The University of Toledo, 1990, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9112966
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND SPINA BIFIDA Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning spina bifida.
Recent Trials on Spina Bifida The following is a list of recent trials dedicated to spina bifida.8 Further information on a trial is available at the Web site indicated. •
Genetics of Spina Bifida Condition(s): Spina Bifida Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: The purpose of this study is to describe the genetic design and structure of spina bifida (SB), which includes identifying patients, defining the roles of certain genes and gene-environment interactions, and identifying variants of SB susceptibility loci (sites on a chromosome where the gene for a trait is located). Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031122
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Sirolimus to Prevent GVHD after Stem Cell Transplant for Blood Cancers Condition(s): Hematologic Neoplasms; Neural Tube Defects; Myeloproliferative Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI)
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These are listed at www.ClinicalTrials.gov.
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Purpose - Excerpt: This study will investigate the safety and effectiveness of a modified stem cell transplant procedure for treating cancers of the blood and immune system. Patients with these cancers can sometimes benefit greatly from, and even be cured by, transplants of stem cells (cells produced by the bone marrow that mature into blood cells). In addition to producing new bone marrow and restoring normal blood production and immunity, the donated cells fight any residual tumor cells that might have remained in the body, in what is called a graft-versus-leukemia effect. However, severe problems, and sometimes death, may follow these transplants as a result of the high-dose chemotherapy and radiation that accompany the procedure. Also, donated immune system cells called T-cells sometimes attack healthy tissues in a reaction called graft-versus-host-disease (GVHD), damaging organs such as the liver, intestines and skin. This study will use the following strategies to try to improve the outcome of stem cell transplants: -Patients will receive "non-myeloblative" chemotherapy that is easier for the body to tolerate (I think this last phrase should be deleted, as the period of immune suppression we use is similar to that conventionally utilized) -Patients will be randomly assigned to one of the following treatments to try to reduce the risk of developing serious GVHD: 1. Cyclosporin A plus Th2 cells (donated immune cells grown in a high concentration of an immune suppression drug called sirolimus); or 2. Cyclosporin A plus sirolimus treatment in tablet form; or 3. Cyclosporin A plus Th2 cells plus sirolimus treatment in tablet form. Patients between 18 and 75 years of age with non-Hodgkin's lymphoma, Hodgkin's lymphoma, multiple myeloma, chronic lymphocytic leukemia, chronic myelogenous leukemia, acute myelogenous leukemia, acute lymphocytic leukemia, myelodysplastic syndrome, and myeloproliferative disorders may be eligible for this study. Candidates will be screened with physical examinations, diagnostic tests, and consultations with various specialists. Participants will have a central venous line placed into a major vein. This tube can stay in the body and be used the entire treatment period to deliver the donated stem cells and give medications, including chemotherapy and other drugs, antibiotics, and blood transfusions, and to withdraw blood samples. Treatment will start with chemotherapy, which will include the drugs fludarabine, cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone. Some patients may also receive an antibody called rituximab. Patients will receive one to three cycles of this treatment, depending on their response to the drugs. (One cycle consists of 4 days on drug therapy followed by a 17-day rest period.) Several days before the transplant procedure, patients will receive additional chemotherapy with cyclophosphamide and fludarabine, and 3 days later, the donor's stem cells will be infused. To help prevent GVHD, all patients will receive cyclosporine therapy for 6 months, beginning the day before the transplant. Depending on their treatment group, patients will also receive either: 1) Th2 cells the day after the transplant, 2) 4 days of sirolimus tablets, or 3) Th2 cells plus 4 days of sirolimus tablets. The average hospital stay for stem cell transplantation is 3 to 4 weeks. After discharge, patients will return for frequent followup visits for the first 3 months. Monthly visits will be scheduled for the next 3 months, then every 3 months for the next 18 months, and less frequently for a total of at least 5 years post-transplant. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00074490
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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 “spina bifida” (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/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON SPINA BIFIDA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “spina bifida” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on spina bifida, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Spina Bifida By performing a patent search focusing on spina bifida, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on spina bifida: •
Compositions, methods and kits relating to remodel Inventor(s): Friesel; Robert E. (Cape Elizabeth, ME), Lindner; Volkhard (South Portland, ME) Assignee(s): Maine Medical Center Research Institute (scarborough, Me) Patent Number: 6,630,325 Date filed: October 19, 2000 Abstract: The invention relates to novel nucleic acids encoding a mammalian adventitia inducible and bone expressed gene designated REMODEL, and proteins encoded thereby, whose expression is increased in certain diseases, disorders, or conditions, including, but not limited to, negative remodeling, arterial restenosis, vessel injury, ectopic ossification, fibrosis, and the like. REMODEL also plays a role in cell-cell and cell-matrix adhesion, bone density, bone formation, dorsal closure, and is associated with spina bifida-like phenotype. The invention further relates to methods of treating and detecting these diseases, disorders or conditions, comprising modulating or detecting REMODEL expression and/or production of REMODEL polypeptide. Excerpt(s): The present invention relates to identifying novel processes involved in mediating arterial remodeling. Arterial stenosis with reduction in blood flow is a common problem in many vascular diseases. Several growth factors have been implicated in the mechanisms leading to vascular stenosis. For instance, fibroblast growth factor 2 (FGF-2) has been identified as an important factor in mediating proliferation of smooth muscle cells leading to intimal lesion formation. Furthermore, it has been demonstrated that arterial stenosis in response to angioplasty is largely due to negative remodeling as a result of adventitial fibrosis. As more fully set forth below, transforming growth factor beta (TGF-.beta.) signaling has been demonstrated to play an important role in arterial stenosis in that, among other things, inhibition of TGF-.beta. signaling using a soluble TGF-.beta. receptor type II dramatically reduced lumen narrowing by decreasing negative remodeling and adventitial matrix deposition as well by decreasing neointima formation. These results indicate the crucial role of TGF-.beta. signaling in arterial response to injury. Vascular remodeling is a response of blood vessels to both physiological and pathological stimuli, leading to either vessel enlargement (positive remodeling) or shrinkage (negative remodeling). It has been demonstrated that neointimal proliferation or intimal mass following angioplasty shows little correlation with restenosis because of permanent changes in vascular geometry (Kakuta et al., 1994, Circulation 89:2809-2815; Nunes et al., 1995, Arterioscler. Thromb. Vasc. Biol. 15:156-165). Negative remodeling has been shown to account for most of the restenosis process (Mintz et al., 1993, Circulation 88:1-654), and is now generally considered the predominant cause of restenosis. A successful therapeutic approach to restenosis, therefore, would target negative vascular remodeling. Web site: http://www.delphion.com/details?pn=US06630325__
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Image processing system and method Inventor(s): Donath; Erwin (Princeton, NJ), Weiss; Theodore F. (Quakertown, PA) Assignee(s): Base Ten Systems, Inc. (trenton, Nj) Patent Number: 5,740,266 Date filed: April 15, 1994 Abstract: A method and system for processing a digital image of an object comprises forming a single pixel image outline of the object in a digital image and producing a measure of the outline shape as a single number. In this way risk of spina bifida can be determined from an ultrasonic image of a fetal skull. Excerpt(s): The present invention relates to image processing, and in particular, to the processing of medical images for subsequent evaluation. A number of techniques are currently available for the imaging of internal parts of the body, e.g., X-ray imaging, magnetic resonance imaging (MRI), ultrasonic imaging, computer aided tomography (CAT), positron emission tomography (PET), etc. In most cases, a "hard" copy of the image is produced and is directly evaluated by a clinician who, in some cases, may be required to evaluate the size or shape of an object in the image to determine an abnormality. It has been found that it would be desirable to be able to evaluate the images automatically, particularly when the evaluation is one of size or shape. Web site: http://www.delphion.com/details?pn=US05740266__
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Low pressure infant seat for normally seating infants with meningomyelocele or other sensitive back deformities Inventor(s): Hawks; Gail B. (4615A Walden Pond Dr., Raleigh, NC 27604) Assignee(s): None Reported Patent Number: 4,291,917 Date filed: September 19, 1979 Abstract: The present invention relates to an infant seat that is particularly adapted to be used for infants with the condition known as spina bifida (open spine), with attention to the related meningocele or meningomyelocele. The infant seat is comprised of a device molded to allow the infant to be maintained in a sitting or supine position without pressure to the above mentioned defect. The lower porton of the device is composed of an open area generally in the shape of a square, across which a detachable mesh insert can be stretched and secured to snaps. Safety straps for securing the infant in the seat are utilized. An adjustable bracing device is attached to the back of the seat for the purpose of adjusting to and maintaining various positions. Excerpt(s): The present invention relates to orthopedic devices, and more particularly to a low pressure infant seat adapted to be utilized for normally seating infants with meningomyelocele or other sensitive back deformities. Infant seats have been used in the past for the purpose of transporting and/or maintaining infants in sitting positions or lying on their backs. For example, see the disclosures found in U.S. Pat. Nos. 3,320,949, 3,747,759, 3,834,759, 3,949,435, 3,974,827, 3,992,056. Infants who are born with the condition of spina bifida with the associated meningocele or menimgomyelocele are not able to tolerate pressure on these areas, and are therefore restricted in respect to positions of comfort. Generally, these infants must be cared for while lying on their
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sides or stomachs. These positions do not generally avail themselves to transportation or care of the infant in a regular infant seat. Web site: http://www.delphion.com/details?pn=US04291917__ •
Orthopedic bracing mechanism for facilitating hip reciprocation Inventor(s): Poplawski; Christopher (3600 Haven Ave. #1, Redwood City, CA 94063) Assignee(s): None Reported Patent Number: 5,320,590 Date filed: December 15, 1992 Abstract: An orthopedic bracing device worn around the posterior pelvic area of a person suffering from severe lower extremity weakness such as found with certain spinal cord injuries resulting in paraplegia. Children born with Spina Bifida who are paraplegics are also potential users of this type of brace. This device is a mechanism whereby the user is forced to extend one hip joint backwards when the other hip joint is flexed forward, thus generating the normal walking pattern of reciprocation. The mechanism consists of two pivot bars with their pivot point located equidistant from the center of the pelvic band. Two lever arms extend from each pivot point. The longer lever arm curves around towards the mechanical hip joint of the brace and attaches through a semi-rigid linkage system. The shorter lever arm extends downwards and attaches to an adjustable connecter bar. The connecter bar joins the two identical pivot bars. As one leg steps forward, forces are transferred through the mechanism forcing the other leg to extend backwards. Excerpt(s): The present invention relates to externally worn orthopedic appliances for facilitating walking and standing by persons with severe lower extremity weakness and particularly to apparatus designed to coordinate the reciprocal flexion and extension of the hip joints during walking. This application is related to application Ser. No. 375,210 filed Jun. 30, 1989, now U.S. Pat. No. 4,964,628, granted Oct. 23, 1990. Heretofore, the mobility of the paraplegic person was accomplished with the assistance of numerous devices, all designed to provide stability and limited mobility to the weakened joints of the lower extremity. These devices all try to maximize stability and allow reciprocation with the least amount of friction, bulk and weight. The "LSU Reciprocating Gait Orthosis" by Durr-Fillauer Medical, Inc. of Chattanooga, Tenn. was the system of choice for many years. The disadvantages of the above-mentioned system revolve around the cable mechanism. Substantial friction is generated as the cables slip back and forth through their housings. Another disadvantage of the cable system is its requirement for high maintenance. Alignment between the cables and their attachment to the hip joints must be pro-fessionally maintained to prevent increased friction and eventual breakage. The required lubrication of the cables within their housings can create oily residues that are unsightly and difficult to clean. Web site: http://www.delphion.com/details?pn=US05320590__
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Therapeutic apparatus for physically impaired children Inventor(s): Richardson; Beverly J. (17 W. 173 Oak La., Bensenville, IL 60106) Assignee(s): None Reported Patent Number: 5,038,761 Date filed: April 2, 1990 Abstract: A therapeutic device for embracing each of the lower legs of a child having neurological, muscular and skeletal impairment generally caused by congential disorders such as cerebral palsy, down syndrome, spina bifida and the like. The structure of the device promotes proper symmetrical alignment of the child's pelvis and lower extremities to program the child into more normal positioning and movement patterns of both the lower and upper body extremities. A single pair of the devices is adapted for children of varying ages and physical sizes. Excerpt(s): This invention relates to therapeutic apparatus for a physically impaired child, and more particularly to an apparatus for use by children who have neurological disorders resulting in impairment of their muscular-skeletal structures and of their bodily motor capabilities. The present invention provides a therapeutic aid for children suffering from muscular-motor afflictions generally congenital in nature. Typical of such congenital disorders are cerebral palsy, Down syndrome and spina bifida which may affect one or both sides of the body in varying degrees. Children afflicted with such diseases generally have impaired neurological capabilities and responses, weak muscle tone impairing normal physical bodily movements, mental retardation in some instances, and poor weight bearing patterns resulting in lack of stability and lack of normal symmetrical posture necessary for normal patterns of movement. Many of such children need ankle-foot-orthoses (AFO's) to correct muscular skeletal misalignments of the lower extremities including the foot, ankle and lower leg. Each afflicted child has a constant battle with the force of gravity because his muscular, motor and skeletal capabilities are deficient in controlling the center of gravity of his body in a normal manner. Additionally, this position tends to immobilize the child and prevents enjoyment of play activities; it frequently leads to further hip, knee, ankle and foot deformities; and it positions the child's back in a stooped, misaligned posture with the neck hyperextended and the shoulders rounded forwardly. Heretofore, there has not been any equipment, aid or device to assist the pediatric physical therapist in correcting and helping with this persistent problem so that the child can independently partake in the planned program of play without constant attention of a physical therapist or other attendant. Web site: http://www.delphion.com/details?pn=US05038761__
Patent Applications on Spina Bifida As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to spina bifida:
10
This has been a common practice outside the United States prior to December 2000.
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Compositions, methods and kits relating to REMODELIN Inventor(s): Friesel, Robert E.; (Cape Elizabeth, ME), Lindner, Volkhard; (South Portland, ME) Correspondence: Morgan, Lewis & Bockius Llp; 1701 Market Street; Philadelphia; PA; 19103-2921; US Patent Application Number: 20020161211 Date filed: October 19, 2001 Abstract: The invention relates to novel nucleic acids encoding a mammalian adventitia inducible and bone expressed gene designated REMODEL, and proteins encoded thereby, whose expression is increased in certain diseases, disorders, or conditions, including, but not limited to, negative remodeling, arterial restenosis, vessel injury, ectopic ossification, fibrosis, and the like. REMODELIN also plays a role in cell-cell and cell-matrix adhesion, bone density, bone formation, dorsal closure, bone mineralization, calcification/ossification, and is associated with spina bifida-like phenotype. In addition, the invention relates to affecting REMODELIN expression by administration of TGF-.beta. and control of cellular gene expression using REMODELIN. The invention further relates to methods of treating and detecting these diseases, disorders or conditions, comprising modulating or detecting REMODELIN expression and/or production of REMODELIN polypeptide. Excerpt(s): The present application is a continuation-in-part of U.S. patent application Ser. No. 09/692,081, filed on Oct. 19, 2000, from which it is entitled priority under 35 U.S.C.sctn.120. The present invention relates to identifying novel processes involved in mediating arterial remodeling and formation of bone and cartilage. Arterial stenosis with reduction in blood flow is a common problem in many vascular diseases. Several growth factors have been implicated in the mechanisms leading to vascular stenosis. For instance, fibroblast growth factor 2 (FGF-2) has been identified as an important factor in mediating proliferation of smooth muscle cells leading to intimal lesion formation. Furthermore, it has been demonstrated that arterial stenosis in response to angioplasty is largely due to negative remodeling as a result of adventitial fibrosis. As more fully set forth below, transforming growth factor beta (TGF-.beta.) signaling has been demonstrated to play an important role in arterial stenosis in that, among other things, inhibition of TGF-.beta. signaling using a soluble TGF-.beta. receptor type II dramatically reduced lumen narrowing by decreasing negative remodeling and adventitial matrix deposition as well by decreasing neointima formation. These results indicate the crucial role of TGF-.beta. signaling in arterial response to injury. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with spina bifida, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “spina bifida” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on spina bifida.
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You can also use this procedure to view pending patent applications concerning spina bifida. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON SPINA BIFIDA Overview This chapter provides bibliographic book references relating to spina bifida. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on spina bifida include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “spina bifida” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on spina bifida: •
Bowel Continence and Spina Bifida Source: Washington, DC: Spina Bifida Association of America. 1995. 53 p. Contact: Available from Spina Bifida Association of America. 4590 MacArthur Boulevard, NW, Suite 250, Washington, DC 20007-4226. (202) 944-3285. Fax (202) 9443295. PRICE: Single copy free. Summary: This booklet is designed to help parents, caregivers, and people with spina bifida understand bowel continence and how people with spina bifida can achieve it. The authors emphasize the need for ongoing assessment of bowel continence status through life. The booklet has three sections: an overview of bowel continence programs and goals for those programs, bowel management by development (infancy through adulthood), and bowel management techniques. Components of a bowel program covered include bowel cleanout, keeping records, determining readiness, balancing diet and fluids, and the role of regular exercise. Bowel management techniques discussed
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include types of programs (enemas, suppositories, habit-training, and digital stimulation), medications, behavioral aspects, constipation and diarrhea, independence, and the consequences of not having a bowel program. The authors emphasize that a bowel program that is effective for one person may not work well for another. The appropriate program will aid the bowel to empty at regular intervals and keep accidents and constipation to a minimal level. The booklet includes an appendix (reminder sheet, sample menus, bowel tracking sheet, behavior management calendar), a glossary of terms, and a bibliography of related materials. 5 figures. 13 references. (AA-M).
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 “spina bifida” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “spina bifida” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “spina bifida” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Guide for Helping the Child With Spina Bifida by Myers; ISBN: 039804113X; http://www.amazon.com/exec/obidos/ASIN/039804113X/icongroupinterna
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A Parent's Guide to Spina Bifida (University of Minnesota Guides to Birth and Childhood Disorders) by Beth-Ann Bloom, et al; ISBN: 0816614865; http://www.amazon.com/exec/obidos/ASIN/0816614865/icongroupinterna
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A Parent's Guide to the Screening Test for Spina Bifida and Down's Syndrome: A Blood Test You Can Choose to Have During Your Pregnancy; ISBN: 1902030737; http://www.amazon.com/exec/obidos/ASIN/1902030737/icongroupinterna
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Anencephalus, spina bifida and congenital hydrocephalus, England and Wales 19641972 by Stephen Clifford Rogers; ISBN: 0116905514; http://www.amazon.com/exec/obidos/ASIN/0116905514/icongroupinterna
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By for and With Young Adults With Spina Bifida by Betty Peiper; ISBN: 0318175827; http://www.amazon.com/exec/obidos/ASIN/0318175827/icongroupinterna
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Caring for the Child With Spina Bifida by John P Lubicky (Editor), et al; ISBN: 0892032375; http://www.amazon.com/exec/obidos/ASIN/0892032375/icongroupinterna
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Child With Spina Bifida by Betty Pieper; ISBN: 0318166097; http://www.amazon.com/exec/obidos/ASIN/0318166097/icongroupinterna
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Children with Spina Bifida at School: A Booklet for Teachers and Students by Association for Spina Bifida and Hydroce; ISBN: 0950130478; http://www.amazon.com/exec/obidos/ASIN/0950130478/icongroupinterna
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Children With Spina Bifida: A Parent's Guide (The Special Needs Collection) by Marlene Lutkenhoff (Editor), Marlene Lutkenhof (Editor); ISBN: 0933149603; http://www.amazon.com/exec/obidos/ASIN/0933149603/icongroupinterna
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Children With Spina Bifida: Early Intervention and Preschool Programming by G. Gordon Williamson (Photographer), Margery Szczepanski (Photographer); ISBN:
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0933716710; http://www.amazon.com/exec/obidos/ASIN/0933716710/icongroupinterna •
Christal: Coping With Spina Bifida by Karen Snyder Travis; ISBN: 0828320624; http://www.amazon.com/exec/obidos/ASIN/0828320624/icongroupinterna
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Comprehensive Management of Spina Bifida by Harold L. Rekate (Editor); ISBN: 0849301513; http://www.amazon.com/exec/obidos/ASIN/0849301513/icongroupinterna
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Congenital Disorders Sourcebook: Basic Information About Disorders Acquired During Gestation, Including Spina Bifida, Hydrocephalus, Cerebral Palsy, Heart Defects, Craniofacial abnorm (Health Reference Series, Vol 29) by Karen Bellenir (Editor); ISBN: 0780802055; http://www.amazon.com/exec/obidos/ASIN/0780802055/icongroupinterna
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Current Concepts in Spina Bifida and Hydrocephalus by Carys M. Bannister (Author), Brian Bannister (Author); ISBN: 0901260916; http://www.amazon.com/exec/obidos/ASIN/0901260916/icongroupinterna
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Decision Making and the Defective Newborn: Proceedings of a Conference on Spina Bifida and Ethics by Springfiel; ISBN: 0398036624; http://www.amazon.com/exec/obidos/ASIN/0398036624/icongroupinterna
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Epidemiology of Anencephalus and Spina Bifida (Oxford Medical Publications) by J. Mark Elwood, J. Harold Elwood; ISBN: 0192612204; http://www.amazon.com/exec/obidos/ASIN/0192612204/icongroupinterna
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Growing up with spina bifida by Olwen Nettles; ISBN: 0950166413; http://www.amazon.com/exec/obidos/ASIN/0950166413/icongroupinterna
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Guide lines for social workers working with sufferers from spina bifida or hydrocephalus; ISBN: 0900102020; http://www.amazon.com/exec/obidos/ASIN/0900102020/icongroupinterna
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Handbook of Spina Bifida by Singh; ISBN: 1565932048; http://www.amazon.com/exec/obidos/ASIN/1565932048/icongroupinterna
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I Have Spina Bifida (One World) by Brenda Pettenuzzo, et al; ISBN: 0863135625; http://www.amazon.com/exec/obidos/ASIN/0863135625/icongroupinterna
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Living with Spina Bifida : A Guide for Families and Professionals by M.D. Adrian Sandler (Author); ISBN: 0807855472; http://www.amazon.com/exec/obidos/ASIN/0807855472/icongroupinterna
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Living With Spina Bifida: Speaking Out About My Disability by Larry E. Appelmann; ISBN: 1553950690; http://www.amazon.com/exec/obidos/ASIN/1553950690/icongroupinterna
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Prevention of Spina Bifida and Other Neural Tube Defects by John Dobbing (Editor); ISBN: 0122188608; http://www.amazon.com/exec/obidos/ASIN/0122188608/icongroupinterna
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Social implications of spina bifida : a study in S.E. Scotland by Margaret F. Woodburn; ISBN: 0950166421; http://www.amazon.com/exec/obidos/ASIN/0950166421/icongroupinterna
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Spina bifida by Theodor Michael (Author), et al; ISBN: 3110150409; http://www.amazon.com/exec/obidos/ASIN/3110150409/icongroupinterna
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Spina Bifida by Satoshi Matsumoto (Editor), H. Sato (Editor); ISBN: 4431702601; http://www.amazon.com/exec/obidos/ASIN/4431702601/icongroupinterna
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Spina Bifida and the Total Care of Spinal Myelomenin by Smith Ed; ISBN: 0398017859; http://www.amazon.com/exec/obidos/ASIN/0398017859/icongroupinterna
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Spina Bifida for the Clinician by G. Bocklehurst (Author), et al; ISBN: 0901260479; http://www.amazon.com/exec/obidos/ASIN/0901260479/icongroupinterna
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Spina Bifida for the Clinician (Clinics in Developmental Medicine Series, Col 57) by Gordon Brocklehurst (Editor); ISBN: 0433044101; http://www.amazon.com/exec/obidos/ASIN/0433044101/icongroupinterna
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Spina Bifida Occulta: Orthopedic, Radiologic and Neurosurgical Aspects by Christopher Compton Michael; ISBN: 0127921621; http://www.amazon.com/exec/obidos/ASIN/0127921621/icongroupinterna
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Spina Bifida: A Multidisciplinary Approach by Robert L. McLaurin (Author), et al; ISBN: 027592100X; http://www.amazon.com/exec/obidos/ASIN/027592100X/icongroupinterna
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Spina Bifida: Problems and Management by G. D. Stark; ISBN: 0632001585; http://www.amazon.com/exec/obidos/ASIN/0632001585/icongroupinterna
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Spina Bifida: The Treatment and Care of Spina Bifida Children by Nancy. Allum; ISBN: 0046180141; http://www.amazon.com/exec/obidos/ASIN/0046180141/icongroupinterna
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Spina Bifida--Neural Tube Defects: Basic Research, Interdisciplinary Diagnostics and Treatment, Results, and Prognosis by D. Voth, et al; ISBN: 0899251498; http://www.amazon.com/exec/obidos/ASIN/0899251498/icongroupinterna
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Spinabilities: A Young Person's Guide to Spina Bifida by Marlene Lutkenhoff (Editor), Sonya G., Md.d Oppenheimer (Editor); ISBN: 0933149867; http://www.amazon.com/exec/obidos/ASIN/0933149867/icongroupinterna
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Spinal dysraphism: spina bifida occulta by Christopher Compton Michael James; ISBN: 0407398708; http://www.amazon.com/exec/obidos/ASIN/0407398708/icongroupinterna
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Teaching the Student With Spina Bifida by Fern L. Rowley-Kelly (Editor), et al; ISBN: 1557660646; http://www.amazon.com/exec/obidos/ASIN/1557660646/icongroupinterna
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The child with spina bifida by Rosemary Dinnage; ISBN: 0700510230; http://www.amazon.com/exec/obidos/ASIN/0700510230/icongroupinterna
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The Child with Spina Bifida by Elizabeth Anderson, Bernie Spain; ISBN: 0416559107; http://www.amazon.com/exec/obidos/ASIN/0416559107/icongroupinterna
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The Child with Spina Bifida: Social, Emotional and Educational Adjustment: An Annotated Bibliography (Report) by Doria Pilling; ISBN: 0856330213; http://www.amazon.com/exec/obidos/ASIN/0856330213/icongroupinterna
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The Official Parent's Sourcebook on Spina Bifida: A Revised and Updated Directory for the Internet Age by Health Publica Icon Health Publications; ISBN: 0597837252; http://www.amazon.com/exec/obidos/ASIN/0597837252/icongroupinterna
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The Spina Bifida Baby by Olwen Nettles; ISBN: 0950166405; http://www.amazon.com/exec/obidos/ASIN/0950166405/icongroupinterna
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VA spina bifida healthcare benefits : healthcare benefits for Vietnam veterans' children with spina bifida (SuDoc VA 1.2:SP 4/4) by U.S. Dept of Veterans Affairs; ISBN: B00010VO5Y; http://www.amazon.com/exec/obidos/ASIN/B00010VO5Y/icongroupinterna
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What You Should Know About Your Child With Spina Bifida by Mark L. Wolraich, Marcia Henderson Lozes (Editor); ISBN: 9996424723; http://www.amazon.com/exec/obidos/ASIN/9996424723/icongroupinterna
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Your child with spina bifida: a practical guide to parents by John Lorber; ISBN: 0950130419; http://www.amazon.com/exec/obidos/ASIN/0950130419/icongroupinterna
Chapters on Spina Bifida In order to find chapters that specifically relate to spina bifida, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and spina bifida using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “spina bifida” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on spina bifida: •
Neurological Disorders Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 336-373. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail:
[email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: Dental staff should be able to recognize abnormalities involving the cranial nerves, especially the trigeminal, facial, glossopharyngeal, vagal and hypoglossal nerves. This chapter on neurologic disorders is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. Topics include congenital neurological disorders, including cerebral palsy (CP), neural tube defects (spina bifida), syringomyelia, Huntington's chorea, and Friedreich's ataxia; acquired neurological disorders, including the examination and lesions of the cranial nerves, facial sensory loss (facial pain is covered in a separate chapter), facial paralysis, Bell's palsy, trigeminal motor neuropathy, abnormal facial movements (dystonias, dyskinesias, facial tics, Tourette syndrome), multiple cranial nerve palsies, blindness and visual impairment, deafness and hearing impairment, Meniere's disease, autonomic dysfunction, epilepsy, syncope (fainting), raised intracranial pressure, hypoxic encephalopathy, infections of the nervous system (including HIV and syphilis), cerebrovascular accidents (stroke), Parkinson's disease, multiple sclerosis, Guillain-Barre syndrome (infective or idiopathic polyneuritis), motor neurone disease, mercury intoxication, tumors of the central nervous system (CNS), myasthenia gravis, patients with respiratory paralysis, and peripheral neuropathies. For each condition, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. 1 appendix. 4 figures. 15 tables. 52 references.
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Bedwetting Source: in Blaivas, J.G. Conquering Bladder and Prostate Problems: The Authoritative Guide for Men and Women. New York, NY: Plenum Publishing Corporation. 1998. p. 71-84. Contact: Available from Kluwer Academic-Plenum Publishing Corporation. 233 Spring Street, New York, NY 10013-1578. (800) 221-9369 or (212) 620-8035. Fax (212) 647-1898. Website: www.plenum.com. PRICE: $26.95. ISBN: 0306458640. Summary: Enuresis is defined as involuntary urination but, in common usage, means bedwetting. This chapter on enuresis is from a book for people who have urinary bladder and prostate problems: people who urinate too often, who plan their daily activities around the availability of a bathroom, men with prostate problems, women with incontinence, and people with bladder pain. The book is written in a clear, nontechnical, humorous style that makes the material more accessible to the lay reader. Primary enuresis means that the person was never successfully toilet trained and wet the bed for as long as he or she can remember. In secondary enuresis, the person was successfully toilet trained and confidently dry at night for a period of time, but subsequently developed bedwetting. The author discusses enuresis in children, including its causes, evaluation, pathology, and treatment; and the same aspects of enuresis in adults. In children, enuresis is very common and usually caused by delayed maturation of the nervous system; often it is the result of urinary tract infection. Sometimes, though, it can be the sign of a more serious condition such as vesicoureteral reflux, posterior urethral valves, spina bifida, and even spinal cord tumors. Children will usually outgrow a problem with enuresis. The author notes that, in the great majority of adults with enuresis, effective treatment can be instituted. However, the author cautions that many of the conditions that cause adult-onset enuresis can also cause silent kidney damage due to high pressures in the bladder. For this reason, it is important to obtain blood tests for kidney function (BUN and creatinine) and a renal ultrasound to ensure that there is not a blockage to the kidney. 2 tables.
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Anesthesia for the Developmentally Disabled Patient Source: in Dionne, R.A.; Phero, J.C.; Becker, D.E. Management of Pain and Anxiety in the Dental Office. Philadelphia, PA: W.B. Saunders Company. 2002. p. 315-323. Contact: Available from W.B. Saunders Company. Book Orders Fulfillment Department, Harcourt Health Sciences, 11830 Westline Industrial Drive, Saint Louis, MO 63146-9988. (800) 545-2522. Website: www.wbsaunders.com. PRICE: $122.00 plus shipping and handling. ISBN: 072167287. Summary: Pain has always been a barrier to dentistry, serving as the inspiration for pioneering efforts by dentists to control pain. This chapter on anesthesia for the developmentally disabled patient is from a text that addresses the management of acute and chronic pain and dental patient apprehension based on accepted pharmacologic (drug) therapies and special applications for dental outpatients. The authors provide an introduction to the anesthetic management of the patient with mental or physical impairments undergoing dental treatment. The intent is to identify the physiologic and anatomic features associated with the developmentally disabled patient that are significant and that require a modification in the patient's anesthetic management. Anesthetic techniques and pharmacologic agents addressed in other chapters also are discussed here in the context of the developmentally disabled patient. The authors begin with considerations of primary assessment, including respiratory, cardiovascular and neurologic assessment strategies. The authors then discuss specific diseases, including
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Down syndrome, cerebral palsy, cystic fibrosis, multiple sclerosis, muscular dystrophy, spinal cord injuries, and spina bifida. The remainder of the chapter focuses on anesthetic techniques and anesthetic agents, including ketamine and nitrous oxide. 2 tables. 12 references. •
(Sphincter) Incontinence in Men Source: in Blaivas, J.G. Conquering Bladder and Prostate Problems: The Authoritative Guide for Men and Women. New York, NY: Plenum Publishing Corporation. 1998. p. 205-218. Contact: Available from Kluwer Academic-Plenum Publishing Corporation. 233 Spring Street, New York, NY 10013-1578. (800) 221-9369 or (212) 620-8035. Fax (212) 647-1898. Website: www.plenum.com. PRICE: $26.95. ISBN: 0306458640. Summary: Sphincteric incontinence is the involuntary loss of urine due to malfunction of the urinary sphincter. In women, sphincteric incontinence is common; in men, it's uncommon and tends to be a complication of a prostate operation or a neurologic disorder such as spina bifida. This chapter on sphincter incontinence in men is from a book for people who have urinary bladder and prostate problems: people who urinate too often, who plan their daily activities around the availability of a bathroom, men with prostate problems, women with incontinence, and people with bladder pain. The book is written in a clear, nontechnical, humorous style that makes the material more accessible to the lay reader. The author details the types of surgeries that carry a risk for sphincteric incontinence and discusses the chances of developing incontinence in each type. Most of the time, when incontinence occurs after prostate surgery, it subsides within a matter of weeks or months, but occasionally takes a year or more. Treatment is difficult during this stage, but effective methods are available to manage the incontinence until it subsides. These methods include absorbent pads, a condom catheter, penile clamp, or indwelling catheter. For persistent incontinence, there are a few treatment options, but the only one that has a good long term cure rate is surgical implantation of an artificial urinary sphincter (sphincter prosthesis). 3 figures. 1 table.
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Developmental Disabilities Source: in Roe, S.N., ed. Dietician's Patient Education Manual. Frederick, MD: Aspen Publishing Company. 1991. p. 20:1-20:60. Contact: Available from Aspen Publishing Company. 7201 McKinney Circle, Frederick, MD 21701. (800) 234-1660 or (301) 698-7140. PRICE: $255.00 plus shipping and handling. ISBN: 0834201968. Summary: This book chapter, from a dietitian's patient education manual, discusses developmental disabilities. The author presents a definition and rationale for treatment, considerations for diet counseling, details of food intake, and strategies for patient education and compliance. Specific topics covered include abnormal oral-motor development; weight problems; vomiting and diarrhea; poor fluid intake; drug and food interactions; dental problems; patient assessment; strategies for cerebral palsy, epilepsy, Prader-Willi syndrome, and spina bifida; determining energy requirements for specific developmental disabilities, including Down syndrome; weight management; problems with constipation; breast-feeding and bottle-feeding; mealtime behavior; dental health; and poison control tips. The manual contains numerous charts and short sidebars for photocopying and incorporation into a patient education program. The chapter concludes with a few recipes and a list of related publications and resource organizations.
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Structure and Function in Continence and Incontinence Source: in Lucas, M.; Emery, S.; Beynon, J., eds. Incontinence. Malden, MA: Blackwell Science, Inc. 1999. p.12-44. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail:
[email protected]. Website: www.blackwell-science.com. PRICE: $162.95. ISBN: 0632050039. Summary: This chapter on structure and function in continence and incontinence is from a textbook on urinary and fecal incontinence. The authors describe the anatomical and pathological principles of normal function and present a classification of incontinence, with an explanation of the common abnormalities (congenital malformations are not discussed in this chapter). Topics include the structure and function of the pelvic floor, the anus, the bladder and urethra; gender differences; neural control of the lower urinary tract, pelvic floor, and canal; detrusor (the muscle that makes up the bladder wall) physiology; classifications of incontinence, including detrusor instability, causes in men and women, underactive bladder, incontinence in the elderly, and urethral instability; and the effects of common neurological disorders, including cerebrovascular disease (stroke), Parkinson's disease, spinal cord injury, multiple sclerosis, spina bifida, cauda equina injury, pelvic plexis injury, and diabetic neuropathy on bladder and bowel function. The authors emphasize the importance of a team approach to diagnosis and management of the patient with incontinence. 22 figures. 4 tables.
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Prenatal Diagnosis and Management of Deviant Fetal Growth and Congenital Malformations Source: in Reece, E.A.; Coustan, D.R., eds. Diabetes Mellitus in Pregnancy. 2nd ed. New York, NY: Churchill Livingstone. 1995. p. 219-249. Contact: Available from Churchill Livingstone. 300 Lighting Way, Secaucus, NJ 07094. (800) 553-5426. PRICE: $92.00. ISBN: 0443089795. Summary: This chapter, from a medical textbook on diabetes mellitus in pregnancy, covers prenatal diagnosis and management of deviant fetal growth and congenital malformations. The authors note that despite improvement in perinatal morbidity and mortality in well-controlled pregnancies complicated with diabetes, problems related to abnormal fetal growth and congenital malformations persist. Most of the perinatal mortality in infants of mothers with diabetes (IDMs) is now attributed to congenital anomalies, whereas most of the perinatal morbidity is related to growth aberrations. Topics include normal fetal growth assessment; first-trimester biometry; second trimester biometry, including biparietal diameter, occipitofrontal diameter, transverse cerebellar diameter, abdominal circumference, and long bones; deviant fetal growth, including macrosomia, prenatal diagnosis, and management and outcome; intrauterine growth retardation, including prenatal diagnosis, the use of pulsed Doppler, and management and outcome; congenital malformations; central nervous system anomalies, including anencephaly, spina bifida, and microcephaly; cardiac abnormalities, including the relationships between diabetes control and structural malformation of the heart, abnormalities of cardiac structure, abnormalities of cardiac function, and the use of fetal echocardiography in the pregnancy complicated by diabetes; gastrointestinal abnormalities; genitourinary abnormalities; and other abnormalities, including caudal regression syndrome, and polyhydramnios. The authors conclude that ultrasound provides much essential information about the fetus of the woman with diabetes and should be used liberally in the management of this
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population. A first-trimester scan should be used to date the pregnancy and to document fetal viability; a second-trimester scan should allow the perinatologist to rule out most serious fetal anomalies; and a third-trimester examination should be directed to assessing fetal growth. 17 figures. 5 tables. 126 references. •
Physical Disability and Sensory Impairment Source: in Griffiths, J. and Boyle, S. Colour Guide to Holistic Oral Care: A Practical Approach. Mosby-Year Book Europe. 1993. p. 131-150. Contact: Available from Mosby-Year Book Europe. Lynton House, 7-12 Tavistock Square, London WC1H 9LB, England. Telephone 0171-391 4471. Fax 0171-391 6598. ISBN: 0723417792. Summary: This chapter, from a textbook that outlines the role of the nurse in oral health care, discusses the oral care of people with physical disability or sensory impairment. The authors summarize the more common conditions that may affect manual dexterity, arm control, and mobility. Topics covered include the prevalence of physical disability; barriers to oral health; arthritis; brittle bone disease (osteogenesis imperfecta); rickets and osteomalacia; osteoporosis; Paget's disease (oteitis deformans); muscular dystrophies and myotonic disorders; myasthenia gravis; motor neurone disease; multiple sclerosis; Guillain-Barre syndrome; stroke (cerebrovascular accident); Bell's palsy; Parkinson's disease; cleft lip and palate; cerebral palsy; spina bifida and hydrocephalus; spinal injuries and trauma; head injury; epilepsy; and sensory impairment. 6 tables. 22 references. (AA-M).
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to spina bifida have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:11 •
Complete Directory for People with Chronic Illness. 4th ed Source: Lakeville, CT: Grey House Publishing, Inc. 2000. 1009 p. Contact: Available from Grey House Publishing, Inc. Pocket Knife Square, Lakeville, CT 06039. (860) 435-0868. Fax (860) 435-0867. PRICE: $165.00. ISBN: 0939300931. Summary: This directory provides a comprehensive overview of the support services and information resources available for people with any of 80 specific chronic illnesses. It presents information on various organizations, educational materials, publications, and databases. A chapter is devoted to each chronic illness and includes a brief description of it. The sections related to kidney and urologic diseases include: AIDS, Alzheimer's disease, cancer, cerebral palsy, diabetes, hypertension, impotence, incontinence, infertility, kidney disease, multiple sclerosis, sexually transmitted diseases, spina bifida, stroke, and substance abuse. The description of each disease is
11 You will need to limit your search to “Directory” and “spina bifida” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “spina bifida” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
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followed by subchapters that identify national and State associations and agencies, libraries, research centers, reference books, children's books, magazines, newsletters, pamphlets, videotapes and films, support groups and hotlines, and websites. In addition, the directory includes a chapter on death and bereavement, as well as a chapter on Wish Foundations for terminally and chronically ill children.
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CHAPTER 8. MULTIMEDIA ON SPINA BIFIDA Overview In this chapter, we show you how to keep current on multimedia sources of information on spina bifida. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on spina bifida is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “spina bifida” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, 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 “Videorecording (videotape, videocassette, etc.).” Type “spina bifida” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on spina bifida: •
Understanding spina bifida Source: Kansas City, KS: ACCESS Plan, University of Kansas Medical Center. 1993. 17 pp., 1 videotape (30 minutes, VHS 1/2 inch). Contact: Available from Grace E. Holmes, M.D., University of Kansas Medical Center, Department of Preventive Medicine, 4004 Robinson Hall, 3901 Rainbow Boulevard, Kansas City, KS 66160-7313. Telephone: (913) 588- 2273 / fax: (913) 588-2780. $15.00, families; $60.00, organizations. Summary: This videotape reviews basic medical problems associated with spina bifida and discusses issues relating to the growth and development of children and adolescents who have the disease. The videotape was developed for use periodically by the patients and their parents to reinforce their understanding of the disease and its implications. The accompanying booklet contains a glossary of the medical terms used in the videotape. [Funded by the Maternal and Child Health Bureau].
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CHAPTER 9. PERIODICALS AND NEWS ON SPINA BIFIDA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover spina bifida.
News Services and Press Releases One of the simplest ways of tracking press releases on spina bifida is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “spina bifida” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to spina bifida. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “spina bifida” (or synonyms). The following was recently listed in this archive for spina bifida: •
In utero surgery shows promise in treating spina bifida Source: Reuters Medical News Date: January 17, 2002
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Fetal surgery helps babies with spina bifida Source: Reuters Health eLine Date: January 17, 2002
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Neural tube defects less common since FDA mandated folate addition to food Source: Reuters Industry Breifing Date: June 19, 2001
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Two drugs linked to neural tube defects in infants Source: Reuters Health eLine Date: May 28, 2001
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Few women at risk of having child with neural tube defect take folic acid Source: Reuters Medical News Date: March 23, 2001
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Hope can improve lives of children with spina bifida Source: Reuters Health eLine Date: October 12, 2000
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Shunting improves cognitive function in some young adults with spina bifida Source: Reuters Medical News Date: June 08, 2000
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In utero myelomeningocele repair lowers incidence of hindbrain herniation in infants with spina bifida Source: Reuters Medical News Date: November 17, 1999
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Shunt, shunt revisions linked to dependence in adult survivors of spina bifida Source: Reuters Medical News Date: November 09, 1999
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Fetal surgery may prevent spina bifida sequelae Source: Reuters Medical News Date: November 20, 1998
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Latex allergy in spina bifida patients is preventable Source: Reuters Medical News Date: August 28, 1998
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Maternal smoking apparently decreases risk of neural tube defects Source: Reuters Medical News Date: June 24, 1998
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Inositol Prevents Folate-Resistant Neural Tube Defects In Mice Source: Reuters Medical News Date: January 06, 1997
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Senate Accepts Link Between Agent Orange And Spina Bifida Source: Reuters Medical News Date: September 09, 1996
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Maternal Obesity Is A Risk Factor For Anencephaly, Spina Bifida Source: Reuters Medical News Date: September 04, 1996
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Maternal Obesity Increases Risk Of Neural Tube Defects In The Newborn Source: Reuters Medical News Date: April 10, 1996
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “spina bifida” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “spina bifida” (or synonyms). If you know the name of a company that is relevant to spina bifida, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “spina bifida” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly
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to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “spina bifida” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on spina bifida: •
Urologic Care of the Child with Spina Bifida Source: Spina Bifida Spotlight. p. 1-4. July 1994. Contact: Available from Spina Bifida Association of America. 4590 MacArthur Boulevard, NW, Suite 250, Washington, DC 20007-4226. (202) 944-3285. Summary: This newsletter article considers the urologic care of the child with spina bifida. The author notes that the emphasis of care is now on early characterization of the child's lower urinary tract function. This provides the basis for preventative treatment to preserve both kidney and bladder function in an attempt to minimize the child's long term disability. In the newborn period, as soon as the neurosurgical condition is stable, an assessment is made of the child's kidneys with a serum creatinine and renal ultrasound (ECHO), and the bladder with urodynamic studies. Topics include indications for intermittent catheterization (CIC), surveillance recommendations throughout infancy and early childhood, medical therapy and surgical treatment for continence, and continent versus incontinent diversions. Because the emphasis has shifted to mainstreaming children into normal school and social situations, it is very important for bladder and bowel function to be controlled before the start of school. Catheterization is started (if it hasn't been done before), and urodynamic studies are performed to determine how best to modulate the incontinence. Medications are given to lower bladder filling pressure, increase capacity, and raise urethral resistance to prevent leaking between each emptying. Another treatment described is transurethral electrical bladder stimulation (TEBS). Surgical procedures designed to increase bladder outlet resistance include bladder neck reconstruction, fascial sling or bladder neck suspension, artificial sphincter implantation, and the Kropp procedure. (AA-M).
Academic Periodicals covering Spina Bifida Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to spina bifida. In addition to these sources, you can search for articles covering spina bifida that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for spina bifida. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with spina bifida. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to spina bifida: Folic Acid (Vitamin B 9 ) •
Systemic - U.S. Brands: Folvite http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202250.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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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 Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
12
These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 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:14 •
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
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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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
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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/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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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
13
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). 14 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
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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 Gateway15 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.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “spina bifida” (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 6686 229 30 6 86 7037
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “spina bifida” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
15
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
16
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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists20 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.21 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.22 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/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Spina Bifida In the following section, we will discuss databases and references which relate to the Genome Project and spina bifida. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).23 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 20 Adapted 21
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. 22 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. 23 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “spina bifida” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for spina bifida: •
Anencephaly--spina Bifida Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?301410
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Neural Tube Defect, Folate-resistant Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601635
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Neural Tube Defect, Folate-sensitive Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601634
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Spina Bifida Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?182940
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Spina Bifida, X-linked Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?300293
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Split-hand with Obstructive Uropathy, Spina Bifida, and Diaphragmatic Defects Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?183802 Genes and Disease (NCBI - Map)
The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
•
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
•
Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
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•
Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
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Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
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Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
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Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “spina bifida” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database25 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis.
24
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “spina bifida” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on spina bifida can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to spina bifida. 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 spina bifida. 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 “spina bifida”:
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Guides on spina bifida Spina Bifida http://www.nlm.nih.gov/medlineplus/spinabifida.html
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Other guides Birth Defects http://www.nlm.nih.gov/medlineplus/birthdefects.html Hydrocephalus http://www.nlm.nih.gov/medlineplus/hydrocephalus.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Neural Tube Defects http://www.nlm.nih.gov/medlineplus/neuraltubedefects.html Prenatal Testing http://www.nlm.nih.gov/medlineplus/prenataltesting.html Spinal Cord Diseases http://www.nlm.nih.gov/medlineplus/spinalcorddiseases.html
Within the health topic page dedicated to spina bifida, the following was listed: •
General/Overviews General Information about Spina Bifida Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/factshe/fs12txt.htm Spina Bifida: General Information Source: Shriners Hospitals for Children http://www.shrinershq.org/patientedu/spinabifida.html
•
Diagnosis/Symptoms Amniocentesis Source: March of Dimes Birth Defects Foundation http://www.marchofdimes.com/pnhec/159_520.asp Prenatal Testing: What's Involved and Who Should Consider It Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=PR00014
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Treatment Questions and Answers - Spina Bifida Source: American Association of Neurological Surgeons http://www.neurosurgery.org/pubpages/patres/askaneuro/mar98.html
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Specific Conditions/Aspects Latex Information for Spina Bifida Source: Spina Bifida Association of America http://www.sbaa.org/html/sbaa_latex.html Tethered Spinal Cord Syndrome Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/tethered_cord.htm
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Children What is Spina Bifida Source: Nemours Foundation http://kidshealth.org/PageManager.jsp?dn=nemours&ps=304&article_set=20729& cat_id=20075&lic=16
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Journals/Newsletters Medical Updates for Spina Bifida Source: Spina Bifida Association of America http://www.sbaa.org/html/sbaa_med-update.html
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Law and Policy Spina Bifida and Agent Orange Source: Spina Bifida Association of America http://www.sbaa.org/html/sbaa_agent.html
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Organizations March of Dimes Source: March of Dimes Birth Defects Foundation http://www.marchofdimes.com/ National Institute of Child Health and Human Development http://www.nichd.nih.gov/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/ Spina Bifida Association of America http://www.sbaa.org/
•
Prevention/Screening Folic Acid Information Source: Spina Bifida Association of America http://www.sbaa.org/html/sbaa_folic.html MEDLINEplus: Folic Acid Source: National Library of Medicine http://www.nlm.nih.gov/medlineplus/folicacid.html
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Triple Screen Source: March of Dimes Birth Defects Foundation http://www.marchofdimes.com/pnhec/159_522.asp •
Research NICHD Study to Test Surgical Technique to Repair Spinal Defect before Birth Source: National Institute of Child Health and Human Development http://www.nih.gov/news/pr/apr2003/nichd-25.htm
•
Statistics Incidence of Spina Bifida Source: Spina Bifida Association of America http://www.sbaa.org/html/sbaa_dyk.html Trends in Spina Bifida and Anencephalus in the United States, 1991-2002 Source: National Center for Health Statistics http://www.cdc.gov/nchs/products/pubs/pubd/hestats/spine_anen.htm
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 spina bifida. 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: •
Dietary management of the child with spina bifida Source: Birmingham, AL: Sparks Center for Developmental and Learning Disorders, University of Alabama at Birmingham. [1995]. 15 pp. Contact: Available from Janet Isaacs, University of Alabama at Birmingham, Sparks Center for Developmental and Learning Disorders, 1720 Seventh Avenue South, Birmingham, AL 35294. Telephone: (205) 934-5471 / fax: (205) 975-2380 / e-mail:
[email protected]. $0.75 (plus $3.00 if not prepaid). Summary: This pamphlet for parents of young children with spina bifida describes the disorder. Health concerns such as urinary tract infections, constipation, obesity, meal patterns for infants, foods for children, sample menus, diet plans, snacks, and tips for decreasing calories are discussed and explained to assist parents in caring for their children with spina bifida. [Funded by the Maternal and Child Health Bureau].
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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 “spina bifida” (or synonyms). The following was recently posted: •
Folic acid for the prevention of neural tube defects Source: American Academy of Pediatrics - Medical Specialty Society; 1999 August; 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2774&nbr=2000&a mp;string=spina+AND+bifida 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: •
FAQ - About Loving Paws Dogs Summary: Loving Paws Dogs are service dogs trained for disabled children (specifically muscular dystrophy, cerebral palsy and spina bifida) up to aged 18. This information answers questions about the program. Source: Loving Paws Assistance Dogs http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4239
•
FAQ - Why Folic Acid Is So Important Summary: The National Center for Environmental Health (NCEH) answers questions on the causes and prevention of the birth defects spina bifida and anencephaly. Discusses the dietary supplement foloic acid. Source: National Center for Environmental Health, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1227
•
Latex Information Summary: This fact sheet discusses the allergic reaction to rubber in individuals with spina bifida. Source: Spina Bifida Association of America http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1045
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Spina Bifida Source: National Information Center for Children and Youth with Disabilities, U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3416
•
The Folic Acid National Campaign Summary: The CDC, the March of Dimes, and the National Council on Folic Acid have organized the National Folic Acid Campaign to promote the use of folic acid to prevent the serious birth defects spina bifida Source: National Center on Birth Defects and Developmental Disabilities http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4470 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 spina bifida. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Associations and Spina Bifida The following is a list of associations that provide information on and resources relating to spina bifida:
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Spina Bifida and Hydrocephalus Association of Canada Telephone: 204-925-3650 Toll-free: 800-565-9488 Fax: 204-925-3654 Email:
[email protected] Web Site: http://www.sbhac.ca Background: The Spina Bifida and Hydrocephalus Association of Canada (SBHAC) is a not-for-profit support organization dedicated to improving the quality of life of individuals with spina bifida and/or hydrocephalus and their families through awareness, education, and research. Spina bifida is a neural tube defect occurring early during fetal development, in which part of one or more of the bones of the spine (vertebrae) fail to develop completely, leaving a portion of the spinal cord exposed and resulting in damage to exposed nerve tissue. Hydrocephalus is a condition in which there is abnormal accumulation of cerebrospinal fluid in the skull, causing increased pressure on the brain. Established in 1981, the SBHAC currently has approximately 2,400 members in 11 chapters throughout Canada. The Association provides a variety of programs and services including and 800 Help Line, support networking, educational workshops and seminars, and annual educational conference, research grants, scholarship programs for students with spina bifida and/or hydrocephalus, and public awareness programs. The Association also offers a variety of educational guides and materials for schools, professionals, parents, and the general public including fact sheets; articles; a lending library of materials including books, guides, handbooks, and videos; and a regular newsletter entitled 'Podium.'. Relevant area(s) of interest: Spina Bifida
•
Spina Bifida Association of America Telephone: (202) 944-3285 Toll-free: (800) 621-3141 Fax: (202) 944-3295 Email:
[email protected] Web Site: http://www.sbaa.org Background: The Spina Bifida Association of America (SBAA) is a not-for-profit association dedicated to promoting the rights and well-being of individuals with spina bifida. The Association supports research into the causes, treatment, and prevention of the disease and seeks to increase public awareness of spina bifida and its prevention. Educational advancement, social and vocational development, and mainstreaming of individuals with disabilities are also goals of the Association. Established in 1973 to address the specific needs of the spina bifida community, the Association s chapters comprise affected individuals, family members, health care professionals, and health institutions. The Association promotes the continuing education to health care professionals involved in the treatment of spina bifida. It maintains a toll-free information and referral service, provides direct program services for its members and chapters, conducts public awareness campaigns, and holds an annual national conference addressing spina bifida issues. The Spina Bifida Association of America publishes a bimonthly newsletter, produces and distributes publications on the entire spectrum of spina bifida issues, and provides a variety of brochures and fact sheets. Relevant area(s) of interest: Spina Bifida
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to spina bifida. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with spina bifida. 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 spina bifida. 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 “spina bifida” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “spina bifida”. 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 “spina bifida” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “spina bifida” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.26
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
26
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)27: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
27
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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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
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on spina bifida: •
Basic Guidelines for Spina Bifida Spina bifida - resources Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002184.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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SPINA BIFIDA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute myelogenous leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute nonlymphocytic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acute nonlymphocytic leukemia: A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute myelogenous leukemia. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adduction: The rotation of an eye toward the midline (nasally). [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
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Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] 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] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]
Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amnion: The extraembryonic membrane which contains the embryo and amniotic fluid. [NIH]
Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH]
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Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anaphylactic: Pertaining to anaphylaxis. [EU] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anophthalmia: Absence of an eye or eyes in the newborn due to failure of development of the optic cup or to disappearance of the eyes after partial development. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anthropology: The science devoted to the comparative study of man. [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
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for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidiuretic: Suppressing the rate of urine formation. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arthropathy: Any joint disease. [EU] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astigmatism: A condition in which the surface of the cornea is not spherical; causes a blurred image to be received at the retina. [NIH] Astringents: Agents, usually topical, that cause the contraction of tissues for the control of bleeding or secretions. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures.
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Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Bereavement: Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. [NIH] Bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the
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target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biochemical reactions: In living cells, chemical reactions that help sustain life and allow cells to grow. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biometry: The use of statistical methods to analyze biological observations and phenomena. [NIH]
Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotin: Hexahydro-2-oxo-1H-thieno(3,4-d)imidazole-4-pentanoic acid. Growth factor present in minute amounts in every living cell. It occurs mainly bound to proteins or polypeptides and is abundant in liver, kidney, pancreas, yeast, and milk.The biotin content of cancerous tissue is higher than that of normal tissue. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Blood 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 transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]
Body Fluids: Liquid components of living organisms. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up
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of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Cells: Cells contained in the bone marrow including fat cells, stromal cells, megakaryocytes, and the immediate precursors of most blood cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [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] Calculus I: An abnormal concretion occurring within the animal body and usually composed of mineral salts. [EU] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [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] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the
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pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell motility: The ability of a cell to move. [NIH] Cell Movement: The movement of cells from one location to another. [NIH] Cell Polarity: Orientation of intracellular structures especially with respect to the apical and basolateral domains of the plasma membrane. Polarized cells must direct proteins from the Golgi apparatus to the appropriate domain since tight junctions prevent proteins from diffusing between the two domains. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell
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division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [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] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is
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also a frequent manifestation of basal ganglia diseases. [NIH] Choreatic Disorders: Acquired and hereditary conditions which feature chorea as a primary manifestation of the disease process. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chromosome Abnormalities: Defects in the structure or number of chromosomes resulting in structural aberrations or manifesting as disease. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic granulocytic leukemia: A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myelogenous leukemia or chronic myeloid leukemia. [NIH] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] 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] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clubfoot: A deformed foot in which the foot is plantarflexed, inverted and adducted. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colitis: Inflammation of the colon. [NIH]
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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] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Coloboma: Congenital anomaly in which some of the structures of the eye are absent due to incomplete fusion of the fetal intraocular fissure during gestation. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the
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formation of a viable zygote. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Continence: The ability to hold in a bowel movement or urine. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Callosum: Broad plate of dense myelinated fibers that reciprocally interconnect regions of the cortex in all lobes with corresponding regions of the opposite hemisphere. The corpus callosum is located deep in the longitudinal fissure. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU]
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Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cranial Nerves: Twelve pairs of nerves that carry general afferent, visceral afferent, special afferent, somatic efferent, and autonomic efferent fibers. [NIH] 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] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclopia: Elements of the two eyes fused into one median eye in the center of the forehead of a fetal monster. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cystoscopy: Endoscopic examination, therapy or surgery of the urinary bladder. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]
Decision Making: The process of making a selective intellectual judgment when presented
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with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Decubitus Ulcer: An ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time. The bony prominences of the body are the most frequently affected sites. The ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Dexterity: Ability to move the hands easily and skillfully. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]
Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disabled Children: Children with mental or physical disabilities that interfere with usual activities of daily living and that may require accommodation or intervention. [NIH]
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Disinfection: Rendering pathogens harmless through the use of heat, antiseptics, antibacterial agents, etc. [NIH] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]
Disposition: A tendency either physical or mental toward certain diseases. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Down syndrome: A disorder caused by the presence of an extra chromosome 21 and characterized by mental retardation and distinguishing physical features. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Ectoderm: The outer of the three germ layers of the embryo. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] 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] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryogenesis: The process of embryo or embryoid formation, whether by sexual (zygotic) or asexual means. In asexual embryogenesis embryoids arise directly from the explant or on intermediary callus tissue. In some cases they arise from individual cells (somatic cell embryoge). [NIH] Embryology: The study of the development of an organism during the embryonic and fetal
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stages of life. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encephalocele: Cerebral tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. [NIH]
Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enuresis: Involuntary discharge of urine after the age at which urinary control should have been achieved; often used alone with specific reference to involuntary discharge of urine occurring during sleep at night (bed-wetting, nocturnal enuresis). [EU] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epiphyseal: Pertaining to or of the nature of an epiphysis. [EU] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH]
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Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Esotropia: A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. [NIH] Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Evacuation: An emptying, as of the bowels. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotropia: A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction. [NIH] Extracellular: Outside a cell or cells. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [NIH] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling
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reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetal Development: Morphologic and physiologic growth and development of the mammalian embryo or fetus. [NIH] Fetal Viability: The potential of the fetus-in-utero to survive after birth. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Fludarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]
Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in
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diagnosis. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluorosis: Discoloration of the tooth enamel due to fluorine. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Foot Deformities: Alterations or deviations from normal shape or size which result in a disfigurement of the foot. [NIH] Fossa: A cavity, depression, or pit. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Techniques: Chromosomal, biochemical, intracellular, and other methods used in
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the study of genetics. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Layers: The three layers of cells comprising the early embryo. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Gliosis: The production of a dense fibrous network of neuroglia; includes astrocytosis, which is a proliferation of astrocytes in the area of a degenerative lesion. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to inulin clearance. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH]
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Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]
Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth Disorders: Deviations from the average values for a specific age and sex in any or all of the following: height, weight, skeletal proportions, osseous development, or maturation of features. Included here are both acceleration and retardation of growth. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [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] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels
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of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heparan Sulfate Proteoglycan: A substance released by astrocytes, which is critical in stopping nervous fibers in their tracks. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterotropia: One in which the angle of squint remains relatively unaltered on conjugate movement of the eyes. [NIH] Holoprosencephaly: Anterior midline brain, cranial, and facial malformations resulting from the failure of the embryonic prosencephalon to undergo segmentation and cleavage. Alobar prosencephaly is the most severe form and features anophthalmia; cyclopia; severe mental retardation; cleft lip; cleft palate; seizures; and microcephaly. Semilobar holoprosencepaly is characterized by hypotelorism, microphthalmia, coloboma, nasal malformations, and variable degrees of mental retardation. Lobar holoprosencephaly is associated with mild (or absent) facial malformations and intellectual abilities that range from mild mental retardation to normal. Holoprosencephlay is associated with chromosome abnormalities. [NIH] Homodimer: Protein-binding "activation domains" always combine with identical proteins. [NIH]
Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hospital Records: Compilations of data on hospital activities and programs; excludes patient medical records. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] 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] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H,
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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] Hydronephrosis: Abnormal enlargement of a kidney, which may be caused by blockage of the ureter (such as by a kidney stone) or chronic kidney disease that prevents urine from draining into the bladder. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hygienic: Pertaining to hygiene, or conducive to health. [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] Hypoglossal Nerve: The 12th cranial nerve. The hypoglossal nerve originates in the hypoglossal nucleus of the medulla and supplies motor innervation to all of the muscles of the tongue except the palatoglossus (which is supplied by the vagus). This nerve also contains proprioceptive afferents from the tongue muscles. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] 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] Illusions: The misinterpretation of a real external, sensory experience. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such
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as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [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]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] 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] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH]
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Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hemorrhages: Bleeding within the intracranial cavity, including hemorrhages in the brain and within the cranial epidural, subdural, and subarachnoid spaces. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intravenous: IV. Into a vein. [NIH] Intravesical: Within the bladder. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Investigative Techniques: Investigative techniques used in pre-clinical and clinical research, epidemiology, chemistry, immunology, genetics, etc. They do not include techniques specifically applied to diagnosis; therapeutics; anesthesia and analgesia, surgery, operative, and dentistry. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction
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of a blood vessel. [EU] Isoelectric: Separation of amphoteric substances, dissolved in water, based on their isoelectric behavior. The amphoteric substances are a mixture of proteins to be separated and of auxiliary "carrier ampholytes". [NIH] Isoelectric Point: The pH in solutions of proteins and related compounds at which the dipolar ions are at a maximum. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [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] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetic: Pertaining to or producing motion. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Latex Allergy: Hypersensitivity to products containing processed natural rubber latex such as rubber gloves, condoms, catheters, dental dams, balloons, and sporting equipment. Both T-cell mediated (delayed hypersensitivity) and IgE antibody-mediated (immediate hypersensitivity) allergic responses are possible. Delayed hypersensitivity results from exposure to antioxidants present in the rubber; immediate hypersensitivity results from exposure to a latex protein. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and
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strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipoma: A benign tumor composed of fat cells. [NIH] 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] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH]
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Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammogram: An x-ray of the breast. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningocele: A congenital or acquired protrusion of the meninges, unaccompanied by neural tissue, through a bony defect in the skull or vertebral column. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mentors: Senior professionals who provide guidance, direction and support to those
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persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesoderm: The middle germ layer of the embryo. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mitotic: Cell resulting from mitosis. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of
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a single species of immunoglobulin molecules. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelodysplasia: Abnormal bone marrow cells that may lead to myelogenous leukemia. [NIH]
Myelodysplastic syndrome: Disease in which the bone marrow does not function normally. Also called preleukemia or smoldering leukemia. [NIH] Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myeloproliferative Disorders: Disorders in which one or more stimuli cause proliferation of hemopoietically active tissue or of tissue which has embryonic hemopoietic potential. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of
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muscles. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] 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] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] 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] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural tube defects: These defects include problems stemming from fetal development of the spinal cord, spine, brain, and skull, and include birth defects such as spina bifida, anencephaly, and encephalocele. Neural tube defects occur early in pregnancy at about 4 to 6 weeks, usually before a woman knows she is pregnant. Many babies with neural tube defects have difficulty walking and with bladder and bowel control. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuromuscular Junction Diseases: Conditions characterized by impaired transmission of impulses at the neuromuscular junction. This may result from disorders that affect receptor function, pre- or postsynaptic membrane function, or acetylcholinesteraseactivity. The majority of diseases in this category are associated with autoimmune, toxic, or inherited conditions. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders
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of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. [NIH]
Notochord: The rod-shaped body, composed of cells derived from the mesoblast and defining the primitive axis of the embryo. In lower vertebrates, it persists throughout life as the main axial support of the body, but in higher vertebrates it is replaced by the vertebral column. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. [NIH] Occupational Health: The promotion and maintenance of physical and mental health in the work environment. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligonucleotide Probes: Synthetic or natural oligonucleotides used in hybridization studies in order to identify and study specific nucleic acid fragments, e.g., DNA segments near or within a specific gene locus or gene. The probe hybridizes with a specific mRNA, if present. Conventional techniques used for testing for the hybridization product include dot blot assays, Southern blot assays, and DNA:RNA hybrid-specific antibody tests. Conventional labels for the probe include the radioisotope labels 32P and 125I and the chemical label biotin. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH]
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Opacity: Degree of density (area most dense taken for reading). [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteogenesis Imperfecta: A collagen disorder resulting from defective biosynthesis of type I collagen and characterized by brittle, osteoporotic, and easily fractured bones. It may also present with blue sclerae, loose joints, and imperfect dentin formation. There are four major types, I-IV. [NIH] Osteomalacia: A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. [EU]
Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsies: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute
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hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pediatric Endocrinologist: A doctor who sees and treats children with problems of the endocrine glands; diabetes is an endocrine disorder. [NIH] Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH]
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PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phrenic Nerve: The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. [NIH]
Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placebos: Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a
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fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet-Derived Growth Factor: Mitogenic peptide growth hormone carried in the alphagranules of platelets. It is released when platelets adhere to traumatized tissues. Connective tissue cells near the traumatized region respond by initiating the process of replication. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polyhydramnios: Excess of amniotic fluid greater than 2,000 ml. It is a common obstetrical complication whose major causes include maternal diabetes, chromosomal disorders, isoimmunological disease, congenital abnormalities, and multiple gestations. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [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
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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] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Preleukemia: Conditions in which the abnormalities in the peripheral blood or bone marrow represent the early manifestations of acute leukemia, but in which the changes are not of sufficient magnitude or specificity to permit a diagnosis of acute leukemia by the usual clinical criteria. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Diagnosis: Determination of the nature of a pathological condition or disease in the postimplantation embryo, fetus, or pregnant female before birth. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary endpoint: The main result that is measured at the end of a study to see if a given treatment worked (e.g., the number of deaths or the difference in survival between the treatment group and the control group). What the primary endpoint will be is decided before the study begins. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prosencephalon: The part of the brain developed from the most rostral of the three primary vesicles of the embryonic neural tube and consisting of the diencephalon and telencephalon. [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]
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Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prosthesis: An artificial replacement of a part of the body. [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] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pupil: The aperture in the iris through which light passes. [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] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH]
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Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH]
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Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory Paralysis: Complete or severe weakness of the muscles of respiration. This condition may be associated with motor neuron diseases; peripheral nerve disorders; neuromuscular junction diseases; spinal cord diseases; injury to the phrenic nerve; and other disorders. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rhabdomyosarcoma: A malignant tumor of muscle tissue. [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] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rituximab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH]
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Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerae: A circular furrow between the sclerocorneal junction and the iris. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scoliosis: A lateral curvature of the spine. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self Concept: A person's view of himself. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming;
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immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin Care: Maintenance of the hygienic state of the skin under optimal conditions of cleanliness and comfort. Effective in skin care are proper washing, bathing, cleansing, and the use of soaps, detergents, oils, etc. In various disease states, therapeutic and protective solutions and ointments are useful. The care of the skin is particularly important in various
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occupations, in exposure to sunlight, in neonates, and in decubitus ulcer. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoldering leukemia: Disease in which the bone marrow does not function normally. Also called preleukemia or myelodysplastic syndrome. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] 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] 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
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a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Spinal Injuries: Injuries involving the vertebral column. [NIH] Spirochete: Lyme disease. [NIH] Spondylolisthesis: Forward displacement of one vertebra over another. [NIH] Spondylolysis: Dissolution of a vertebra, especially the pars interarticularis. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] 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] Strabismus: Deviation of the eye which the patient cannot overcome. The visual axes assume a position relative to each other different from that required by the physiological conditions. The various forms of strabismus are spoken of as tropias, their direction being indicated by the appropriate prefix, as cyclo tropia, esotropia, exotropia, hypertropia, and hypotropia. Called also cast, heterotropia, manifest deviation, and squint. [EU] Streptavidin: A 60kD extracellular protein of Streptomyces avidinii with four high-affinity biotin binding sites. Unlike AVIDIN, streptavidin has a near neutral isoelectric point and is free of carbohydrate side chains. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or
Dictionary 197
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] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supine: Having the front portion of the body upwards. [NIH] Supine Position: The posture of an individual lying face up. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral 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] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]
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Syringomyelia: The presence in the spinal cord of elongated central fluid containing cavities surrounded by gliosis. [NIH] Syrinx: A fistula. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Teratoma: A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a
Dictionary 199
specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Traction: The act of pulling. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transforming Growth Factor beta: A factor synthesized in a wide variety of tissues. It acts synergistically with TGF-alpha in inducing phenotypic transformation and can also act as a negative autocrine growth factor. TGF-beta has a potential role in embryonal development, cellular differentiation, hormone secretion, and immune function. TGF-beta is found mostly as homodimer forms of separate gene products TGF-beta1, TGF-beta2 or TGF-beta3. Heterodimers composed of TGF-beta1 and 2 (TGF-beta1.2) or of TGF-beta2 and 3 (TGFbeta2.3) have been isolated. The TGF-beta proteins are synthesized as precursor proteins. [NIH]
Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transurethral: Performed through the urethra. [EU] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH]
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Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]
Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urodynamic: Measures of the bladder's ability to hold and release urine. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital Diseases: Diseases of the urogenital tract. [NIH] Urologic Diseases: Diseases of the urinary tract in both male and female. It does not include the male genitalia for which urogenital diseases is used for general discussions of diseases of both the urinary tract and the genitalia. [NIH] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax
Dictionary 201
and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Valproic Acid: A fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GABA levels in the brain or by altering the properties of voltage dependent sodium channels. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vesicoureteral: An abnormal condition in which urine backs up into the ureters, and occasionally into the kidneys, raising the risk of infection. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual Perception: The selecting and organizing of visual stimuli based on the individual's past experience. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitamin D: The vitamin that mediates intestinal calcium absorption, bone calcium metabolism, and probably muscle activity. It usually acts as a hormone precursor, requiring
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2 stages of metabolism before reaching actual hormonal form. It is isolated from fish liver oils and used in the treatment and prevention of rickets. [NIH] Vitamin U: A vitamin found in green vegetables. It is used in the treatment of peptic ulcers, colitis, and gastritis and has an effect on secretory, acid-forming, and enzymatic functions of the intestinal tract. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Wounds, Gunshot: Disruption of structural continuity of the body as a result of the discharge of firearms. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
203
INDEX A Abdominal, 27, 112, 153, 161, 185 Aberrant, 13, 153 Accommodation, 14, 153, 166 Acrylonitrile, 153, 192 Actin, 9, 10, 153, 182 Activities of Daily Living, 34, 153, 166 Acute lymphoblastic leukemia, 153 Acute lymphocytic leukemia, 94, 153 Acute myelogenous leukemia, 94, 153 Acute myeloid leukemia, 153 Acute nonlymphocytic leukemia, 153 Adaptability, 153, 160, 161 Adduction, 65, 153 Adipocytes, 153, 178 Adjustment, 26, 60, 108, 153 Adolescence, 5, 55, 153, 186 Adverse Effect, 22, 153, 194 Aerosol, 153, 184 Afferent, 154, 165, 178 Affinity, 154, 156, 195, 196 Algorithms, 154, 158 Alimentary, 154, 186 Alleles, 7, 36, 54, 73, 154, 179 Allergen, 12, 32, 54, 154, 166, 194 Alopecia, 154, 165 Alpha Particles, 154, 190 Alternative medicine, 119, 154 Ambulatory Care, 154 Amino Acid Sequence, 154, 155, 171 Amino Acids, 154, 171, 186, 188, 190, 197 Amnion, 154 Amniotic Fluid, 27, 77, 154, 188 Amplification, 22, 155 Amputation, 17, 155 Anaesthesia, 33, 155, 176 Anal, 22, 31, 36, 51, 155, 170, 179 Analgesic, 155, 184 Anaphylactic, 12, 25, 44, 155 Anaphylaxis, 50, 155 Anatomical, 112, 155, 168, 176, 193 Anemia, 42, 74, 88, 131, 155, 171, 182 Anesthesia, 25, 110, 155, 168, 177, 178 Angioplasty, 98, 102, 155 Animal model, 20, 155 Ankle, 65, 101, 155 Anomalies, 18, 19, 46, 112, 155, 198 Anophthalmia, 155, 174
Anorexia, 155, 185 Anthropology, 23, 86, 155 Antibacterial, 155, 167, 195 Antibiotic, 155, 165, 167, 195 Antibodies, 7, 50, 155, 188, 192 Antibody, 12, 94, 154, 155, 156, 163, 174, 175, 176, 178, 181, 184, 192, 194 Anticoagulant, 156, 190 Anticonvulsant, 156, 159, 201 Antidiuretic, 58, 76, 156 Antigen, 154, 155, 156, 163, 174, 175, 176, 193 Anti-infective, 156, 177, 195 Anti-inflammatory, 156, 172, 189 Antineoplastic, 156, 165, 167, 188, 201 Antioxidants, 156, 178 Anus, 112, 155, 156, 159, 168 Aqueous, 156, 157, 165 Arterial, 27, 98, 102, 156, 161, 175, 190, 198 Arteries, 156, 158, 164, 181 Arterioles, 156, 158, 159 Arthropathy, 32, 156 Asphyxia, 156, 184 Assay, 19, 156 Astigmatism, 65, 156, 191 Astringents, 156, 181 Astrocytes, 156, 172, 174 Asymptomatic, 65, 156 Ataxia, 109, 131, 156, 174, 198 Atopic, 55, 157 Atrophy, 130, 131, 157 Autoimmune disease, 157, 182 Autonomic, 109, 157, 165, 172, 186, 197 B Bacteria, 9, 16, 155, 156, 157, 170, 181, 195, 199, 200 Bacteriophage, 157, 187, 199 Bacterium, 10, 157 Basal Ganglia, 157, 159, 162 Basal Ganglia Diseases, 157, 162 Base, 15, 99, 157, 166, 171, 178, 198 Benign, 9, 157, 159, 173, 179 Benign tumor, 157, 179 Bereavement, 114, 157 Bilateral, 29, 157, 185, 186 Bile, 157, 171, 179 Binding Sites, 157, 196 Bioavailability, 16, 19, 157
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Biochemical, 7, 10, 11, 19, 20, 154, 158, 171 Biochemical reactions, 19, 158 Biological therapy, 158, 173 Biometry, 112, 158 Biosynthesis, 158, 185 Biotechnology, 24, 25, 119, 127, 129, 130, 131, 132, 158 Biotin, 158, 184, 196 Biotransformation, 158 Blood pressure, 158, 175, 181, 195 Blood transfusion, 94, 158 Blood vessel, 98, 158, 160, 161, 162, 168, 172, 178, 195, 197, 198, 201 Blot, 158, 184 Body Fluids, 158, 167, 195 Bone Density, 22, 98, 102, 158 Bone Marrow, 94, 153, 158, 159, 162, 165, 175, 179, 182, 189, 195, 196 Bone Marrow Cells, 159, 182 Bowel, 30, 31, 63, 64, 81, 105, 112, 120, 155, 159, 164, 166, 168, 177, 183, 196 Bowel Movement, 159, 164, 166, 196 Brain Diseases, 159, 185 Brain Neoplasms, 159, 174, 198 Brain Stem, 159, 161 Branch, 149, 159, 186, 190, 195, 198 C Calcification, 102, 159 Calcium, 159, 163, 181, 185, 186, 194, 201 Calculus I, 25, 64, 159 Callus, 159, 167 Capillary, 159, 172, 201 Capsules, 159, 171, 172 Carbamazepine, 52, 159 Carbohydrate, 159, 196 Carcinogens, 160, 184 Cardiac, 66, 112, 160, 182 Cardiovascular, 110, 160 Case report, 4, 15, 21, 29, 31, 39, 47, 85, 160, 162 Case series, 160, 162 Catheterization, 5, 10, 65, 120, 155, 160, 177 Catheters, 5, 9, 160, 178 Cauda Equina, 112, 160 Caudal, 20, 112, 160, 188 Causal, 13, 160 Cell Cycle, 160, 169 Cell Death, 7, 11, 160, 169, 183 Cell Differentiation, 160, 194 Cell Division, 130, 157, 160, 161, 169, 173, 187, 193
Cell motility, 8, 160 Cell Movement, 8, 9, 160 Cell Polarity, 8, 9, 15, 160 Cell proliferation, 7, 19, 160, 194 Cell Survival, 161, 173 Cell Transplantation, 161 Central Nervous System, 4, 109, 112, 159, 161, 171, 172, 173, 174, 182, 188 Central Nervous System Infections, 161, 173, 174 Cerebellar, 112, 157, 161, 191 Cerebellum, 14, 19, 27, 159, 161, 188, 191 Cerebral Infarction, 161, 174 Cerebral Palsy, 17, 21, 25, 34, 38, 101, 107, 109, 111, 113, 139, 161 Cerebrospinal, 32, 141, 161, 174, 194 Cerebrospinal fluid, 32, 141, 161, 174, 194 Cerebrovascular, 109, 112, 113, 157, 161, 198 Cerebrum, 161, 200 Cervical, 39, 62, 161, 187 Cervix, 161, 170 Cesarean Section, 14, 161 Character, 10, 161 Chemoprevention, 20, 161 Chemotherapy, 94, 161 Chorea, 109, 161, 162 Choreatic Disorders, 161, 162 Chromosomal, 18, 155, 162, 171, 188 Chromosome, 18, 68, 93, 162, 167, 174, 179, 193 Chromosome Abnormalities, 162, 174 Chronic, 5, 6, 12, 23, 56, 90, 94, 110, 113, 130, 162, 164, 168, 175, 176, 178, 188, 197 Chronic Disease, 13, 23, 162 Chronic granulocytic leukemia, 162 Chronic lymphocytic leukemia, 94, 162 Chronic myelogenous leukemia, 94, 162 Chronic renal, 162, 188 Circulatory system, 162, 168, 177 CIS, 17, 162 Clamp, 111, 162 Cleft Palate, 63, 68, 162, 174 Clinical study, 20, 162, 164 Clinical trial, 6, 12, 93, 95, 127, 162, 164, 165, 187, 190, 191 Cloning, 158, 162 Clubfoot, 31, 162 Cofactor, 162, 190, 198 Colitis, 162, 202 Collagen, 163, 171, 185 Collapse, 155, 163
Index 205
Coloboma, 163, 174 Complement, 163, 194 Complementary and alternative medicine, 81, 88, 163 Complementary medicine, 81, 163 Computational Biology, 127, 129, 163 Conception, 163, 170, 196 Concretion, 159, 164 Condoms, 164, 178 Cone, 164, 197 Conjunctiva, 164, 199 Connective Tissue, 159, 163, 164, 170, 171, 179, 192 Consciousness, 155, 164, 197 Constipation, 33, 49, 106, 111, 138, 164 Constitutional, 164, 182 Consultation, 58, 85, 164 Consumption, 38, 164, 192 Continence, 3, 5, 14, 33, 49, 105, 112, 120, 164 Contraindications, ii, 164 Control group, 164, 187, 189, 190 Controlled clinical trial, 12, 164 Coordination, 91, 161, 164, 182 Cornea, 156, 164 Coronary, 164, 181 Coronary Thrombosis, 164, 181 Corpus, 19, 90, 164 Corpus Callosum, 19, 90, 164 Cortex, 157, 159, 164, 169, 170, 191 Cortisone, 165, 189 Cranial, 109, 161, 165, 172, 173, 174, 175, 177, 186, 199, 200 Cranial Nerves, 109, 165 Craniocerebral Trauma, 157, 165, 173, 174, 198 Creatinine, 110, 120, 165 Crossing-over, 165, 191 Curative, 165, 192, 198 Cutaneous, 81, 165 Cyclophosphamide, 94, 165 Cyclopia, 165, 174 Cyclosporine, 94, 165 Cyst, 47, 165 Cystoscopy, 33, 165 Cytoplasm, 165, 173 Cytoskeleton, 7, 10, 165 Cytotoxic, 165, 194 D Data Collection, 19, 165 Databases, Bibliographic, 127, 165 Daunorubicin, 165, 167
Decision Making, 58, 85, 107, 165 Decubitus, 166, 195 Decubitus Ulcer, 166, 195 Defecation, 78, 166 Deletion, 16, 18, 166 Density, 22, 158, 166, 185 Dental Care, 5, 166 Dentists, 5, 110, 166 Depolarization, 166, 194 Desensitization, 12, 166 Detergents, 166, 194 Dexterity, 113, 166 Diabetes Mellitus, 112, 166, 172, 173 Diagnostic procedure, 97, 119, 166 Diarrhea, 106, 111, 166 Diastolic, 166, 175 Dietitian, 111, 166 Digestion, 154, 157, 159, 166, 177, 179, 186, 196 Digestive system, 95, 166 Dihydrotestosterone, 166, 191 Dilatation, 155, 166, 189 Dilation, 5, 166, 174 Direct, iii, 17, 20, 121, 141, 160, 166, 191 Disabled Children, 139, 166 Disinfection, 85, 167 Dislocation, 29, 36, 64, 167 Disposition, 72, 77, 167 Distal, 22, 29, 167, 190 Dorsal, 98, 102, 167, 188 Dorsum, 167 Down syndrome, 101, 111, 167 Doxorubicin, 94, 167 Drug Interactions, 122, 167 Duct, 160, 167, 193 Dyskinesia, 167 Dysplasia, 131, 167 Dystrophy, 21, 111, 131, 139, 167 E Echocardiography, 112, 167 Ectoderm, 17, 167 Ectopic, 98, 102, 167 Efficacy, 12, 14, 22, 37, 63, 91, 167 Electrolyte, 167, 195 Electrons, 157, 167, 177, 190 Embryo, 6, 9, 11, 17, 154, 160, 167, 170, 172, 176, 181, 184, 185, 189, 196 Embryogenesis, 17, 38, 167 Embryology, 11, 72, 78, 167 Enamel, 168, 171 Encephalocele, 168, 183 Encephalopathy, 109, 168
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Spina Bifida
Endarterectomy, 155, 168 Endocrine Glands, 168, 186 Endocrine System, 168 Endocrinology, 21, 168 Endothelial cell, 168, 170, 198 End-stage renal, 162, 168, 188 Enema, 49, 168 Energy balance, 168, 178 Enuresis, 47, 84, 110, 168 Environmental Exposure, 168, 184 Environmental Health, 126, 128, 139, 168 Enzymatic, 159, 163, 168, 202 Enzyme, 38, 75, 168, 172, 181, 191, 194, 198, 202 Epidemic, 5, 64, 87, 168, 196 Epidemiological, 11, 20, 168 Epiphyseal, 29, 168 Epithelial, 10, 168, 169 Epithelial Cells, 10, 169 Erectile, 4, 38, 169 Erection, 169 Erythrocytes, 155, 158, 169, 191, 194 Esophagus, 166, 169, 191, 196 Esotropia, 169, 196 Essential Tremor, 131, 169 Etoposide, 94, 169 Evacuation, 164, 169 Exogenous, 158, 169 Exotropia, 169, 196 Extracellular, 21, 156, 164, 169, 195, 196 Extraction, 12, 161, 169 Extremity, 92, 100, 169, 186 F Facial, 10, 12, 68, 109, 169, 174 Facial Pain, 109, 169 Facial Paralysis, 109, 169 Faecal, 40, 82, 85, 87, 169 Family Planning, 127, 169 Fat, 153, 158, 159, 166, 170, 178, 179, 182, 192, 195 Fathers, 16, 170 Fecal Incontinence, 49, 87, 112, 170, 176 Feces, 164, 169, 170, 196 Femur, 22, 170 Fetal Development, 141, 170, 183 Fetal Viability, 113, 170 Fetus, 16, 40, 112, 161, 170, 189, 196, 200 Fibroblast Growth Factor, 98, 102, 170 Fibrosis, 98, 102, 111, 131, 170, 193 Fissure, 162, 163, 164, 170 Fistula, 170, 198 Fixation, 170, 194
Flatus, 170, 171 Flexion, 42, 100, 170 Fludarabine, 94, 170 Fluorescence, 8, 170 Fluorine, 171 Fluorosis, 47, 171 Folate, 11, 16, 19, 27, 47, 53, 62, 72, 73, 74, 75, 77, 80, 81, 83, 84, 85, 86, 118, 130, 171 Foot Deformities, 101, 171 Fossa, 161, 171 Friction, 100, 171, 179 Fundus, 170, 171 Fungi, 171, 173, 181, 202 G Gallbladder, 153, 166, 171 Ganglia, 157, 171, 183, 186, 197 Gas, 170, 171, 175, 184, 201 Gastrin, 171, 174 Gastritis, 171, 202 Gastrointestinal, 112, 171, 197 Gelatin, 171, 197 Gene Expression, 7, 102, 131, 171 Genetic Code, 171, 184 Genetic Techniques, 7, 171 Genital, 172, 200 Genitourinary, 112, 172, 200 Genotype, 39, 83, 172, 187 Germ Layers, 167, 172 Gestation, 14, 15, 47, 82, 107, 163, 172, 186, 196 Gland, 165, 172, 179, 185, 186, 187, 190, 193, 198 Gliosis, 172, 198 Glomerular, 53, 172, 177, 191 Glomerular Filtration Rate, 53, 172 Glomerulus, 172 Glossopharyngeal Nerve, 169, 172 Glucocorticoid, 172, 189 Glucose, 27, 52, 130, 166, 172, 173, 176 Glucose Intolerance, 166, 172 Glutamic Acid, 171, 172 Glutathione Peroxidase, 172, 193 Governing Board, 172, 189 Grade, 173 Grading, 26, 173 Graft, 94, 173, 174, 176 Graft Rejection, 173, 176 Grafting, 173, 176 Granulocytes, 173, 194, 202 Grasses, 171, 173 Gravis, 109, 113, 173 Growth Disorders, 21, 173
Index 207
Growth factors, 98, 102, 173 H Habitual, 161, 173 Habituation, 13, 173 Headache, 173, 174 Health Services, 23, 173 Hemoglobin, 155, 169, 173, 174 Hemoglobinuria, 130, 174 Hemorrhage, 165, 173, 174, 197 Heparan Sulfate Proteoglycan, 74, 174 Hereditary, 11, 162, 174, 182, 192 Heredity, 171, 172, 174 Heterotropia, 174, 196 Holoprosencephaly, 17, 174 Homodimer, 174, 199 Homologous, 11, 16, 154, 165, 174, 193, 194, 197 Hormonal, 157, 174, 202 Hormone, 58, 76, 165, 171, 174, 177, 178, 186, 188, 192, 194, 198, 199, 201 Hospital Records, 45, 174 Host, 94, 157, 174, 175, 176 Hybrid, 174, 184 Hybridization, 22, 174, 184 Hydrogen, 157, 160, 172, 174, 181, 184, 187, 190 Hydrolysis, 158, 175, 187, 188 Hydronephrosis, 5, 175 Hydrophilic, 19, 166, 175 Hygienic, 175, 194 Hypersensitivity, 25, 154, 155, 166, 175, 178, 192, 194 Hypertension, 113, 175, 177 Hypoglossal Nerve, 109, 175 Hysterotomy, 161, 175 I Id, 79, 87, 90, 136, 137, 139, 140, 148, 150, 175 Idiopathic, 21, 109, 175 Illusions, 32, 175, 193 Immune function, 175, 199 Immune response, 156, 157, 165, 173, 175, 193, 197, 201 Immune system, 94, 158, 175, 176, 182, 200, 202 Immunity, 94, 175 Immunization, 175, 176, 189, 194 Immunodeficiency, 130, 175 Immunologic, 12, 175 Immunology, 25, 32, 35, 39, 40, 44, 46, 50, 54, 60, 66, 154, 175, 177 Immunosuppressive, 165, 172, 175, 176
Immunosuppressive therapy, 175, 176 Immunotherapy, 12, 158, 166, 176 Impairment, 101, 109, 113, 156, 167, 176, 180 Implantation, 111, 120, 163, 176 Impotence, 113, 169, 176 In situ, 49, 176 In vitro, 10, 17, 24, 47, 49, 176 In vivo, 10, 15, 17, 49, 176 Incontinence, 5, 6, 34, 40, 65, 82, 85, 86, 87, 110, 111, 112, 113, 120, 174, 176 Incubation, 10, 176 Indicative, 106, 176, 186, 201 Induction, 176, 178 Infancy, 105, 120, 176, 192 Infarction, 161, 164, 176, 181 Infection, 9, 23, 28, 158, 175, 176, 179, 183, 192, 197, 200, 201, 202 Infertility, 113, 176 Inflammation, 156, 162, 170, 171, 176, 192 Innervation, 175, 176 Inositol, 27, 52, 72, 118, 176 Insight, 21, 177 Insulator, 177, 182 Intermittent, 5, 65, 120, 177 Internal Medicine, 168, 177 Interstitial, 177, 191 Intestinal, 177, 180, 201, 202 Intestine, 159, 177, 178 Intoxication, 109, 177, 202 Intracellular, 160, 171, 176, 177, 193, 194 Intracranial Hemorrhages, 174, 177, 198 Intracranial Hypertension, 173, 174, 177 Intracranial Pressure, 109, 177 Intravenous, 22, 177 Intravesical, 76, 83, 177 Intrinsic, 17, 90, 154, 177 Intubation, 160, 177 Inulin, 172, 177 Invasive, 175, 177, 180 Investigative Techniques, 23, 177 Involuntary, 12, 22, 110, 111, 157, 161, 168, 169, 170, 177, 182 Iodine, 46, 80, 177 Ions, 157, 167, 175, 177, 178, 195 Ischemia, 157, 166, 177 Isoelectric, 178, 196 Isoelectric Point, 178, 196 J Joint, 36, 42, 57, 64, 65, 100, 156, 178, 179, 197
208
Spina Bifida
K Kb, 126, 178 Ketamine, 111, 178 Kidney Disease, 95, 113, 126, 131, 175, 178 Kidney stone, 175, 178 Kinetic, 178 L Large Intestine, 166, 177, 178, 191, 195 Latent, 178, 189 Latex Allergy, 5, 12, 32, 34, 35, 39, 40, 44, 49, 55, 60, 178 Leptin, 54, 75, 178 Lesion, 52, 86, 98, 102, 172, 178, 179 Lethal, 11, 178 Lethargy, 174, 178 Leukemia, 94, 130, 162, 167, 178, 182, 189 Leukocytes, 158, 173, 178 Library Services, 148, 178 Life Expectancy, 4, 178 Ligament, 178, 190 Ligands, 25, 179 Linkage, 18, 100, 179 Linkage Disequilibrium, 18, 179 Lip, 63, 113, 174, 179 Lipid, 179, 182 Lipoma, 38, 39, 47, 179 Liver, 94, 153, 157, 158, 165, 166, 170, 171, 179, 189, 202 Localization, 74, 179 Localized, 170, 176, 179, 187, 200 Longitudinal study, 17, 19, 26, 51, 179 Lubricants, 179 Lubrication, 100, 179 Lumbar, 32, 51, 52, 160, 179 Lumen, 98, 102, 179 Luxation, 167, 179 Lymph, 161, 162, 168, 179 Lymph node, 161, 179 Lymphatic, 176, 179, 195 Lymphoblasts, 153, 179 Lymphocytic, 179 Lymphoid, 155, 179, 180 Lymphoma, 94, 130, 180 M Magnetic Resonance Imaging, 47, 99, 180 Malabsorption, 130, 180 Malformation, 14, 20, 57, 112, 180 Malignant, 130, 156, 159, 180, 182, 192, 198 Malignant tumor, 180, 182, 192 Malnutrition, 157, 180, 182 Mammogram, 159, 180, 181 Manifest, 180, 196
Mastication, 180, 199 Medical Records, 174, 180, 192 Medicament, 180, 197 MEDLINE, 127, 129, 131, 180 Megaloblastic, 171, 180 Melanocytes, 180 Melanoma, 130, 180 Membrane, 10, 154, 156, 160, 163, 164, 166, 180, 183, 187, 192, 194, 195 Memory, 67, 155, 180 Meninges, 161, 165, 180, 196 Meningocele, 45, 99, 180 Mental Disorders, 96, 180, 189 Mental Health, iv, 6, 96, 126, 128, 180, 184, 189, 190 Mental Retardation, 61, 101, 132, 167, 174, 180 Mentors, 23, 180 Mercury, 109, 181 Mesoderm, 9, 181 Metabolite, 31, 78, 158, 181 Methionine, 47, 58, 72, 74, 84, 88, 181, 197 Methyltransferase, 33, 181 MI, 38, 47, 86, 151, 181 Microbiology, 22, 181 Microcalcifications, 159, 181 Microorganism, 162, 181, 186, 202 Microscopy, 8, 181 Milliliter, 158, 181 Mineralization, 102, 181, 185 Mitotic, 169, 181 Mobility, 10, 45, 46, 100, 113, 181 Modeling, 13, 17, 181 Modification, 87, 110, 181, 190 Molecule, 156, 157, 163, 175, 181, 184, 191, 194, 201 Monitor, 165, 181 Monoclonal, 181, 192 Morphogenesis, 6, 8, 182 Morphological, 11, 167, 180, 182 Motility, 8, 182 Movement Disorders, 182, 198 Multiple Myeloma, 94, 182 Multiple sclerosis, 109, 111, 112, 113, 182 Muscle Fibers, 182 Muscular Atrophy, 131, 182 Muscular Diseases, 169, 182, 185 Muscular Dystrophies, 113, 167, 182 Mutagenesis, 7, 9, 182 Mutagens, 182 Myasthenia, 109, 113, 182 Mydriatic, 166, 182
Index 209
Myelin, 182, 194 Myelodysplasia, 21, 23, 182 Myelodysplastic syndrome, 94, 182, 195 Myelogenous, 182 Myeloproliferative Disorders, 93, 94, 182 Myocardium, 181, 182 Myosin, 7, 182 Myotonic Dystrophy, 131, 183 N Narcotic, 183, 184 NCI, 1, 93, 95, 125, 162, 183 Necrosis, 161, 176, 181, 183 Need, 3, 9, 14, 15, 19, 22, 38, 55, 101, 105, 109, 113, 115, 119, 142, 162, 183 Neonatal, 14, 45, 46, 64, 183 Neoplasia, 130, 183 Neoplastic, 169, 180, 183 Nephropathy, 178, 183 Neural tube defects, 4, 5, 7, 10, 11, 15, 18, 19, 24, 41, 46, 60, 62, 72, 73, 74, 75, 76, 77, 78, 81, 82, 83, 84, 85, 86, 87, 109, 118, 139, 183 Neurogenic, 28, 83, 85, 183 Neurologic, 109, 110, 111, 168, 174, 183 Neuromuscular, 169, 183, 185, 192 Neuromuscular Junction, 183, 192 Neuromuscular Junction Diseases, 183, 192 Neuropathy, 109, 112, 183 Neurosurgery, 26, 32, 34, 35, 38, 39, 42, 47, 48, 49, 50, 51, 55, 57, 59, 62, 64, 68, 77, 136, 183 Neutrons, 154, 184, 190 Nitrogen, 165, 170, 184 Nitrous Oxide, 111, 184 Notochord, 8, 184 Nuclei, 154, 167, 169, 180, 184, 190 Nucleic acid, 22, 98, 102, 171, 174, 182, 184 Nucleic Acid Hybridization, 174, 184 Nucleus, 157, 165, 175, 184, 190, 198 Nursing Care, 5, 184 O Occult, 59, 184 Occupational Exposure, 52, 184 Occupational Health, 13, 184 Ointments, 184, 194, 195 Oligonucleotide Probes, 22, 184 Oncogene, 130, 184 Opacity, 166, 185 Oral Health, 109, 113, 185 Orofacial, 11, 57, 169, 185 Ossification, 98, 102, 185, 192
Osteogenesis, 21, 113, 185 Osteogenesis Imperfecta, 21, 113, 185 Osteomalacia, 113, 185 Osteoporosis, 21, 113, 185 Outpatient, 185 Ovaries, 185, 194, 198 Ovum, 172, 185 P Palate, 113, 162, 172, 185 Palliative, 185, 198 Palsies, 109, 185 Palsy, 21, 109, 113, 185 Pancreas, 153, 158, 166, 185 Pancreatic, 130, 185 Pancreatic cancer, 130, 185 Paralysis, 39, 67, 169, 185, 186 Paraplegia, 25, 27, 28, 40, 64, 100, 185 Parathyroid, 185, 186, 192 Parathyroid Glands, 185, 186, 192 Paresis, 169, 186 Paroxysmal, 130, 186 Particle, 186, 199 Pathogen, 22, 176, 186 Pathogenesis, 21, 46, 74, 186 Pathologic, 35, 159, 164, 175, 186, 192, 196 Patient Compliance, 31, 186 Patient Education, 111, 138, 146, 148, 151, 186 Pediatric Endocrinologist, 21, 186 Pediatrics, 15, 18, 21, 22, 23, 37, 39, 43, 50, 52, 55, 64, 72, 73, 74, 77, 87, 139, 186 Pelvic, 58, 100, 112, 186, 190 Peptic, 186, 202 Peptic Ulcer, 186, 202 Peptide, 170, 178, 186, 188, 190 Perception, 13, 43, 91, 164, 186, 193 Perinatal, 40, 112, 186 Peripheral Nervous System, 185, 186, 197 Peripheral Nervous System Diseases, 185, 186 PH, 24, 37, 42, 158, 187 Pharmacokinetic, 187 Pharmacologic, 110, 155, 187, 199 Phenotype, 57, 98, 102, 187 Phospholipases, 187, 194 Phospholipids, 170, 176, 187 Phrenic Nerve, 187, 192 Physical Examination, 94, 187 Physical Therapy, 29, 187 Physiologic, 110, 158, 170, 177, 187, 191, 192 Physiology, 30, 112, 168, 187
210
Spina Bifida
Pigment, 180, 187 Pilot study, 48, 187 Pituitary Gland, 170, 187 Placebos, 4, 187 Plants, 172, 177, 187, 199 Plaque, 155, 187 Plasma, 20, 37, 53, 58, 73, 76, 155, 160, 171, 172, 173, 182, 188, 193 Plasma cells, 155, 182, 188 Platelet Activation, 188, 194 Platelet-Derived Growth Factor, 24, 188 Platelets, 188, 198 Podophyllotoxin, 169, 188 Poisoning, 177, 181, 188 Polycystic, 131, 188 Polyhydramnios, 112, 188 Polymorphic, 27, 72, 188 Polymorphism, 16, 36, 73, 188 Polypeptide, 98, 102, 154, 163, 174, 188, 202 Pons, 159, 169, 188 Posterior, 4, 100, 110, 155, 157, 161, 167, 172, 185, 188 Postmenopausal, 185, 188 Postnatal, 14, 15, 28, 56, 188, 196 Postsynaptic, 183, 188, 194 Potentiation, 188, 194 Practice Guidelines, 128, 139, 188 Precursor, 165, 168, 189, 199, 201 Predisposition, 11, 189 Prednisolone, 189 Prednisone, 94, 189 Preleukemia, 182, 189, 195 Prenatal, 28, 31, 34, 40, 64, 77, 112, 136, 167, 189 Prenatal Diagnosis, 28, 112, 189 Prevalence, 12, 21, 55, 59, 61, 66, 76, 78, 113, 189 Primary endpoint, 12, 189 Primary Prevention, 37, 87, 189 Probe, 184, 189 Progression, 59, 91, 155, 189 Progressive, 17, 44, 160, 162, 173, 182, 183, 188, 189, 191 Prone, 47, 189 Prophylaxis, 4, 37, 59, 76, 189 Prosencephalon, 174, 189 Prospective study, 179, 189 Prostate, 110, 111, 130, 190 Prosthesis, 111, 190 Protein C, 17, 154, 157, 190 Protein S, 131, 132, 158, 171, 190
Proteinuria, 182, 190 Protocol, 15, 187, 190 Protons, 154, 175, 190 Proximal, 32, 54, 75, 167, 190 Psychic, 81, 190, 193 Psychomotor, 159, 168, 190 Public Health, 11, 41, 73, 75, 83, 85, 128, 190 Public Policy, 127, 190 Publishing, 24, 86, 110, 111, 113, 190 Pupil, 164, 166, 182, 190 Q Quality of Life, 14, 15, 23, 35, 36, 40, 44, 83, 90, 91, 141, 190 R Radiation, 4, 94, 168, 170, 190, 202 Radioactive, 175, 176, 190 Radioisotope, 184, 190 Random Allocation, 190, 191 Randomization, 15, 191 Randomized, 12, 14, 81, 167, 191 Randomized clinical trial, 14, 191 Reagent, 12, 191 Receptor, 11, 24, 25, 54, 75, 84, 98, 102, 156, 164, 183, 191, 194 Recombination, 11, 16, 191 Rectum, 156, 159, 166, 170, 171, 176, 178, 190, 191, 197 Recurrence, 11, 76, 86, 161, 191 Red blood cells, 74, 169, 191 Red Nucleus, 157, 191 Reductase, 16, 20, 34, 36, 37, 39, 53, 54, 58, 59, 72, 73, 74, 75, 77, 83, 85, 191 Refer, 1, 163, 170, 171, 179, 184, 191 Reflux, 110, 191 Refraction, 191, 195 Refractory, 49, 191 Regeneration, 47, 74, 170, 191 Regimen, 167, 186, 191 Registries, 66, 191 Remission, 191 Renal failure, 5, 191 Resorption, 174, 192 Respiration, 181, 192 Respiratory Paralysis, 109, 192 Restoration, 187, 192, 202 Retina, 156, 192 Retinoblastoma, 130, 192 Retrospective, 24, 192 Retrospective study, 24, 192 Rhabdomyosarcoma, 52, 192 Rheumatism, 192
Index 211
Rheumatoid, 25, 192 Rheumatoid arthritis, 25, 192 Rickets, 113, 192, 202 Rigidity, 177, 187, 192 Risk factor, 12, 16, 25, 35, 38, 39, 48, 54, 55, 58, 60, 75, 77, 189, 192 Rituximab, 94, 192 Rod, 157, 162, 184, 192 Rubber, 12, 46, 55, 139, 153, 178, 192 S Salivary, 166, 185, 193 Salivary glands, 166, 193 Schizoid, 193, 202 Schizophrenia, 193, 202 Schizotypal Personality Disorder, 193, 202 Sclerae, 185, 193 Sclerosis, 131, 182, 193 Scoliosis, 22, 193 Screening, 9, 12, 36, 40, 52, 61, 106, 137, 162, 193 Secretion, 193, 199 Secretory, 193, 202 Segmentation, 9, 174, 193 Segregation, 191, 193 Seizures, 159, 174, 186, 193 Selenium, 74, 193 Self Care, 153, 193 Self Concept, 46, 193 Semen, 190, 193 Semisynthetic, 169, 193 Senile, 185, 193 Sensibility, 155, 193 Sensitization, 12, 37, 45, 50, 60, 66, 193 Sensor, 22, 194 Sensory loss, 109, 194, 198 Serum, 77, 120, 163, 194 Sex Characteristics, 153, 194, 198 Sex Determination, 131, 194 Sexually Transmitted Diseases, 113, 194 Shock, 44, 155, 194, 199 Shunt, 14, 51, 118, 194 Side effect, 121, 153, 158, 165, 194, 199 Signal Transduction, 7, 15, 176, 194 Skeletal, 21, 101, 162, 173, 182, 194 Skeleton, 153, 170, 178, 194, 195 Skin Care, 5, 194 Skull, 99, 141, 165, 168, 177, 180, 183, 195, 198 Small intestine, 174, 177, 195, 201 Smoldering leukemia, 182, 195 Smooth muscle, 98, 102, 182, 195, 197 Soaps, 194, 195
Social Environment, 190, 195 Social Problems, 55, 195 Social Work, 90, 107, 195 Socioeconomic Factors, 66, 195 Sodium, 77, 78, 82, 195, 201 Sodium Channels, 195, 201 Soft tissue, 158, 194, 195 Solid tumor, 167, 195 Somatic, 153, 165, 167, 172, 186, 195, 200 Specialist, 55, 142, 166, 195 Species, 20, 21, 22, 161, 174, 182, 195, 197, 199, 202 Spectrum, 141, 195 Sperm, 162, 196, 198 Sphincter, 48, 111, 120, 196 Spinal Cord Diseases, 136, 185, 192, 196 Spinal Cord Injuries, 100, 111, 196 Spinal Injuries, 113, 196 Spirochete, 196, 197 Spondylolisthesis, 62, 196 Spondylolysis, 64, 196 Spontaneous Abortion, 29, 196 Sporadic, 192, 196 Steel, 162, 196 Stem cell transplantation, 94, 196 Stem Cells, 11, 17, 94, 196 Sterility, 165, 176, 196 Stomach, 153, 166, 169, 171, 174, 191, 195, 196 Stool, 176, 178, 196 Strabismus, 16, 65, 196 Streptavidin, 22, 196 Stress, 3, 60, 189, 192, 196, 200 Stroke, 10, 96, 109, 112, 113, 126, 137, 197 Styrene, 192, 197 Subacute, 176, 197 Subclinical, 176, 193, 197 Subspecies, 195, 197 Substance P, 181, 193, 197 Sulfur, 181, 197 Supine, 99, 197 Supine Position, 99, 197 Supplementation, 11, 12, 16, 45, 74, 76, 78, 82, 83, 84, 86, 87, 197 Support group, 114, 197 Suppositories, 106, 171, 197 Suppression, 94, 197 Sympathetic Nervous System, 184, 197 Symphysis, 190, 197 Symptomatic, 9, 197 Synaptic, 194, 197 Syncope, 109, 197
212
Spina Bifida
Syphilis, 109, 197 Syringomyelia, 109, 198 Syrinx, 59, 198 Systemic, 12, 56, 122, 155, 158, 176, 177, 189, 198 Systolic, 175, 198 T Telangiectasia, 131, 198 Temporal, 9, 15, 198 Teratogenic, 11, 16, 198 Teratoma, 48, 198 Testicles, 198 Testosterone, 191, 198 Thalamic, 157, 198 Thalamic Diseases, 157, 198 Therapeutics, 82, 85, 86, 122, 177, 198 Thorax, 179, 198, 200 Threshold, 175, 198 Thrombin, 190, 198 Thrombomodulin, 190, 198 Thrombosis, 190, 197, 198 Thrombus, 164, 176, 198, 201 Thyroid, 177, 185, 186, 198 Tomography, 99, 158, 199 Topical, 46, 156, 195, 199 Toxic, iv, 165, 168, 173, 175, 183, 188, 193, 197, 199 Toxicity, 167, 181, 199 Toxicokinetics, 199 Toxicology, 52, 78, 128, 199 Toxins, 156, 176, 199 Traction, 162, 199 Transduction, 7, 194, 199 Transfection, 158, 199 Transforming Growth Factor beta, 98, 102, 199 Transfusion, 199 Transplantation, 51, 60, 162, 175, 199 Transurethral, 120, 199 Trauma, 21, 113, 183, 199 Trees, 192, 199 Trigeminal, 109, 169, 199 Trophic, 68, 199 Tuberculosis, 164, 199 Tuberous Sclerosis, 131, 200 U Ultrasonography, 26, 200 Unconscious, 175, 200 Uremia, 191, 200 Ureter, 175, 200 Urethra, 112, 190, 199, 200
Urinary, 5, 6, 9, 14, 22, 58, 65, 90, 110, 111, 112, 120, 138, 165, 168, 172, 174, 176, 200 Urinary tract, 5, 9, 22, 110, 112, 120, 138, 200 Urinary tract infection, 5, 9, 22, 110, 138, 200 Urinate, 110, 111, 200 Urine, 22, 77, 111, 156, 158, 164, 165, 168, 174, 175, 176, 178, 190, 200, 201 Urodynamic, 36, 120, 200 Urogenital, 172, 200 Urogenital Diseases, 200 Urologic Diseases, 113, 200 Urologist, 5, 200 Urticaria, 155, 200 Uterus, 161, 164, 170, 171, 175, 185, 200 V Vaccine, 190, 200 Vagal, 109, 200 Vaginal, 179, 200 Vagus Nerve, 200 Valproic Acid, 78, 88, 201 Valves, 110, 201 Vascular, 27, 98, 102, 155, 176, 196, 198, 200, 201 VE, 36, 57, 81, 109, 201 Vector, 199, 201 Vein, 94, 177, 201 Venereal, 197, 201 Venous, 34, 94, 161, 190, 201 Venous Thrombosis, 34, 201 Ventricle, 198, 201 Ventricular, 14, 15, 66, 174, 201 Venules, 158, 159, 201 Vertebrae, 4, 141, 196, 201 Vertebral, 157, 180, 184, 196, 201 Vesicoureteral, 110, 201 Veterinary Medicine, 127, 201 Villi, 174, 201 Vinca Alkaloids, 201 Vincristine, 94, 201 Viral, 199, 201 Virus, 157, 161, 187, 199, 201 Visceral, 165, 172, 200, 201 Visual Perception, 56, 201 Vitamin A, 176, 201 Vitamin D, 74, 192, 201 Vitamin U, 39, 53, 59, 75, 83, 85, 202 Vitro, 202 Vivo, 202 Volition, 177, 202
Index 213
W Weight Gain, 75, 202 White blood cell, 153, 155, 162, 178, 179, 188, 202 Withdrawal, 58, 202 Wound Healing, 170, 202 Wounds, Gunshot, 196, 202
X Xenograft, 155, 202 X-ray, 99, 158, 170, 180, 202 Y Yeasts, 171, 187, 202 Z Zymogen, 190, 202
214
Spina Bifida
Index 215
216
Spina Bifida
