VOMITING 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., 1960Vomiting: 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: 0-597-84683-9 1. Vomiting-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 vomiting. 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 VOMITING ................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Vomiting ....................................................................................... 7 E-Journals: PubMed Central ....................................................................................................... 30 The National Library of Medicine: PubMed ................................................................................ 31 CHAPTER 2. NUTRITION AND VOMITING ....................................................................................... 77 Overview...................................................................................................................................... 77 Finding Nutrition Studies on Vomiting...................................................................................... 77 Federal Resources on Nutrition ................................................................................................... 79 Additional Web Resources ........................................................................................................... 80 CHAPTER 3. ALTERNATIVE MEDICINE AND VOMITING ................................................................. 83 Overview...................................................................................................................................... 83 The Combined Health Information Database............................................................................... 83 National Center for Complementary and Alternative Medicine.................................................. 84 Additional Web Resources ........................................................................................................... 94 General References ..................................................................................................................... 116 CHAPTER 4. DISSERTATIONS ON VOMITING ................................................................................. 117 Overview.................................................................................................................................... 117 Dissertations on Vomiting......................................................................................................... 117 Keeping Current ........................................................................................................................ 118 CHAPTER 5. PATENTS ON VOMITING............................................................................................ 119 Overview.................................................................................................................................... 119 Patents on Vomiting .................................................................................................................. 119 Patent Applications on Vomiting .............................................................................................. 144 Keeping Current ........................................................................................................................ 168 CHAPTER 6. BOOKS ON VOMITING ............................................................................................... 169 Overview.................................................................................................................................... 169 Book Summaries: Federal Agencies............................................................................................ 169 Book Summaries: Online Booksellers......................................................................................... 179 Chapters on Vomiting................................................................................................................ 180 Directories.................................................................................................................................. 182 CHAPTER 7. MULTIMEDIA ON VOMITING..................................................................................... 183 Overview.................................................................................................................................... 183 Video Recordings ....................................................................................................................... 183 CHAPTER 8. PERIODICALS AND NEWS ON VOMITING.................................................................. 185 Overview.................................................................................................................................... 185 News Services and Press Releases.............................................................................................. 185 Newsletters on Vomiting ........................................................................................................... 187 Newsletter Articles .................................................................................................................... 188 Academic Periodicals covering Vomiting .................................................................................. 189 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................. 191 Overview.................................................................................................................................... 191 U.S. Pharmacopeia..................................................................................................................... 191 Commercial Databases ............................................................................................................... 199 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 203 Overview.................................................................................................................................... 203 NIH Guidelines.......................................................................................................................... 203 NIH Databases........................................................................................................................... 205 Other Commercial Databases..................................................................................................... 207
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APPENDIX B. PATIENT RESOURCES ............................................................................................... 209 Overview.................................................................................................................................... 209 Patient Guideline Sources.......................................................................................................... 209 Associations and Vomiting ........................................................................................................ 218 Finding Associations.................................................................................................................. 219 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 221 Overview.................................................................................................................................... 221 Preparation................................................................................................................................. 221 Finding a Local Medical Library................................................................................................ 221 Medical Libraries in the U.S. and Canada ................................................................................. 221 ONLINE GLOSSARIES................................................................................................................ 227 Online Dictionary Directories ................................................................................................... 229 VOMITING DICTIONARY......................................................................................................... 231 INDEX .............................................................................................................................................. 325
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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 vomiting 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 vomiting, 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 vomiting, 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 vomiting. 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 vomiting, 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 vomiting. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON VOMITING Overview In this chapter, we will show you how to locate peer-reviewed references and studies on vomiting.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and vomiting, 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 “vomiting” (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: •
Diagnostic Evaluation of Children with Cyclic Vomiting: A Cost-Effectiveness Assessment Source: Journal of Pediatrics. 141(5): 724-728. November 2002. Contact: Mosby, Inc. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Because patients with cyclic vomiting often (82 percent) have a family history of migraines and often (60 percent) respond to antimigraine therapy, the authors of this article investigated whether an initial therapeutic trial could precede diagnostic testing. The authors used a decision analysis program to compare the cost and benefit of three initial treatment strategies. The costs of the three strategies were extensive diagnostic evaluation, $3020; empiric treatment alone, $1830; and upper GI series with small bowel
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follow through (UGI-SBFT) plus empiric treatment, $1600. When compared with the extensive evaluation strategy, initial antimigraine treatment avoided 65 percent of the esophagogastroduodenoscopies. On the basis of this decision analysis, a UGI-SBFT plus empiric migraine therapy was the most cost-effective initial strategy to treat cyclic vomiting syndrome. The cost of complications of a missed malrotation with volvulus was higher than that of adding a UGI-SBFT to each evaluation. 5 figures. 2 tables. 10 references. •
Psychogenic Vomiting-A Disorder of Gastrointestinal Motility? Source: Lancet. Volume 339: 279. February 1, 1992. Summary: For many people, psychogenic vomiting is an occasional event associated with severe emotional stress. For a few people, continuing emotional conflicts lead to a syndrome of persistent or recurrent vomiting serious enough to require medical intervention. This brief article reviews this condition, focusing on the clinical presentation and some research done in this area. The author concludes that it is time to abandon the belief that psychogenic vomiting is a diagnosis to be considered only after organic disorders have been excluded. 14 references.
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Cyclic Vomiting Syndrome Source: Practical Gastroenterology. 26(5): 77-78. May 2002. Contact: Available from Shugar Publishing. 12 Moniebogue Lane, Westhampton Beach, NY 11978. (516) 288-4404. Fax (516) 288-4435. Summary: In cyclic vomiting syndrome (CVS), people experience bouts or cycles of severe nausea and vomiting that last for hours or even days and alternate with longer periods of no symptoms. CVS occurs mostly in children, but the disorder can affect adults too. This article reviews the symptoms and phases of CVS, its diagnosis, treatment, and complications. CVS has four phases: prodrome phase which signals that an episode of nausea and vomiting is about to begin; the episode itself; recovery; and the symptom-free interval between episodes. CVS is difficult to diagnose because there is no one test that can identify the condition. Treatment varies, but people with CVS are generally advised to get plenty of rest; sleep; and take medications that prevent a vomiting episode, stop or alleviate one that has already started, or relieve other symptoms. The severe vomiting that defines CVS is a risk factors for several complications: dehydration, electrolyte imbalance, peptic esophagitis, hematemesis (blood in the vomit), Mallory-Weiss tear in the esophagus, and tooth decay. One additional section discusses the potential relationship between migraine and CVS.
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Cyclic Vomiting Syndrome: The Corticotropin-Releasing-Factor Hypothesis Source: Digestive Diseases and Sciences. 44(8 Supplement): 79S-86S. August 1999. Contact: Available from Kluwer Academic Publishers. Customer Service Department, P.O. Box 358, Accord Station, Hingham, MA 02018-0358. (781) 871-6600. Fax (781) 6819045. E-mail:
[email protected]. Website: www.wkap.nl. Distribution Centre, P.O. Box 322, 3300 AH Dordrecht, The Netherlands. 31 78 6392392. Fax: 31 78 6546474. E-mail:
[email protected]. Summary: The characterization of corticotropin-releasing factor (CRF) and CRF receptors, and the use of specific CRF antagonists have paved the way to establish a key role of brain CRF in the coding of the stress response. In this article, the authors review recent advances on CRF related peptides and CRF receptors and on the development of
Studies
5
selective CRF antagonists that have provided valuable tools to assess the role of endogenous (in the body) CRF in the stress response. The authors detail experimental evidence supporting the role of brain CRF in mediating the inhibition of gastric (stomach) motor alterations induced by various stressors. Whether central CRF can induce vomiting is still to be established, since most studies on the inhibitory effect of CRF on gastric motor function were performed in nonretching rodents. However, nausea and vomiting are often attributed to impaired gastric motility and transit. The authors consider the possible relevance of brain CRF in the pathophysiology of cyclic vomiting syndrome (CVS). CVS is brought on by stimuli or states associated with stimulation of CRF release, and the resulting endocrine, autonomic, and visceral changes are indicative of central CRF activation. Moreover, empiric pharmacology alleviating CVS symptoms are known experimentally to block CRF release or action. 1 figure. 1 table. 5 references. •
Cyclic Vomiting Syndrome: A Pediatric Rorschach Test (editorial) Source: Journal of Pediatric Gastroenterology and Nutrition. 17(4): 351-353. 1993. Contact: Available from Raven Press, Ltd. 1185 Avenue of the Americas, 37th Floor, New York, NY 10190-0222. (212) 930-9500. Summary: This article comments on cyclic vomiting sydrome and on two relevant articles appearing in this same journal. The article addresses the lack of understanding about this disorder; symptoms and recurrence; potential triggers of cyclic vomiting and their prevalence; prognosis for children with this disorder; issues of classification; the role of psychologic stress; recommended diagnostic tests; and patient management considerations. The author concludes with a call for collaboration between pediatric gastroenterologists and colleagues in neurology, psychology, and psychiatry in an attempt to help patients with cyclic vomiting syndrome. 18 references.
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Cyclic Vomiting Syndrome Described Source: Journal of Pediatric Gastroenterology and Nutrition. 21(supplement): S1-S5. 1995. Summary: This article describes cyclical vomiting syndrome (CVS), which consists of discrete episodes of nausea and vomiting lasting hours or days, separated by symptomfree intervals of similar or varying lengths. The disorder is not caused by underlying organic disease. The episodes are self-limited, and for each patient, tend to be similar in time of onset, duration, and symptomatology. The majority of patients can identify experiences or conditions that may precipitate episodes, the most common being heightened emotional states and infections. The onset of CVS most often occurs during preschool or early school years, although it may begin at any age, from infancy to mature adulthood. 5 figures. 7 references. (AA-M).
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Psychophysiologic Treatment of Cyclic Vomiting Source: Journal of Pediatric Gastroenterology and Nutrition. 21(supplement): S31-S36. 1995. Summary: This article explores ways of lessening the psychologic and social effects of cyclical vomiting (CV) in children. The author describes a multidisciplinary treatment plan for the family that involves the pediatrician, school, psychotherapist, and family as effective therapeutic agents. The author contends that the child needs help expressing feelings that he or she cannot put into words. The article describes dramatic play
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involving symbolization of the illness, creation of metaphors in stories and drawings for the dilemmas surrounding CV, and family therapy in which unnamed stresses are given consideration. Through this treatment, health and hope are promoted. 10 references. (AA-M). •
Nausea, Vomiting and Diarrhea: An Unusual Presentation of Multiple Sclerosis Source: Canadian Journal of Gastroenterology. 11(4): 367-370. May-June 1997. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Summary: This article presents the case of a young woman who presented with nausea, vomiting, and diarrhea. The etiology turned out to be a first attack of multiple sclerosis (MS). MS is a multifocal demyelinating disorder that usually affects young adults with subacute onset of focal neurological symptoms. The majority (80 percent) of patients present with visual, sensory or gait disturbances; patients older than 40 years more commonly exhibit symptoms of progressive myelopathy. The 33-year-old woman presented to the emergency room with a two-week history of nausea, vomiting and intermittent (one to four times per day) loose watery stools without blood. The vomiting and diarrhea were not associated with cramps, fever, or chills. She experienced mild light- headedness, especially on arising, and complained of mild left neck pain. There was no history of alcohol or substance abuse. The patient's mother died of disabling MS and a younger brother was recently diagnosed with MS. Physical examination at admission disclosed a thin woman in no acute distress, with normal vital signs; general and neurological examinations were entirely within normal limits. The gastroenterologic workup was normal. Because symptoms persisted and nausea was a prominent feature, and because of the family history, neurological consultation was obtained and supported the diagnosis of MS. The authors describe her treatment and subsequent improvement. She has been well without gastrointestinal or neurological symptoms for the five years of followup. The authors conclude that cases such as these should alert non-neurology physicians that persistent upper and lower gastrointestinal symptoms may, on occasion, be a consequence of primary central nervous system pathology. 1 figure. 23 references. (AA-M).
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Effective Prophylactic Therapy for Cyclic Vomiting Syndrome in Children Using Amitriptyline or Cyproheptadine Source: Pediatrics. 100(6): 977-981. December 1997. Contact: Available from American Academy of Pediatrics. P.O. Box 927, Elk Grove Village, IL 60009-0927. Summary: This article reports on a study in which the authors evaluate their experiences using the antimigraine prophylactic drugs, amitriptyline and cyproheptadine, for the prophylactic management of cyclic vomiting syndrome (CVS) in children. Twentyseven patients (16 males) ranging in age from 2 to 16 years at diagnosis, fulfilling the diagnostic criteria for CVS and treated prophylactically with either amytriptyline (n = 22) or cyproheptadine (n = 6; some patients received both) were identified through retrospective chart review. Individual patient data were corroborated by the attending physician and interviews with patients and families. Minimum followup time before entry into the study group was 5 months. Patients were stratified according to three treatment outcomes: complete response, no attacks; partial response, 50 percent or greater reduction in frequency of attacks; or no response, less than 50 percent decrease in frequency of attacks. Of the 22 patients treated with amitriptyline, 16 (73 percent) had
Studies
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a complete response, while 4 (18 percent) had a partial response. Of the 6 patients treated with cyproheptadine, 4 (66 percent) had a complete response and 1 (17 percent) had a partial response. Thus, 91 percent of the amitriptyline group and 83 percent of the cyproheptadine groups had at least a partial response to therapy. No patients experienced significant side effects to either medication. The authors conclude that the antimigraine prophylactic drugs, amitriptyline and cyproheptadine, represent effective prophylactic agents for the management of CVS in the vast majority of patients fulfilling the diagnostic criteria for this syndrome. 2 tables. 25 references. (AA-M).
Federally Funded Research on Vomiting The U.S. Government supports a variety of research studies relating to vomiting. 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 vomiting. 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 vomiting. The following is typical of the type of information found when searching the CRISP database for vomiting: •
Project Title: A GASTROPARESIS
MULTI-CHANNEL
GASTRIC
PACER
FOR
TREATING
Principal Investigator & Institution: Ross, Robert A.; Virginia Technologies, Inc. 2015 Ivy Rd, Ste 423 Charlottesville, Va 22903 Timing: Fiscal Year 2003; Project Start 15-SEP-2000; Project End 31-JUL-2006 Summary: (provided by applicant): In a new therapeutic approach for delayed gastric emptying and gastroparesis, Virginia Technologies, Inc. (VTI) proposes: (1) to develop a 4-channel implantable gastric pacemaker, using pulse train electrical signals and capacitive coupling for patient safety and energy efficiency; (2) to develop a multichannel pacing lead, optimized for gastric applications; (3) to develop a transcutaneous programmer and wand, enabling healthcare providers to customize and optimize pacing parameters to the needs of each patient; and (4) to test this system in animal models, studying safety and efficacy. The long-term goal of this research is to develop an implantable device for the superior treatment of motility disorders associated with gastroparesis in humans. Electrical stimulation of the gastrointestinal organs represents a promising new treatment for gastric motility disorders. These organs have natural pacemakers that generate myoelectrical activity, regulating contractions and motility. Myoelectrical abnormalities can disturb muscular activity, impairing contraction and leading to delay or failure of gastric emptying. In gastroparesis, impaired gastric 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).
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emptying can lead to nausea, vomiting, premature satiety, abdominal pain, abdominal bloating, weight loss, bacterial overgrowth, and obstruction, as well as difficulties in managing blood glucose levels in diabetics. Traditional therapies for gastroparesis including, prokinetic medications, tube feeding via jejunostomy and total parenteral nutrition (TPN), have various limitations. A number of patients are refractory to the available medications, which also pose the risk of side effects and medicinal interactions. Jejunostomy and TPN offer nutritional support and address the symptoms of gastroparesis, but pose quality-of-life issues and do not correct the underlying disorder. Single-point, low-energy electrical stimulation, such as that provided by Medtronic's Enterra TM Therapy, also generally treats symptoms of nausea and vomiting, rather than the underlying disorder. In a new treatment option for motility disorders, the multi-channel phased gastric pacemaker uses electrical pacing to mimic the natural propagation of gastric slow waves. It generates peristaltic electrical waves that progress from the proximal to the distal stomach, seeking to entrain gastric slow waves, normalize gastric myoelectrical dysrhythmias, and normalize gastric emptying. Recent studies have shown that multi-channel pacing entrains gastric slow waves more effectively than prior single-channel high-energy approaches, and that a multi-channel design requires less energy, making it more appropriate for a long-term humanimplantable therapeutic device. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ACUPUNCTURE TO PREVENT POSTOPERATIVE PARALYTIC LLEUS Principal Investigator & Institution: Chiang, Joseph S.; Anesthesiology; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 28-FEB-2005 Summary: (provided by applicant): The primary aim of this prospective randomized trial is to determine if acupuncture is effective in preventing postoperative paralytic ileus (PPI) among cancer survivors undergoing colostomy/ileostomy closure. Additional objectives are to: 1) compare post-surgical quality of life status between treatment and control groups in terms of pain, use of opioid analgesics, nausea, vomiting, insomnia, abdominal distention/fullness, activity, and sense of well-being; and 2) compare costs due to extended hospital stay and care related to ileus between patients who develop PPI and those who do not. This study will also provide preliminary data for subsequent large scale projects and serve as a basis for future research in an area where existing evidence is sparse, yet potential benefits to patient care are considerable. The treatment group will receive acupuncture with electrical stimulation twice each day for 20 minutes beginning on postoperative day 1 and ending on postoperative day 4 for a total of 8 treatments. With each treatment session, 10 needles will be placed on points LI-4, Sp-6, St-36, St-25, CV-6, and CV-12, and electroacupuncture will be applied at points LI-4 and St-36. A bowel motility index including bowel sounds, passage of flatus, bowel movement, and diet tolerance will be recorded for both groups until 72 hours after acupuncture treatments have been stopped or until hospital discharge. Information regarding pain, use of opioid analgesics, nausea, vomiting, insomnia, abdominal distention/fullness, activity, and general sense of wellbeing will be compared between groups. Time (in hours) for each bowel motility indicator (bowel sounds, passage of flatus, and bowel movement) and time to hospital discharge will be compared between groups using standard survival techniques both as Kaplan-Meier analysis and adjusting for the other measured parameters in the study
Studies
9
using proportional hazards analyses. Contingency table methods and logistic regression will be used to determine related parameters. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AIRWAY PROTECTION AGAINST ASPIRATION OF GASTRIC CONTENT Principal Investigator & Institution: Shaker, Reza; Professor and Chief; Medicine; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532260509 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: A large number of pulmonary and aerodigestive tract disorders, ranging from aspiration pneumonitis, and lung abscesses to benign inflammatory lesions of the larynx and aerodigestive tract are caused by misdirection of gastric content into the respiratory system. The mechanisms of airway protection during retrograde transit of gastric content through the esophagopharyngeal lumen is not completely understood. In addition, although substantial information is available regarding the volume clearance of the aspirated material by the pulmonary structures, the defense mechanisms of the alveolar and bronchial linings against aspirated gastric acid remains unclear. Because of multisystem/organ involvement, systematic investigation of these mechanisms in health and disease conditions requires expertise from multiple disciplines. For this reason, during the past three years a concerted multidisciplinary, multidepartmental effort with participation of investigators from the Departments of Medicine, Otolaryngology, and Radiology was organized at the Medical College of Wisconsin Dysphagia Institute to systematically address these issues. The long-term objective of this program project is to provide the basis for preventive and/or therapeutic interventions in the future through the understanding of the central neural control and peripheral protective mechanisms against retrograde aspiration. All of the projects in this program share the common interest of identifying, characterizing, and quantitating the mechanisms that contribute to the protection of the airway against aspiration of gastric content in health and disease. The theme of this program project grant encompasses the function of the gastroesophageal junction as it relates to escape of gastric content into the esophagus, the significance of esophagopharyngeal, esophagolaryngeal, and pharyngolaryngeal reflexes in the closure mechanism of the tracheal inlet in response to gastroesophageal and esophagopharyngeal reflux and vomiting, and the role of bronchoalveolar defense mechanisms against acid alkaline and water exposure. The proposed program includes four projects and the administrative core. Projects 1 and 2 address the issue of extrapulmonary defense mechanisms against retrograde aspiration. Project 3 addresses the intrapulmonary defense mechanism against aspirated gastric content. Project 4 examines the mechanisms of airway protection during vomiting. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: AIRWAY PROTECTION DURING VOMITING Principal Investigator & Institution: Lang, Ivan M.; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532260509 Timing: Fiscal Year 2002 Summary: Vomiting is a complex motor behavior that requires the coordinated action of musculature within the gastrointestinal and aerodigestive tracts. The mechanisms of airway protection during vomiting have not been studied and are presently unknown. This is in contrast to an extensive body of literature providing information on airway
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protective mechanisms operational during swallowing. Acute and chronic animal models will be utilized to study the role of the laryngeal, pharyngeal and hyoid muscles during vomiting. Investigation of the associated movements of the tongue base, hyoid bone, cricoid and thyroid cartilage, and epiglottis will also be studied. The action of these aerodigestive muscles will be temporally correlated with the action of the esophagus and gastrointestinal tract, and lower respiratory musculature. Finally, the relative contribution of peripheral reflexes and direct central nervous system control over the motor events that comprise vomiting will be studied. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL TRANSMISSION
EXPERIMENT
OF
HELICOBACTOR
PYLORI
Principal Investigator & Institution: Parsonnet, Julie; Associate Professor; Medicine; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 30-SEP-1997; Project End 28-FEB-2006 Summary: (Adapted from the Applicant's Abstract): Humans are the only known reservoir of H. pylori infection. How the organism is transmitted from one person to another, however, remains unknown. Data collected during the investigators initial funding period indicate that viable H. pylori are shed by infected hosts in vomitus and diarrheal stools under conditions that simulate gastroenteritis. In addition, H. pylori infection has been linked to increased risk for diarrheal disease, specifically, symptomatic cholera and infantile diarrhea. The investigators postulate that H. pylori decreases gastric acidity, allowing gastroenteritis pathogens to circumvent the first barrier to entry into the intestine. The gastroenteritis pathogens then cause diarrhea and vomiting, fostering excretion of H. pylori and completion of the transmission cycle. With this submission, they propose: 1) to determine whether H. pylori infection, by decreasing gastric acidity, is permissive of gastrointestinal infection with acid sensitive organisms. and 2) to determine whether gastrointestinal infection which leads to diarrhea and vomiting increases shedding of H. pylori. These aims will be accomplished in a three-pronged fashion: First, they will identify suitable acid-resistant and acidsensitive strains of non-pathogenic E. coli for human inoculation, and determine the conditions for recovering these organisms from stools. Next, they will administer the acid-resistant/acid-sensitive pair to human subjects and determine the effects of H. pylori infection and gastric acidity on bacterial survival. Last, they will inoculate H. pylori infected and uninfected human subjects with low doses of an acid-sensitive, enteropathogenic E. coli (EPEC) and determine both how H. pylori affects EPEC infectivity and how EPEC affects H. pylori shedding. H. pylori infection causes gastric cancer-the second leading cause of cancer death worldwide-and peptic ulcer disease. Diarrheal disease remains a leading killer of children in developing countries, causing 20 percent of infant mortality worldwide. In these same countries where diarrheal disease runs rampant, H. pylori infects up to 80 percent of the population. If a causal link between these diseases can be established, then treatment or prevention of H. pylori would attain a significantly higher public health priority than it currently occupies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYNDROME
CLONIDINE
TREATMENT
FOR
NEONATAL
ABSTINENCE
Principal Investigator & Institution: Gauda, Estelle B.; Associate Professor; Pediatrics; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218
Studies
11
Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2006 Summary: (provided by applicant): In the United States, as many as 20,000 babies a year are born to opioid ("narcotic") addicted mothers. Like their mothers, these infants are opioid dependent. Following birth, the infant is removed from its opioid source, inducing a withdrawal syndrome in these infants. Withdrawal symptoms in newborns include vomiting, diarrhea, poor feeding, tachycardia, hypertension, diaphoresis, restlessness, insomnia, irritability, tremors, clonus, hyperphagia with poor growth and acidosis, reversible neurologic abnormalities, and even seizures. This complex of signs and symptoms is referred to as neonatal abstinence syndrome (NAS). Reinstitution of opioids followed by a slow tapering protocol is currently the standard of care, necessitating prolonged hospitalization from weeks to months. Clonidine is a nonnarcotic central alpha2-adrenergic receptor agonist that blocks the effects of overexcitation of the sympathetic nervous system and is an approved treatment for opioid withdrawal in adults. We currently have a physician sponsored IND (#63,781) to study the effect of clonidine as adjunct therapy to opioids for the treatment of NAS. This proposal will test the hypothesis that combination therapy of clonidine and opioids is 1) safe and efficacious, 2) allows reduced amount of opioid drug use, and 3) results in shorter time of treatment and hospitalization. This will be accomplished in a randomized, placebo controlled double blind clinical trial comparing diluted tincture of opium (DTO) combined with a placebo (control) vs. DTO combined with clonidine. Additional sub-studies include determination of 1) pharmacokinetics and pharmacodynamics of DTO and clonidine in the enrolled cohort and 2) further safety evaluation by evaluating developmental outcome on the Bayley Scale of Infant Development (BSID) at 6 and 12 months of age. Pharmacokinetics will be determined by measuring serum concentrations of clonidine and morphine and analyzing volume of distribution, elimination half-life and clearance. These results will have important clinical implications and may change the standards of care not only for management of infants with severe NAS, but also for the management of infants and children, after long-term iatrogenic opioid exposure for instance following prolonged analgesia for mechanical ventilation or multiple operations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMBINATION THERAPY RITONAVIR (ABT 538), LAMIVUDINE AND ZIDOVUDINE IN HIV Principal Investigator & Institution: Markowitz, Martin H.; Clincal Director; Rockefeller University New York, Ny 100216399 Timing: Fiscal Year 2002 Summary: Our group has recently reported a mean reduction in viral load of 2.1 logs in our series of 20 patients treated with the protease inhibitor ritonavir (ABT-538) in a dose range of 600 mg to 1200 mg daily. Durability of response appears to be dose related. Data recently presented by others were equally encouraging, with the most durable responses seen in the patients treated with 600 mg BID. Therefore, we have chosen the most active drugs available -- zidovudine (AZT) and lamivudine (3TC) and ritonavir -to treat the acutely infected person, the host with the least genetic diversity, and therefore the one least likely to harbor multiply resistant viruses. We propose that achieving a four-to-five-log reduction in viral load, which would then be followed by the appearance of the immune response, should dramatically alter the natural history of HIV-1 infection. Ritonavir (ABT-538) will be administered at 300 mg orally BID on Day 1, 400 mg orally BID on days 2 and 3, 500 mg orally BID on day 4, and 600 mg orally BID on Day 5 and subsequently, provided the patient can tolerate the dose escalation
12
Vomiting
without severe nausea and/or vomiting. If needed, the dose escalations may be delayed. AZT will be administered at 200 mg orally TID, and 3TC at 150 mg orally BID. Virologic studies will include plasma RNA determinations, quantitative plasma and cell culture for HIV-1, and quantitative DNA PCR on patient PBMC. In addition, frequent monitoring of T-cell subsets will be performed to assess the viral load in the cellular compartment using flow cytometric techniques. Pharmacokinetic studies will also be performed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTROL OF ENTEROTOXIN GENE EXPRESSION IN S AUREUS Principal Investigator & Institution: Stewart, George C.; Professor; Diagnostic Med/Pathobiology; Kansas State University 2 Fairchild Hall Manhattan, Ks 665061103 Timing: Fiscal Year 2002; Project Start 01-JUL-1999; Project End 30-JUN-2004 Summary: Description (Adapted from applicant's abstract: Staphylococcus aureus is a major cause of human disease, especially nosocomial infections. It is also the third most common cause of confirmed bacterial food borne disease in the United States. The organism produces one or more serologically distinct enterotoxins when growing in food and the ingestion of the preformed toxin is responsible for the vomiting and diarrhea symptomology which is the hallmark of staphylococcal food poisoning. Despite its usual association with food poisoning, the enterotoxins are also virulence factors for the bacterium. The toxins, by virtue of being superantigens, can elicit a polyclonal T-cell activation in an infected individual. This activation diminishes the capacity of the individual to mount an appropriate immune response against the bacterial infection. Expression of many of the enterotoxins, like that of other virulenceassociated exotoxins of S. aureus, is enhanced when activated by the accessory gene regulator (agr) network. The agr system involves a two component regulatory system which functions as a quorum sensor in S. aureus. It is thought that this system maximizes exotoxin production at a time in the infectious process when the host is mounting an inflammatory-response to the infection and the organism must respond to fight off the phagocytic cells. Consistent with this are the findings that agr mutants, which cannot activate exotoxin production, are significantly less virulent than then wild-type parent strain. This project utilizes the enterotoxin B and D genes as a model system to determine how the agr system works to activate exotoxin expression. Short DNA fragments from the promoter region of these enterotoxin genes have been positioned in front of a chloramphenicol acetyltransferase reporter gene and have been shown to contain the sequences necessary for agr related activation of expression. In this project, site-specific mutations will be introduced into the sequence and the specific bases responsible for the agr activation will be identified. The nature of the regulatory species responsible for the enhanced expression will be identified. The molecular nature of the interaction between the effector species and the enterotoxin gene promoter will be defined. The specific role of RNAIII, the effector species first generated by the initial activation of the two component system, will be evaluated with regard to enhancement of enterotoxin gene expression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VOMITING
CORTICOTROPIN-RELEASING
FACTOR
ROLE
IN
CYCLIC
Principal Investigator & Institution: Li, B U.; Children's Memorial Hospital (Chicago) Chicago, Il 606143394
Studies
13
Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Cyclic vomiting syndrome (CVS) is the most severe recurrent vomiting disorder in humans and is more prevalent than previously appreciated (1 in 50 school-aged children). Although the pathogenesis remains unknown, corticotropin-releasing factor (CRF) is a tenable candidate brain-gut neuroendocrine mediator of vomiting in CVS. CRF has a well-established role in inducing gastric stasis and vomiting in animals and its resulting behavioral, autonomic, endocrine effects resemble those clinical features seen in CVS. The model of CRFinduced emeses may explain the antiemetic utility of dexamethasone during chemotherapy-induced vomiting and migraine headaches. We hypothesize that systemic CRF levels and hypothalamic-pituitary-ad renal (HPA) axis activity are heightened during episodes of CVS and migraine headache especially in those who experience concomitant nausea and vomiting. To provide direct clinical evidence of involvement of CRF pathways in CVS and migraine, we will examine CRF and HPA axis activation (ACTH, cortisol, catecholamines) in subjects with CVS, migraine headaches and controls under three conditions including: 1) when well (i.e. in between episodes), 2) during acute episodes of cyclic vomiting or migraine headaches treated with a saline placebo, and, 3) during acute episodes of cyclic vomiting or migraine headaches in which CRF is treated by dexamethasone. Under each condition, we will establish the diurnal variation of CRF and HPA axis activity and compare them to pediatric controls, both healthy and with non-CVS vomiting (gastroenteritis). In a randomized, double blind, cross-over design, we will examine the effect of dexamethasone on CRF and HPA axis activity, objective signs and subjective GI and migraine headache symptoms. CVS and migraine headaches may ultimately both be disorders involving dysregulation of CRF pathways. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DETECTING ASPIRATION ASSOCIATED WITH TUBE FEEDINGS Principal Investigator & Institution: Metheny, Norma A.; Dorothy A. Votsmeier Professor; None; St. Louis University St. Louis, Mo 63110 Timing: Fiscal Year 2002; Project Start 01-AUG-1999; Project End 31-MAY-2005 Summary: (provided by applicant) The ultimate goal of the proposed study is to increase the safety of mechanically ventilated (MV) tube-fed patients. This group is at high risk for aspiration of regurgitated gastric contents with deleterious consequences including transient hypoxemia, chemical pneumonitis, and potentially life-threatening nosocomial pneumonia. Efforts are made in practice settings to detect aspirations early so that interventions can be initiated to prevent morbidity and mortality. However, clinicians are unsure about how to accomplish this since currently available bedside methods to detect aspirations are unreliable. A laboratory method of detecting aspirations based on pepsin was tested in an animal model in the current study (8/1/997/31/02) and found to be highly sensitive and specific. Preliminary studies have indicated that the laboratory assay can detect pepsin (a proxy for the aspiration of gastric contents) in tracheal secretions suctioned from critically ill tube-fed patients. To determine the extent to which pepsin in tracheal secretions predicts the development of pneumonia, daily Clinical Pulmonary Infection Scores will be calculated. Another problem in the management of tube-fed MV patients is uncertainty about how to assess for significantly slowed gastrointestinal (GI) motility, a condition that predisposes to aspiration. Especially problematic is difficulty in determining when indicators of slowed GI motility, such as large GI residual volumes, are of sufficient magnitude to warrant temporary withholding of feedings. As a result feedings are often withheld
14
Vomiting
unnecessarily, leading to significantly reduced caloric intake. Therefore, another aim of the proposed study is to identify the signs of slowed GI motility that are most predictive of aspirations of gastric contents. Additional aims are to examine the effect of risk factors for aspiration on the detection of pepsin in tracheal secretions as well as the effect of risk factors for pneumonia on the development of pneumonia. The proposed work is a prospective, descriptive study of 680, critically ill, tube-fed patients who will be monitored 24 hours a day for the first 3 days of tube feedings to assess for: pepsin in suctioned tracheal secretions, signs of GI intolerance to tube feedings (large GI residual volumes, absence of bowel sounds, and presence of vomiting), and risk factors for aspiration and pneumonia. In addition, Clinical Pulmonary Infection Scores will be calculated daily for the first 4 days of tube feedings. Patients will be recruited from 5 intensive care units at a Level I trauma center. Data collection will occur over a 24month period and the data will be analyzed by logistic regression and multiple linear regression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GINGER CONTROL OF CHEMOTHERAPY INDUCED NAUSEA AND EMESIS Principal Investigator & Institution: Zick, Suzanna M.; Family Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 15-MAY-2003; Project End 28-FEB-2005 Summary: (provided by applicant): Chemotherapy induced nausea and vomiting significantly reduces patients' quality of life, increases fatigue, anxiety, and increases costs of health care delivery. Ginger (Zingiber officinalis) is already used in traditional folk medicine to treat nausea and vomiting in various populations. Ginger's ability to block 5-HT3 receptors and its free-radical scavenging in the intestines suggest that it may be beneficial for reducing both the prevalence and severity of chemotherapy induced nausea and vomiting. Despite ginger's possible benefits in reducing the prevalence and severity of chemotherapy induced nausea and vomiting, no dosing and/or safety studies have been performed. Therefore we propose a double-blind, placebo-controlled, five-armed, randomized clinical trial to assess the efficacy and safety of four dose levels (100 mg, 500 mg, 1000 mg, or 1500 mg, orally/day) of Zingiber officinalis extract (standardized for 5% gingerols) in patients undergoing chemotherapy (cisplastin or adriamycin) who have experienced at least one episode of chemotherapy induced nausea and vomiting despite optimal conventional medical therapy. The primary aim of the study is to determine the most efficacious dose of powdered gingerroot for reducing the prevalence and severity of acute nausea and vomiting. Secondary aims of the study include (1) determination of the most efficacious dose of powdered ginger-root for reducing the prevalence and severity of delayed nausea and vomiting; (2) assessment of the safety of different doses of oral powdered ginger root in patients receiving chemotherapy; and (3) determination if study participants can discern if they are receiving placebo or ginger. Participants receiving either adriamycin or cisplatin for cancer related treatment will be randomized to receive one of four doses of powdered ginger or placebo immediately prior to chemotherapy infusion. Participants will be followed for 48 hours after infusion in order to assess frequency and severity of nausea and vomiting. Baseline and 48 hour post chemotherapy labs will be used to assess safety profile of ginger. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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15
Project Title: HOME HYGIENE INTERVENTION Principal Investigator & Institution: Larson, Elaine; Professor; None; Columbia University Health Sciences Po Box 49 New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2002 Summary: The role of the home environment in the transmission of infectious diseases and the impact of use of anti microbial products for cleaning in the home have not been studied in the U.S. The purposes of this blinded clinical trial with randomized group assignment are to test the effectiveness of two home hygiene regimens in reducing transmission of infectious disease symptoms among household members and to examine the effects of use of antibacterial products for dishwashing, laundry, and personal hygiene on the microbial flora of the hands and the development of anti microbial resistance. 240 households in the Washington Heights neighborhood of northern Manhattan, recruited from neighborhood schools, churches, neighbor referrals and three local WIC program offices, will be studied. Each household will be randomized to one of two interventions: a regimen in which anti microbial-containing, commercially available products will be used for dishwashing, laundry, and personal hygiene or a non-anti microbial regimen in which parallel products, but without anti microbial ingredients, will be used. Investigators and subjects will be blinded to group assignment. Study households will be contacted by telephone weekly and by home visit monthly for 12 months. Test products will be provided free to all participant households. The primary homemaker will provide information about hygiene practices in the home and about infectious disease symptoms in each member of the household. Disease transmission in the household will be defined as two or more persons in the same household with at least one related symptom (vomiting, diarrhea, fever, runny nose, cough, conjunctivitis, skin infection). The accuracy of symptom self-reporting will be verified by physical examination by a nurse practitioner. A hand culture will be obtained from the primary homemaker at the beginning of the study and quarterly during the study to examine any effects of use of anti microbial or non-anti microbial products on the types, numbers, and resistance patterns of bacteria on the hands. Logistic regression, Liang-Zeger regression, and Chi Square analyses will be used to test differences in rates of transmission of symptoms and changes in quantity, types and resistance patterns of microbial flora of the hands. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMMUNOLOGIC HYPERSENSITIVITIES
BASIS
OF
COW
MILK
INDUCED
Principal Investigator & Institution: Sampson, Hugh A.; Professor; Pediatrics; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-AUG-1999; Project End 31-JUL-2003 Summary: Cow mil is one of the major causes of food hypersensitivity in children. Based on 4 prospective studies, 2.5% of infants develop cow milk allergy in the first year of life [100,000 babies/year in the U.S.] Although exclusive breast feeding reduces the incidence of cow milk allergy, 0.5% of infants exclusively breast fed through the first 6 months of life develop cow milk allergy due to cow milk antigen passed in maternal breast milk. Long-term follow-up indicates that about 80% of these infants "outgrow" [become "tolerant"] their milk allergy by 3 years. However, 15% of infants with milkspecific IgE antibodies at 1 year of age remained milk allergic at 10 years of age and 35% were allergic to other foods at the age of 10 years. Cow milk allergy is associated with a broad spectrum of both IgE- and non-IgE-hypersensitivity disorders: IgE-mediated
16
Vomiting
[urticaria, eczema, rhinoconjunctivitis, asthma, colic, vomiting, diarrhea and hypotension; and non-IgE-mediated [milk-induced enterocolitis syndrome, benign eosinophilic proctocolitis, enteropathy syndrome, allergic eosinophilic gastroenteritis, eosinophilic eosophagitis, and gastroesopha-geal reflex]. The immunologic mechanisms responsible for these hypersensitivities, and the subsequent development of tolerance are poorly understood, and will be addressed in this program project. The combined resources of this program project provide a unique opportunity to define the immunologic bases for four common forms of cow milk hypersensitivity. The first project will identify four distinct patient groups with cow milk allergy [both IgE- and non-IgE-mediated] and non-allergic control group, establish the relative allergenicity of cow milk proteins and map allergenic epitopes [B cell and/or T cell] in these four forms of mil hypersensitivity, investigate basic immunologic mechanisms associated with these hypersensitivities and determine the changes that occur when milk allergy is "outgrown". The second project will seek to define whether pathway(s) employed by intestinal epithelial cells [IELs] to handle cow milk proteins differ from those of nonallergens [e.g. tetanus toxoid] and whether IECs from milk allergic patients handle antigen differently compared to normal controls. Since most patients "outgrow" their milk allergy, IEC function will be re-evaluated once clinical tolerance has developed to determine whether antigen processing of cow milk protein changed [normalized], contributing to the loss of hypersensitivity. The third project provides a unique opportunity to address the issue of oral tolerance induction in normal children and those with distinct forms of cow milk hypersensitivity. Finally the fourth project provides an opportunity to dissect basic immunologic mechanisms of IgE-mediated food hypersensitivity not possible in man. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LIGAND BINDING DOMAINS IN THE 5-HT3 RECEPTOR Principal Investigator & Institution: Machu, Tina K.; Professor; Pharmacology; Texas Tech University Health Scis Center Health Sciences Center Lubbock, Tx 79430 Timing: Fiscal Year 2003; Project Start 01-DEC-2002; Project End 30-AUG-2003 Summary: (provided by applicant): The 5-Hydroxytryptamine3 (5-HT3) receptor, which may be composed of homomers of A subunits or heteromers of A and B subunits, is the least studied member of the nicotinic acetylcholine receptor family of ligand-gated ion channels. In addition to its role in mediating synaptic transmission in the nervous system, it also regulates gastrointestinal motility and the vomiting reflex. The recently published crystal structure of the acetylcholine binding protein has identified the generalized structure of the N-terminal domains of this superfamily, but the precise three-dimensional configuration of the ligand recognition site and the residues involved in mediating ion channel activation are unknown. The goal of this proposal is to map amino acid residues that contribute to ligand recognition and model their spatial configuration. Mouse and human 5-HT3A receptors possess 84 percent identity at the amino acid level, yet have differential sensitivities to numerous drugs that bind to the ligand recognition site, such as d-tubocurarine (curare) and 3-(2-hydroxy, 4-methoxybenzylidene)-anabaseine (2-OHMBA). The addition of the B subunit to the A subunit further alters potency of these compounds. Mouse-human and human-mouse chimeras will be constructed and expressed in Xenopus oocytes. Domains responsible for the change in drug action will be assessed with two-electrode voltage clamp electrophysiological recordings. Individual amino acids will then be identified for their roles in conferring sensitivity. Structure-activity relationships of key moieties in the substituted 3-benzylideneanabaseine analogs with identified residues will be assessed.
Studies
17
Thermodynamic mutant cycle analysis will pinpoint the specific point of contact of the key drug moiety with the identified amino acid residue in the ligand binding domain. 5HT3A receptors with C-terminal hexa-histidine tags will be expressed and purified. Receptor will then be photolabeled with [3H]-5-HT and [14C]-2-OHMBA, with and without azido side-chains, and radiolabeled residues will be identified through sequencing. Amino acids identified with photoaffinity labeling and electrophysiological experiments, along with the structures of 5-HT, curare, and benzylidene-anabaseine analogs, will serve as a template for molecular modeling studies of the agonistrecognition site. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MATERNAL HYPOTENSION & EPIDURAL ANESTHESIA FOR CSECTION Principal Investigator & Institution: Fiedler, Michael A.; None; University of Tennessee Health Sci Ctr Memphis, Tn 38163 Timing: Fiscal Year 2002; Project Start 01-APR-2002 Summary: Data on central hemodynamics of pregnant women during regional anesthesia is lacking. The purpose of this study is to determine the 1) influence of heart rate (HR), stroke volume (SV), systemic vascular resistance (SVR) and IV fluid administration on maternal hypotension after epidural anesthesia and 2) the pattern of these variables throughout C-section. Despite preventative measures, hypotension during regional anesthesia for cesarean section is common. Maternal hypotension poses a risk to fetal oxygenation, causes maternal nausea and vomiting, and poses maternal danger when extreme. Intravenous fluid is most often used to prevent hypotension, but an optimal volume of fluid has not been found and the incidence of hypotension varies widely. Fluid alone at best reduces the incidence of hypotension at 38%. An underlying practice assumption is that regional anesthesia, which results in a chemical sympathectomy, causes hypotension by reducing venous return and does not significantly reduce widely. Fluid alone at best reduces the incidence of hypotension at 38%. An underlying practice assumption is that regional anesthesia, which results in a chemical sympathectomy, causes hypotension by reducing venous return and does not significantly reduce SVR. This view is based on an average 15% (range up to 40%) reduction in SVR in non-pregnant persons. But there is evidence that SVR is reduced more in pregnant than non-pregnant women during regional anesthesia. If SVR is reduced sufficiently, fluid alone will not increase cardiac output enough to prevent hypotension. In this case, addressing SVR should result in superior prevention of hypotension. Determining which variables have a significant influence on the pattern of hypotension over time is necessary to direct future interventional studies. Elimination of maternal hypotension will reduce the risk of fetal hypoxemia, maternal discomfort, and maternal morbidity while improving maternal enjoyment of the birth experience. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISMS OF REGULATION OF CARDIAC AFFERENTS Principal Investigator & Institution: Longhurst, John C.; Professor; Medicine; University of California Irvine Irvine, Ca 926977600 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2006 Summary: (provided by the applicant): Reflexes from the heart play an important role in regulation of the cardiovascular system during myocardial ischemia and reperfusion. Responses can include profound alterations in hemodynamic function manifested as
18
Vomiting
either reflex cardiovascular depression during stimulation of vagal afferent endings or excitation with activation of sympathetic (spinal) afferents. Stimulation of sensory nerves in the heart thus can cause hypotension, bradyarrhythmias, nausea and vomiting (vagal afferents) or angina, hypertension and tachyarrhythmias (sympathetic afferents). Limited information is available on mechanisms of activation of sympathetic cardiac afferents that also function as cardiac nociceptors, although our recent data in cats indicate that, in contrast to adenosine, reactive oxygen species (ROS), especially hydroxyl radicals ('OH), kinins, protons (H+) and prostaglandins are important stimuli. Because inhibition of these stimuli and their receptor interactions does not fully eliminate the response of these sensory afferent endings to ischemia, we suspect that other metabolic or mechanical stimuli play a role in their activation and that interactions between stimuli are present. We propose a series of studies to test the hypotheses that platelets are a source of serotonin (5HT) and histamine. Activated platelets release serotonin and histamine that, through 5HT3 and H1 and possibly H2 receptors, respectively, stimulate cardiac sympathetic afferents during ischemia and reperfusion. Interactions between these two putative and other known chemical mediators will be explored. In addition, the role of diacylglycerol/protein kinase C (PKC) and cyclic adenosine monophosphate (cAMP)/protein kinaseA (PKA) signaling systems in histamine's action on ischemically sensitive cardiac sympathetic afferents will be defined. We will employ liquid chromatography to measure the production of mediators in blood and tissue. Single unit afferent electrical activity will be recorded and selective pharmacological receptor blockade or enzymatic pathway inhibition will be used to evaluate the role of each potential chemical mediator. Chemosensitive, mechanosensitive and bimodal endings of unmyelinated and myelinated fibers will be identified through a series of chemical and mechanical challenges, the latter assessed by hemodynamic measurement and regional myocardial deformation. The proposed studies therefore will define mechanisms by which cardiac sympathetic endings are activated during ischemia and reperfusion. Such information will provide physicians with a better understanding of angina and potentially dangerous sympathoexcitatory cardiac reflexes and may suggest therapeutic approaches designed to limit these events that impact patient morbidity and mortality during myocardial ischemia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTOXICATION.
MECHANISMS/GHB/MODELS/ACUTE/CHRONIC
GBH
Principal Investigator & Institution: Mody, Istvan; Professor; Neurology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 31-JUL-2006 Summary: Gamma-hydroxybutyrate is abused by humans occasionally or chronically due to its euphoric and sedative effects. An overdose of GHB can lead to a severe depression of the consciousness, seizures, vomiting and even death, while long-term abuse can be associated with a marked withdrawal syndrome. Thus, ingestion of GHB causes biological changes in the brain that may have major influence on the well-being of the individual. The goal of this proposal is to characterize specific alterations in the brain in a mouse model of GHB abuse. The fundamental hypothesis to be tested by the present proposal is that chronic GHB administration affects the mammalian brain through GHB effects via GABAB receptors. This causes behavioral alterations attributable to changes in physiological processes, such as neuronal firing and excitatory and inhibitory synaptic transmission. As GABAB receptors may be the major target of GHB action, the chronic effects of oral GHB should be dampened by GABAB receptor
Studies
19
antagonists, or should be absent in animals where the GABAB receptor has been genetically ablated. Presently, changes in the CNS caused by GHB abuse are poorly understood. We propose a number of investigations relying on behavioral and electrophysiological examination of orally GHB-treated mice. Each of the three specific aims addresses critical features of the mechanism of action of GHB. The aims are 1) to determine the in vivo neuronal correlates of chronic, oral GHB-administration and withdrawal in wild-type mice and in GABAB receptor knockout mice; 2) to establish the cellular and neuronal network changes in the cerebral cortex in the mice after chronic, oral GHB- administration; and 3) to ascertain whether GABAB-receptor antagonists and GHB-receptor antagonist NCS-382 offer protection against the GHB-induced changes in behavior and cellular properties. To accomplish these goals, oral treatment with GHB will be carried out in mice subjected to behavioral and electrophysiological tests. Furthermore, high resolution electrophysiological recordings will be obtained from neurons identified with IR-DIC methods and anatomical reconstruction of the recorded cells. Selective GABAB receptor antagonists will be used, while the newly generated GABAB receptor knockout animals will serve as an advanced tool to test the involvement of GABAB receptors in these processes. The study is expected to yield novel and specific insights into the GHB-induced changes in the mammalian brain. By developing and characterizing a mouse model of GHB abuse, our study will open the possibility of further using genetically altered mice for studying the effects of GHB on the brain or other organs. Understanding the specific alterations that accompany GHB abuse will lead to a better grasp of the clinical problems associated with GHB ingestion, including acute intoxication, long-term abuse, and the GHB withdrawal syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MITOCHONDRIAL DNA ANALYSIS IN CYCLIC VOMITING SYNDROME Principal Investigator & Institution: Boles, Richard G.; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, Ca 900276062 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: (from applicants abstract): Cyclic vomiting syndrome (CVS) is a disabling condition characterized by multiple severe and distinct episodes of nausea, vomiting, lethargy and variable other symptoms separated by asymptomatic intervals. Although CVS is generally believed to be a (predominantly) childhood variant of migraine, its etiology and pathogenesis are poorly understood. Several features of CVS, including a maternal bias in inheritance, suggest that mitochondrial DNA (mtDNA) sequence variations/mutations may be involved in its etiology. A significant subset of children with CVS have additional neuromuscular disease manifestations including cognitive dysfunction and epilepsy. Maternal inheritance of migraine and/or various neuromuscular disorders and lactic acidosis are present in ten children with CVS followed by the investigators, strongly suggesting that mtDNA mutations are involved in at least some cases. An inherited complex mtDNA rearrangement was found in one. Preliminary results using temporal temperature gradient gel electrophoresis (TTGE) found heteroplasmic sequence variations in the mtDNA D-loop in 2 additional CVS cases. TTGE is a novel mutation detection assay which was developed for use with mtDNA by the PI and collaborators. TTGE is sensitive and cost effective relative to other methods and for the first time permits the screening of large groups of patients for mutations throughout the entire mtDNA. Since mtDNA sequence variations are postulated to be more likely involved among CVS sufferers with additional neuromuscular disease manifestations, in the first sub-study 50 of these individuals will
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be screened by TTGE for all sequence variations throughout the mtDNA. The incidence of CVS cases caused by mtDNA sequence variations will be determined in a second substudy in which the mtDNA in an unbiased group of 100 CVS sufferers will be screened. All sequence variations found in CVS sufferers will be compared against those found upon an identical screening of 100 control individuals, and any of interest will be sequenced. Pathogenicity of suspected mutations will be determined in rho negative cybrids. An extensive amount of clinical and laboratory data will be collected in all patients, allowing for the comparison of CVS sufferers with and without mtDNA mutations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOCICEPTION IN BULIMIA NERVOSA Principal Investigator & Institution: Faris, Patricia L.; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 01-AUG-1993; Project End 30-JUN-2005 Summary: (provided by applicant): This application for renewal of R01 DK 052291-05 proposes to further study the role of vagal afferents in the perpetuation of binge-eating and vomiting. We previously proposed that the pathophysiology of bulimia nervosa involves dysregulation of the afferent vagus nerve. During the last funding period, this hypothesis was tested using two main strategies: (1) the use of somatic pain detection as a physiological marker of vagal afferent activity; and (2) the use of ondansetron (a 5 HT3 antagonist known to reduce vagal neurotransmission) as a pharmacological challenge test of vagal modulation of both the bulimic behaviors and on elevated pain detection thresholds. The principle findings from these studies are: 1) pain detection thresholds rise dynamically across the interval between bulimic binge/vomit episodes, apparently reaching their zenith as the next bulimic episode is approached and dropping to their nadir in close temporal association with having recently engaged in a bulimic episode; and (3) ondansetron treatment was associated with a significant moderation in both the cyclic fluctuations in pain detection thresholds and the primary disorder symptom of binge/vomit episodes per week in a group of patients with severe and chronic bulimia nervosa under randomized, placebo controlled, double-blind condition. Collectively, the above summarized physiological and clinical data have led to the refined hypothesis that the pathophysiology of bulimia nervosa involves a cyclic hyperactivity in vagal afferent nerves. This overall hypothesis will be tested through an interactive combination of clinical pharmacology and psychophysiological approaches. Specific Aim I will investigate the association between disorder severity as indicated by binge/vomit frequencies and dynamic changes in pain detection thresholds. The approach of this Aim is based on the idea that if dynamic increases in vagal activity drive bulimic episodes, then the rate of cyclic changes in vagal activity should be a significant statistical predictor of the frequency of bulimic behaviors. Specific Aim II will investigate the effect of psychotherapeutic intervention on physiological indices of vagal activity, namely thresholds for pain detection and induction of satiety. The approach of the Aim is based on the idea that if vagal hyperactivity represents the critical factor involved in symptom production, then any therapeutic method resulting in a decrease in symptoms would be predicted to be accompanied by a demonstrable correction in vagal function. In addition to generating important basic science information on vagus nerve function in bulimia nervosa, these studies will also provide insight into the utility of ondansetron in the clinical treatment of this debilitating disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NOVEL DYSMOTILITY
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Principal Investigator & Institution: Parkman, Henry P.; Associate Professor; Medicine; Temple University 406 Usb, 083-45 Philadelphia, Pa 19122 Timing: Fiscal Year 2002; Project Start 01-MAR-2001; Project End 28-FEB-2006 Summary: Gastric dysmotility may be due to delayed gastric emptying, antral hypomotility, and/or gastric dysrhythmias. Gastric motor dysfunction is an important component of several clinical disorders including gastroparesis, functional dyspepsia, and intestinal pseudoobstruction. Our overall hypothesis is that gastric motility can be measured conveniently with noninvasive tests which can have widespread availability and provide clinically relevant information. The studies described in this research protocol will address our long-term research objectives of evaluating and treating disorders of gastric motility using simpler, less expensive, and less invasive techniques. Each of these patient-oriented research protocols involves the close interaction between the principal investigator and beginning clinical investigators in order to encourage and develop their clinical research potential. The first specific aim is to demonstrate the clinical validity of two novel noninvasive techniques to assess gastric motility. We will develop the 13C-octanoate breath test for gastric emptying into a practical, clinically useful test for the measurement of gastric emptying using an easily prepared standardized meal. We will also assess the clinical utility of a newly modified electrogastrographic instrument that records high frequency gastric myoelectric activity (up to 120 cycles per minute), in addition to the usual 3 cpm activity. The second specific aim is to use these two noninvasive tests (breath testing and electrogastrography) to assess gender-related aspects of gastric motility. We will demonstrate the effects of gender and the menstrual cycle on gastric motility and determine if the changes in gastric motility during the menstrual cycle correlate with estrogen. and progesterone levels. We will determine whether gastric motility is altered during pregnancy, and to investigate if nausea and vomiting that occurs in the first trimester of pregnancy are related to gastric dysmotility and/or alterations of estrogen, progesterone, and/or chorionic gonadotropin blood levels. The third specific aim is to explore novel treatment strategies for abnormal gastric emptying. We will determine whether accelerating or delaying gastric emptying affects postprandial glucose tolerance in diabetic patients. We will determine whether botulinum toxin injection into the pyloric sphincter improves gastric emptying and symptoms in gastroparesis. The fourth specific aim is to enable the principal investigator to continue and even expand his mentoring activities for beginning clinical investigators in patient- oriented research to include mentoring of specialized motility fellows, gastroenterology fellows, medical residents, medical students, and college students. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL INHALATION SYSTEM FOR DELIVERING VAPOR-STATE DRUGS Principal Investigator & Institution: Mufson, Daniel; Alexza Molecular Delivery Corporation 1001 E Meadow Cir Palo Alto, Ca 94303 Timing: Fiscal Year 2002; Project Start 27-AUG-2002; Project End 31-OCT-2002 Summary: Delta-9-tetrahydrocannibinol (THC) is approved for AIDS-related anorexia, chemotherapy-related nausea and vomiting, and clinical evidence supports efficacy of THC in pain, even suggesting an opioid sparing strategy with equivalent analgesia. Current THC formulations have significant disadvantages, including imprecise dosing,
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variable absorption, poor bioavailability, slow onset of action, and toxic components and legal issues if smoked. Medical experts agree that a rapid-onset, reliable and safe delivery system for THC represents an unmet patient need. MDC proposes its handheld inhaler to meet this need. The inhaler is the first to deliver vapor-state drug without excipients. The inhaled, reproducible dose will be absorbed from the lung rapidly with high bioavailability, providing effective blood levels, and rapid-onset of action. Utilizing an in vitro test apparatus, MDC demonstrate feasibility by generating ultrafine particles of optimal size and distribution, without degradation, for vapor-state inhalation delivery. In Phase I we propose developing a benchtop prototype device and conducting in-vitro verification. Phase I AIMS include: 1) designing, constructing and testing a benchtop prototype producing acceptable, ultrafine particle sizes and PSD, 2) producing doses reproducibly without degradation, and 3) analyzing economical scaledown for hand-help operation. The ultimate goal is clinical evaluation of efficacy and safety leading to an NDA and regulatory approval. PROPOSED COMMERCIAL APPLICATION: The commercial market potential for the MDC Inhalation Delivery of THC alone includes, among others, millions of cancer patients and thousands of AIDS patients who would benefit from improved management of pain, cachexia, nausea, and other symptoms using inhaled analgesia medications (as prescribed by their doctors) in the United States and other countries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHOTOPHYSICAL PROPERTIES OF TRICYCLIC ANTIEPILEPTIC DRUGS Principal Investigator & Institution: Garcia, Carmelo; University of Puerto Rico at Humacao Box 428, Barrio Tejas Humacao, Pr 00791 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: The intense research devoted over the last few years to the study of epilepsy and antiepileptic drugs (AEDs) has only dealt with the physiology of the disease. This quality research has been aimed to replace the older AEDs with broad activity profiles and several severe side effects with new AEDs with better defined mechanism of action and fewer side effects. Nevertheless, most of these drugs still produce serious adverse reactions, including among others, dizziness, ataxia, somnolence, headache, blurred vision, nausea, vomiting, skin, allergy and photosensitization. The molecular photochemical mechanisms for the photosensitizing ability of some AEDs has never been studied, even through it was reported over ten years ago. Recent studies on the laser flash phototysis of related neuroleptic drugs (imipramine) showed that the triplet state can be efficiently quenched by the protons in the solution. The effectiveness of the quenching is very sensitive to the structure of the drug and seems to be involve in their phototoxicity. We propose to perfor the same set of experiments on several phototoxic antiepileptics. The goal of this project is to measure the photophysicat properties of a selected group of tricydic antiepileptic drugs and to study their short-lived transients. Special attention will be given to those transients associated with adverse effects in vivo: the cation radical, the first triplet excited state and singlet oxygen, Basic UV-Vis and luminescence techniques will be employed to study their absorption/emission properties. The transients will be characterized using optical absorption measurements with a Nd-YAG laser set-up. For the triplet state of these compounds, the extinction coefficient and the quantum yield will be determined using a comparative method and the triplet-triplet energy transfer principle, respectively. The triplet state will be bleached with a second delayed pulse to elucidate the reaction mechanism of these u'ansients. Combined MM+/PM3/RHF theoretical calculations will be performed with
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HyperCHEM (TM) 7.0 on the whole set ofphotophysical parameters, The theoretical values will be correlated with the experimental ones. The major goal of this project is to find a molecular/photophysical descriptor for the phototoxic side effect of tricydic antiepileptics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOIMMUNE OUTCOMES: INTERVENTION IN BREAST CANCER Principal Investigator & Institution: Kang, Duck-Hee H.; Associate Professor; None; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-MAY-2000; Project End 31-JAN-2004 Summary: The specific aims of this study are (1) to examine immunological, psychosocial, and clinical symptom outcomes of an 8-week integrated support program for patients with newly diagnosed breast cancer, and (2) to determine whether the support program has differential effects on patients with persistently low versus high baseline natural killer cell (NK) activity pattern (below versus above median NK activity x 2). The integrated support program includes weekly stress management and social support programs and exercise training activities three times a week. Background and Significance: Cancer diagnosis and treatment are a major source of significant psychological, emotional, and physical distress. Most previous interventions have been limited by a unidimensional approach (psychosocial or physical support, not both), and by the lack of immunological assessments. Given the importance of mind-body interactions in human functioning, an integrated approach of concurrent psychological and physical support will be most beneficial to assist patients in distress. Further, there is indication that breast cancer patients with lower baseline NK activity pattern have a poorer prognosis than those with higher baseline NK activity pattern. A comprehensive examination of an integrated approach will provide insights to improving quality of life for patients with newly diagnosed breast cancer. Design and Method: Using a longitudinal, experimental design with pretest and posttest, 90 patients with stage I-IV newly diagnosed breast cancer will be stratified by disease stage (I-IIB vs. locally advanced) and randomly assigned to the Experimental (intervention) or Control (waitlist) group. NK activity will be examined twice prior to the beginning of intervention to determine the pattern of NK activity. The intervention will begin at the start of chemoor radiotherapy. Post-intervention data will be collected immediately after intervention and at 6 and 12 months from the initiation of intervention, coinciding with patients' routine clinic visits. Dependent Measures and Analysis: The impact of intervention will be measured on immune responses (NK activity and number, lymphokine activated killer cell activity, IL-1alpha, IL-2 and interferon-gamma), psychosocial well-being (distress, mood states, and quality of life), and clinical symptoms (fatigue, nausea, vomiting, and sleep). Longitudinal data analysis methods will be employed to analyze repeated measures of outcome variables, whereas 2-sample t-test or nonparametric Wilcoxon rank-sum test will be used to perform univariate analysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RAPID FIELD DEVICE FOR MEASURING ARSENIC IN WATER Principal Investigator & Institution: Bunker, Stephen N.; Implant Sciences Corporation 107 Audubon Rd, #5 Wakefield, Ma 01880 Timing: Fiscal Year 2002; Project Start 17-SEP-2002; Project End 16-AUG-2003
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Summary: (provided by applicant): The presence of arsenic in drinking water is both a national as well as a global concern due to the lack of field equipment capable of verifying compliance with EPA and WHO arsenic safety guidelines. Arsenic is a natural element found in the earth's crust and, when ingested chronically, results in vomiting, esophageal and abdominal pain, and diarrhea. Arsenic is also a proven carcinogen and has been linked to the onset of cancer of the skin, lungs, urinary bladder, and kidneys. Objective: Implant Sciences proposes to investigate a novel, two-stage technique for selectively ionizing arsenic in solution. When coupled with an ion mobility spectrometer, this technique would offer high ionization specificity and efficiency and is expected to result in a method of measuring arsenic in drinking water at concentrations as low as a few parts per trillion. The information obtained in this study would be used to manufacture a rugged and portable field device for quantifying drinking water compliance with EPA and WHO guidelines. Specific Aims: The specific goal of this phase I investigation is to investigate the feasibility of using a two stage ionization method to allow for the measurement of arsenic in water. A secondary goal of this project would be to prove that this two-stage technique would offer arsenic detection capabilities better than 100 ppt, with a desired target sensitivity of 1 ppt. To achieve this goal, an electrospray liquid conversion module will be built and tested for compatibility with a novel laser-enhanced ionization IMS system developed internally at Implant Sciences Corporation. Aqueous arsenic standards will be generated and used for the purposes of this investigation. The proposed IMS system will use these standards to initially identify the arsenic signal at the IMS output. Once the arsenic signal is identified, parameters such as the drift gas, gas pressure, laser energy and density, electrospray voltage and drift tube potential will be optimized to achieve ppt arsenic sensitivity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STCE, AN E.COLI O157:H7 PROTEASE SPECIFIC FOR C1-INH Principal Investigator & Institution: Welch, Rodney A.; Professor & Chair; Medical Microbiol & Immunology; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 16-JAN-2003; Project End 31-DEC-2007 Summary: (Provided by applicant): Enterohemorrhagic Escherichia coli (EHEC), principally serotype O157:H7, cause an estimated 20,000 cases of diarrheal disease in the United States per year. 2-6 percent of the infected individuals, mostly young children progress to a severe renal disease, hemolytic uremic syndrome (HUS). The EHEC pathogenic factors that lead to bloody colitis and HUS are poorly understood, but knowledge of some mechanisms has recently emerged. Intimin-mediated adherence and type III effectors are encoded by a chromosomal locus termed LEE. The phage-encoded Shiga toxins (Stxs) are responsible for significant aspects of EHEC disease. EHEC strains commonly possess large plasmids, the prototype being pO157. We have identified a new pO157 gene, stcE, which encodes an extracellular zinc-metalloendoprotease (ZMP) that specifically cleaves the critical anti-inflammatory regulator C l-esterase inhibitor (C 1-Inh). C 1-Inh is a serine protease inhibitor (serpin) that provides the principal inhibition of the proteolytic cascades involved in classic and mannan-binding ligand complement activation, contact activation and intrinsic coagulation. C l-Inh inhibits diverse proteases: Clr and Cls, MASP-1, MASP-2, kallikrein, FXIIa, FXIa, and plasmin. Deficiencies in Cl-Inh cause profound clinical syndromes. The best known is hereditary angioedema (HAE), a genetic deficiency in Cl-Inh, which is characterized by transient, recurrent attacks of intestinal cramps, vomiting, diarrhea and life-threatening episodes
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of tracheal swelling. Fluorescenated StcE binds to cultured macrophages, B- and T-cells. Thus, StcE is an example of a growing class of ZMPs such as tetanus, botulinum and anthrax lethal factor toxins. These ZMPs, in contrast to the homologous Pseudomonas and Vibrio ZMPs, have specific, non-extracellular matrix protein targets. We will test the hypothesis that StcE degrades soluble or cell-associated Cl-Inh, and this results in poorly regulated serine protease cascades involving complement activation, contact activation and coagulation. This dysregulation would then contribute to local inflammation, tissue damage and edema. The elucidation of StcE structure and function(s) may result in new targets for chemotherapeutic or immune prevention or treatment of EHEC infections, which now are best managed only by supportive therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRUCTURE OF CALICIVIRUS & INHIBITOR COMPLEX W/ INFLUENZA VIRUS NEURAMINIDASE Principal Investigator & Institution: Luo, Ming; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002 Summary: We continue our efforts in design of high potency inhibitors of influenza virus neuraminidase. The inhibitors designed have shown antiviral activities in the laboratory. A patent concerning these inhibitors have been issued. We also made progress toward a final structure solution of a new RNA virus, calicivirus, by collecting more diffraction data at SSRL. This virus cases vomiting and diarrhea in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STUDY OF A CANNABINOID RECEPTOR INTERACTING PROTEIN Principal Investigator & Institution: Niehaus, Jason L.; Pharmacology and Toxicology; Medical College of Georgia 1120 15Th St Augusta, Ga 30912 Timing: Fiscal Year 2003; Project Start 24-SEP-2003; Project End 23-SEP-2005 Summary: (provided by applicant): Marijuana is the most widely abused illegal drug in the United States. Central nervous system responses to the active compound in marijuana include beneficial therapeutic effects, such as analgesia, appetite stimulation, and reduction of nausea and vomiting, while undesired effects include short-term memory and motor impairment, dysphoria, and sedation. The endogenous function of the cannabinoid receptor and the mechanism by which these effects are produced remains ill-defined. The goal of this project is to investigate the role of an uncharacterized cannabinoid receptor interacting protein on the signaling and function of the receptor. The proposed studies will use patch clamp recording of primary neurons to identify the effects of the interacting protein on ion channel modulation and receptor function. A yeast two-hybrid assay will identify the protein-protein interaction domains and confocal microscopy will be used to determine the effect of the novel protein on receptor expression and localization. The results of these studies will increase the knowledge of cannabinoid receptor signaling pathways and function, which is important to facilitate the design of new therapeutic strategies utilizing cannabinoid compounds to select for desired effects, while excluding side-effects. In addition, further insight into the cannabinoid system may lead to a better understanding of marijuana abuse, tolerance and dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SYMPTOM CLUSTERS IN CANCER PATIENTS UNDERGOING TREATMENT Principal Investigator & Institution: Barsevick, Andrea M.; Associate Members; Fox Chase Cancer Center Philadelphia, Pa 19111 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): The specific aims of the proposed pilot research are to: 1) systematically examine the relationships between and among a group of physical symptoms (fatigue, insomnia, pain, and nausea/vomiting) typically experienced during cancer chemotherapy to determine whether or not they form one or more clusters; and, 2) test alternative models of the impact of these symptoms (and/or symptom clusters) on psychological and functional well-being. The overall goal of this research is to generate hypotheses for future research about the characteristics and effects of symptom clusters during cancer treatment. Indicators of a symptom cluster include two or more symptoms with a common predictor (or cause), pattern, or effect on another symptom(s). A longitudinal descriptive design will be used to examine symptoms and quality of life during one cycle of chemotherapy. Measures will be taken at three data points: 1) day 1 of cycle prior to receiving chemotherapy; 2) day 4 of cycle; 3) last day of cycle. Administering measures at these data points will allow us to track the pattern of symptoms from baseline before treatment to a known symptom high point (day 4) for fatigue, insomnia, and delayed nausea/vomiting to a known symptom low point (last day). The use of repeated measures will enable us to examine symptom patterns as well as temporal patterns by which symptoms could influence other symptoms over time. This design also will allow us to examine relationships between symptoms and other quality of life dimensions at each data point as well as changes over time. For aim #1, five research questions will be examined independently using correlation, multiple regressions, and/or repeated measures ANOVA. The result of each analysis will provide one indication of the presence or absence of a symptom cluster. The number of indicators and the nature of the relationships described will be used to decide whether or not the symptoms under investigation form a cluster. For aim #2, two hypotheses will be examined using multiple regression techniques to test whether functional well-being is a mediator between individual symptoms (or symptom clusters) and psychological well-being. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE DEVELOPMENT OF EATING DISORDERS IN MALES AND FEMALES Principal Investigator & Institution: Field, Alison E.; Assistant Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: This proposal is to follow 9,039 girls and 7,843 boys, currently ages 14- 19., through their transition to late adolescence and early adulthood. The girls and boys are members of the Growing Up Today Study, which was established in 1996 when the participants were 9 to 14 years of age. The cohort was initially funded by NIDDK to assess predictors of dietary intake, activity, and weight gain during a four year period. We now seek to follow the cohort for five additional years to investigate determinants of purging (i.e., use of vomiting or laxatives) and eating disorders of at least subsyndromal severity. The mothers of the children are participants in the ongoing Nurses' Health Study II and have been followed biennially since 1989. We will obtain information annually from the participants, as well as continue to collect information
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from the mothers on their weight, concern with weight, weight control behaviors, and concern with their child's weight. Using this data we will assess the predictiveness of personal factors, peer influences, family influences and media influences on the development and course of purging and eating disorders of at least subsyndromal severity. Eating disorders are difficult to treat, Therefore, we believe it is essential to identify and quantify their risk factors so that better means of prevention can be developed. Not only do eating disorders have serious physical health consequences, but also their precursors, weight concerns, are associated with obesity and can lead young people to adopt unhealthy weight control behaviors, such as smoking. Thus eating disorders and their precursors are associated with two serious public health problems among young people in the United States. Due to the paucity of prospective cohort studies, little is known about the etiology and course of development of eating disorders in young women and much less is known in men. This study will have sufficient power to detect associations of at least moderate magnitude (e.g., RR> 1.7). By following the approximately 16,000 adolescents in the Growing Up Today Study for five additional years we will have the largest prospective cohort study capturing the time periods of highest risk of developing disordered eating. The size of the cohort and the length of follow-up (9 years) will enable us to answer many questions about the development and course of purging and eating disorders that no other prospective study has the statistical power to address. Moreover, since this is the only large prospective cohort study to assess the development of eating disorders in males, our results will make a lasting contribution to the field. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THERAPEUTIC POTENTIAL OF INTESTINAL PACING FOR OBESITY Principal Investigator & Institution: Chen, Jiande; Associate Professor; Transneuronix, Inc. 100 Stierli Ct, Ste 106 Mt. Arlington, Nj 07856 Timing: Fiscal Year 2003; Project Start 15-MAR-2003; Project End 30-SEP-2003 Summary: (provided by applicant): The prevalence of obesity is rising to epidemic proportions around the world at an alarming rate. Obesity is a serious medical problem: in the United States, it is estimated that about 300,000 deaths are caused by obesity every year; more than $100 billion is spent each year for the treatment of obesity and its primary co-morbidities. However, currently there is no satisfactory therapy for morbid obesity and there is a great need to explore new therapeutic options. The long-term aim of this project is to develop a safe and effective therapy using intestinal electrical stimulation for the treatment of morbid obesity. This is based on our preliminary data demonstrating that intestinal electrical stimulation inhibits gastric motility, induces vomiting and reduces food intake. The aim of this project is to prove feasibility of intestinal electrical stimulation for the treatment of obesity in dogs. Specific aims are: 1) to study the effect of intestinal electrical stimulation on gastric tone/contractions as well as gastric emptying and to derive the most effective stimulation method that inhibits gastric motility; 2) to investigate the efficacy and safety of intestinal electrical stimulation in reducing food intake; and 3) to study vagally-mediated mechanisms involved with intestinal electrical stimulation. It is anticipated that intestinal electrical stimulation inhibits gastric contractions or induces gastric relaxation, impairs gastric myoelectrical activity and delays gastric emptying, leading to a significant reduction in food intake in a canine model. It is further hypothesized that the inhibitory effects of intestinal electrical stimulation on gastric motility and food intake are mediated via the vagal afferent pathway. Further studies on the long-term effects of intestinal electrical
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stimulation on weight loss, possible mechanisms involving certain hormones, such as CCK, and the development of an implantable stimulator will be the topics of the Phase II application. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TNF BLOCKADE IN PANCREATIC CANCER PATIENTS Principal Investigator & Institution: Villalona, Miguel A.; Associate Professor; Internal Medicine; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): The poor prognosis of patients with advanced pancreatic adenocarcinoma, with a median survival of less than 12 months, indicates an obvious need for more effective treatments. In addition, patients with pancreatic carcinoma are frequently debilitated by cachexia, anorexia, nausea/vomiting and abdominal pain. Pro-inflammatory cytokines like tumor necrosis factor (TNF) alpha, interleukin 6 (IL-6) and interleukin 1 (IL-1) have all been found to be elevated in pancreatic cancer patients and have been implicated in causing many of these symptoms, in addition to the possibility of directly promoting tumor progression. One potential target for anticancer therapy is blocking the effects of TNF. We hypothesize that TNF blockade should make chemotherapy more tolerable, should improve quality of life and should retard the time to tumor progression. In the current proposal, we seek to combine standard chemotherapy (gemcitabine) and TNF blockade with soluble TNF receptor molecules (etanercept) in a pilot trial in patients with metastatic or recurrent pancreatic cancer. We will evaluate if TNF blockade can improve the clinical benefit response, quality of life and the rate of cancer progression-free survival at six months obtained with chemotherapy. In addition, serial levels of TNF and other inflammatory cytokines, as well as the transcription factor NF-kappaB, a candidate pathway through which TNF stimulates tumor growth, will be obtained from peripheral blood mononuclear cells lysates. Quality of life and levels of the cytokines and NF-kappaB will also be measured in a control group of 10 patients receiving gemcitabine as a single agent. The observation of benefits in either quality of life or progression-free survival in patients undergoing TNF blockade would encourage evaluation of this novel strategy in properly powered randomized clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TNF, VAGAL TONE AND GASTRIC MOTILITY Principal Investigator & Institution: Rogers, Richard C.; Professor; None; Lsu Pennington Biomedical Research Ctr 6400 Perkins Rd Baton Rouge, La 70808 Timing: Fiscal Year 2002; Project Start 15-JAN-1997; Project End 31-AUG-2007 Summary: (provided by applicant): Cytokine production by immune effector cells forms part of the host response to antigenic challenge, trauma or irradiation. Protection of the host relies on cytokine release to stimulate: immune attack on pathogens, wound healing, tissue remodeling and energy mobilization. However, elevation of the proinflammatory cytokine, tumor necrosis factor-alpha (TNF], following these insults is also associated with the onset of gastric stasis, nausea, vomiting and anorexia. Degradation of the control of gastrointestinal, fluid and nutritional homeostasis causes significant morbidity and mortality apart from that caused by the primary disease process.Our work has shown that: a) initiation of gastric inhibition by peripheral immune challenge is dependent on TNF synthesis, b) peripherally generated cytokines suppress CNS-commanded, vagally mediated increases in gastric motility and c) TNF
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can operate directly on neurons of the dorsal vagal complex [DVC] of the brainstem to produce profound gastroinhibition. These results satisfied the initial goals of the project, i.e., the unambiguous demonstration of a role for the dorsal medulla and vagal control circuitry in TNF-mediated gastric stasis.Now we wish to investigate the physiological mechanisms by which TNF dramatically alters vagal control of the stomach. The present proposal focuses on three Specific Aims: 1) which vagal efferent pathway(s) are invoked by central TNF action, 2) the specific phenotype of brainstem neuron(s) activated by TNF and 3) the cellular mechanisms activated within the DVC by TNF. We expect that TNF suppresses gastric motility by acting at several sites within vago-vagal reflex circuits in the medulla. We predict that: 1) TNF enhances glutamate neurotransmission between vagal afferents and the solitary nucleus, 2) TNF directly affects the excitability of specific phenotypes of solitary neurons which control the activity of vagal efferent [DMN] neurons, and 3) these DMN neurons (which ultimately control gastric motility) are also likely to be under the direct influence of TNF. Perhaps TNF produces its profound and prolonged inhibition of gastric motility, (and, perhaps, the generation of nausea, emesis and suppression of feeding) by acting at several points in the DVC simultaneously. These hypotheses will be tested using a combination of in vivo and in vitro neurophysiological methods. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSMISSION OF H. PYLORI INFECTION IN THE RHESUS MONKEY Principal Investigator & Institution: Solnick, Jay V.; Associate Professor of Medicine; Internal Medicine; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2002; Project Start 12-SEP-2001; Project End 31-AUG-2006 Summary: (provided by the applicant): Infection with Helicobacter pylori causes a histological gastritis that in some individuals is associated with the development of peptic ulcer disease or gastric malignancy. Although H. pylori may be the most common human bacterial infection, the mechanism by which it is transmitted remains unknown. Person to person transmission probably accounts for most infections. Yet one of the great paradoxes in the epidemiology of H. pylori is that when one examines the gastric lining, the bacterium is ubiquitous, but when fecal or oral secretions are studied it is often difficult to find. This may reflect the difficulty of studying in humans the role of acuity of infection, age of the host, and the possible effects of vomiting, diarrhea, and the CagA pathogenicity island on transmission. Rhesus monkeys are naturally infected with H. pylori that is very similar to strains that infect humans, and this animal model provides a unique opportunity to study experimentally the transmission of H. pylori in a naturally infected host. We hypothesize that acuity of infection, the presence of vomiting and diarrhea, and the CagA pathogenicity island are critical variables in transmission of H. pylori. Furthermore, we propose that there may be a cooperativity between transmission of H. pylori and transmission of bacterial enteric diseases. Diarrheal and vomiting diseases may increase H. pylori transmission by increasing the shedding H. pylori in feces and vomitus, and in turn, H. pylori infection may cause increased gastric pH and thereby promote infection with enteric bacteria by reducing the gastric bactericidal barrier. We propose to address four specific aims in this proposal: l) Determine how H. pylori is shed into the environment during acute and chronic infection; 2) Examine experimentally the effects of vomiting, diarrhea and the CagA pathogenicity island on the natural transmission of H. pylori; 3) Determine the
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effects of H. pylori infection on the acquisition of Campylobacter jejuni; and 4) Determine the effects of the CagA pathogenicity island on colonization and shedding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATING ACUPRESSURE
CHEMOTHERAPY
INDUCED
NAUSEA
WITH
Principal Investigator & Institution: Dibble, Suzanne L.; Professor; Institute for Health and Aging; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 02-AUG-2001; Project End 31-MAR-2004 Summary: Although the newer antiemetic agents have controlled a notable portion of the vomiting associated with chemotherapy administration, nausea continues to be a significant problem. Therefore, the specific aims of this [randomized clinical trial] are to compare differences in the nausea experience and intensity among three groups (Total N=237) undergoing doxorubicin hydrochloride (Addamycin ) and cyclophosphamide with or without fluorouracil chemotherapy for breast cancer. The groups are those receiving a) usual nausea care plus "Active Acupressure" via finger pressure on the nei guan point (P6), b) usual nausea care plus placebo acupressure and c) usual nausea care. Secondarily, the differences in quality of life, anxiety, and functional status among these group participants will be explored. Using eight oncology settings, participants will be recruited who had experienced nausea with their previous chemotherapy treatment. They will be randomly assigned to treatment groups. Stratification criteria will include regimen and site. The interventions will be conducted by carefully trained research assistants. All participants will be followed on a daily basis for two cycles of chemotherapy (a cycle is usually 21- 28 days). Analyses will be done using repeated measures analysis of variance and analysis of covariance, when baseline data is an appropriate covariate. A strength of this study is that it does not pit modem Western and Chinese medicine against each other to determine which is more effective. All participants will continue to receive their Western medical care, but the added value of acupressure will be explored. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National 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 “vomiting” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for vomiting in the PubMed Central database:
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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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A summertime peak of "winter vomiting disease": Surveillance of noroviruses in England and Wales, 1995 to 2002. by Lopman BA, Reacher M, Gallimore C, Adak GK, Gray JJ, Brown DW.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153520
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Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. by Tramer MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ.; 2001 Jul 7; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34325
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Discordance between physical symptoms versus perception of severity by women with nausea and vomiting in pregnancy (NVP). by Chandra K MSc, Magee L MD, Koren G MD.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117801
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Impact of Nausea and Vomiting on Quality of Life in Cancer Patients During Chemotherapy. by Ballatori E, Roila F.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=212194
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The use of CAM by women suffering from nausea and vomiting during pregnancy. by Hollyer T, Boon H, Georgousis A, Smith M, Einarson A.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=113747
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Treatment of established postoperative nausea and vomiting: a quantitative systematic review. by Kazemi-Kjellberg F, Henzi I, Tramer MR.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=60651
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 vomiting, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “vomiting” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for vomiting (hyperlinks lead to article summaries): •
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A 2-year-old girl with a several-day history of vomiting and lethargy. Author(s): Listernick R. Source: Pediatric Annals. 2003 September; 32(9): 570-3, 575. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14508890
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 2-year-old patient with fever and vomiting. Author(s): Mador JA. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2003 June; 29(3): 297-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12776091
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A case of proximal jejunal ectopic pancreas causing sporadic vomiting. Author(s): Olguner M, Ozdemir T, Ates O, Akgur FM, Aktug T, Ozer E. Source: Turk J Pediatr. 2003 April-June; 45(2): 161-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12921307
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A comparison of cyclizine, ondansetron and placebo as prophylaxis against postoperative nausea and vomiting in children. Author(s): O'Brien CM, Titley G, Whitehurst P. Source: Anaesthesia. 2003 July; 58(7): 707-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886917
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A comparison of granisetron, droperidol, and metoclopramide in the treatment of established nausea and vomiting after breast surgery: a double-blind, randomized, controlled trial. Author(s): Fujii Y, Tanaka H, Kawasaki T. Source: Clinical Therapeutics. 2003 April; 25(4): 1142-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12809962
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A comparison of intravenous ketoprofen versus pethidine on peri-operative analgesia and post-operative nausea and vomiting in paediatric vitreoretinal surgery. Author(s): Subramaniam R, Ghai B, Khetarpal M, Subramanyam MS. Source: Journal of Postgraduate Medicine. 2003 April-June; 49(2): 123-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12867686
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A comparison of the costs and efficacy of ondansetron and dolasetron in the prophylaxis of postoperative vomiting in pediatric patients undergoing ambulatory surgery. Author(s): Olutoye O, Jantzen EC, Alexis R, Rajchert D, Schreiner MS, Watcha MF. Source: Anesthesia and Analgesia. 2003 August; 97(2): 390-6, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12873923
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A dose ranging study of dexamethasone for preventing patient-controlled analgesiarelated nausea and vomiting: a comparison of droperidol with saline. Author(s): Lee Y, Lai HY, Lin PC, Lin YS, Huang SJ, Shyr MH. Source: Anesthesia and Analgesia. 2004 April; 98(4): 1066-71, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15041600
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A mitochondrial DNA mutation (A3243G mtDNA) in a family with cyclic vomiting. Author(s): Salpietro CD, Briuglia S, Merlino MV, Di Bella C, Rigoli L. Source: European Journal of Pediatrics. 2003 October; 162(10): 727-8. Epub 2003 August 02. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12905015
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A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. Author(s): Sripramote M, Lekhyananda N. Source: J Med Assoc Thai. 2003 September; 86(9): 846-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649969
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A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. Author(s): Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. Source: Obstetrics and Gynecology. 2003 July; 102(1): 129-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850618
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A response to 'A comparison of cyclizine, ondansetron and placebo as prophylaxis against postoperative nausea and vomiting in children' O'Brien CM, Titley G, Whitehurst P, Anaesthesia 2003; 58: 707-11. Author(s): Oldman M, Youngs P, Johnson A. Source: Anaesthesia. 2003 November; 58(11): 1151. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616647
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Abdominal migraine and cyclical vomiting. Author(s): Catto-Smith AG, Ranuh R. Source: Semin Pediatr Surg. 2003 November; 12(4): 254-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655164
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Abdominal pain and vomiting in an elderly diabetic woman. Author(s): Koduri S, Guptha SH. Source: Postgraduate Medical Journal. 2003 December; 79(938): 709. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14707253
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Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial. Author(s): Streitberger K, Diefenbacher M, Bauer A, Conradi R, Bardenheuer H, Martin E, Schneider A, Unnebrink K. Source: Anaesthesia. 2004 February; 59(2): 142-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14725517
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Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Author(s): Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A, Evans JK, Horgan KJ, Lawson F; Aprepitant Protocol 054 Study Group. Source: Cancer. 2003 June 15; 97(12): 3090-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12784346
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Addition of the oral NK1 antagonist aprepitant to standard antiemetics provides protection against nausea and vomiting during multiple cycles of cisplatin-based chemotherapy. Author(s): de Wit R, Herrstedt J, Rapoport B, Carides AD, Carides G, Elmer M, Schmidt C, Evans JK, Horgan KJ. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 November 15; 21(22): 4105-11. Epub 2003 October 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14559891
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Advice on postop nausea and vomiting. Author(s): Ninger L. Source: Or Manager. 2003 November; 19(11): 25-6, 28. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639792
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An audit of post-operative nausea and vomiting, following cardiac surgery: scope of the problem. Author(s): Mace L. Source: Nursing in Critical Care. 2003 September-October; 8(5): 187-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14653525
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Assessing the impact of chemotherapy-induced nausea and vomiting on patients' daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5day recall. Author(s): Martin AR, Pearson JD, Cai B, Elmer M, Horgan K, Lindley C. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2003 August; 11(8): 522-7. Epub 2003 June 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12827483
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Barrett's esophagus and squamous cell carcinoma in a patient with psychogenic vomiting. Author(s): Dessureault S, Coppola D, Weitzner M, Powers P, Karl RC. Source: International Journal of Gastrointestinal Cancer. 2002; 32(1): 57-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12630772
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Behavioral analysis and treatment of reflexive vomiting associated with visceral sensations: a case study of interoceptive conditioning? Author(s): Hegel MT, Ahles TA. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1992 September; 23(3): 237-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1487541
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Behavioral medicine treatment of ruminative vomiting and associated weight loss in an adolescent with autism. Author(s): Luiselli JK, Medeiros J, Jasinowski C, Smith A, Cameron MJ. Source: Journal of Autism and Developmental Disorders. 1994 October; 24(5): 619-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7814310
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Behavioral treatment of chemotherapy-induced nausea and vomiting. Author(s): Morrow GR, Hickok JT. Source: Oncology (Huntingt). 1993 December; 7(12): 83-9; Discussion 93-4, 97. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8292509
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Benefits and risks of newer treatments for chemotherapy-induced and postoperative nausea and vomiting. Author(s): Kovac AL. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2003; 26(4): 227-59. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12608887
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Benign retropneumoperitoneum induced by vomiting. Author(s): Heyman SN, Adler S, Stewart B, Aviad I. Source: Journal of Clinical Gastroenterology. 1995 January; 20(1): 88-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7884190
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Better control of nausea and vomiting in transplant recipients. Author(s): Tolman-Jager A, Banks T. Source: Oncology Nursing Forum. 1998 April; 25(3): 472. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9568601
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Bilateral internal carotid artery dissection from vomiting. Author(s): Kumar SD, Kumar V, Kaye W. Source: The American Journal of Emergency Medicine. 1998 November; 16(7): 669-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9827744
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Bilateral temporomandibular joint dislocation in a 10-month-old infant after vomiting. Author(s): Whiteman PJ, Pradel EC. Source: Pediatric Emergency Care. 2000 December; 16(6): 418-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11138886
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Bilious vomiting during the first week of life. Author(s): Kao HA. Source: Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1994 May-June; 35(3): 202-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8042503
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Bilious vomiting in a 6-month-old infant. Author(s): Donnelly D, Lam A, Martin HC, Fitzgerald DA. Source: Journal of Paediatrics and Child Health. 2003 May-June; 39(4): 305-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755940
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Bilious vomiting in a 9-month-old infant. Author(s): Brennan DF. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1997 July; 4(7): 706-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9223695
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Bilious vomiting in the newborn: How often is it pathologic? Author(s): Godbole P, Stringer MD. Source: Journal of Pediatric Surgery. 2002 June; 37(6): 909-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12037761
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Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. Author(s): Kimura K, Loening-Baucke V. Source: American Family Physician. 2000 May 1; 61(9): 2791-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10821158
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Bionursing: the management of migraine and vomiting. Author(s): Torrance C, Jordan S. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1996 January 31; 10(19): 40-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8695413
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Bitter taste perception and severe vomiting in pregnancy. Author(s): Sipiora ML, Murtaugh MA, Gregoire MB, Duffy VB. Source: Physiology & Behavior. 2000 May; 69(3): 259-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10869591
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Black esophagus induced by severe vomiting in a healthy young man. Author(s): Katsinelos P, Pilpilidis I, Dimiropoulos S, Paroutoglou G, Kamperis E, Tsolkas P, Kapelidis P, Limenopoulos B, Papagiannis A, Pitarokilis M, Trakateli C. Source: Surgical Endoscopy. 2003 March; 17(3): 521. Epub 2002 December 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12488997
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Boerhaave's syndrome after postoperative vomiting. Author(s): Atallah FN, Riu BM, Nguyen LB, Seguin PO, Fourcade OA. Source: Anesthesia and Analgesia. 2004 April; 98(4): 1164-6, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15041618
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Boy with a cough and vomiting. Author(s): Walsh S. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 2001 July-August; 15(4): 211, 219-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11462130
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Chemotherapy-induced nausea and vomiting: the importance of acute antiemetic control. Author(s): Schnell FM. Source: The Oncologist. 2003; 8(2): 187-98. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12697943
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Chemotherapy-related nausea and vomiting - past reflections, present practice and future management. Author(s): Miller M, Kearney N. Source: European Journal of Cancer Care. 2004 March; 13(1): 71-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14961778
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Children with Rolandic spikes and ictal vomiting: Rolandic epilepsy or Panayiotopoulos syndrome? Author(s): Covanis A, Lada C, Skiadas K. Source: Epileptic Disorders : International Epilepsy Journal with Videotape. 2003 September; 5(3): 139-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14684348
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Clinical microbiological case: Vomiting followed by breathlessness. Author(s): El-Saleeby C, Hallward G, Lynn W. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2003 December; 9(12): 1248, 1264-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14686994
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Clinical observations on postoperative vomiting treated by auricular acupuncture. Author(s): Kim Y, Kim CW, Kim KS. Source: The American Journal of Chinese Medicine. 2003; 31(3): 475-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12943178
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Comment on “A comparison of the effects of droperidol and the combination of droperidol and ondansetron on postoperative nausea and vomiting for patients undergoing laparoscopic cholecystectomy”. Author(s): Vaidya JS. Source: Journal of Clinical Anesthesia. 2003 November; 15(7): 570. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14698374
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Comparative study of low-dose oral granisetron plus dexamethasone and high-dose metoclopramide plus dexamethasone in prevention of nausea and vomiting induced by CHOP-therapy in young patients with non-Hodgkin's lymphoma. Author(s): Numbenjapon T, Sriswasdi C, Mongkonsritragoon W, Leelasiri A, Prayoonwiwat W. Source: J Med Assoc Thai. 2002 November; 85(11): 1156-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12546311
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Comparison of acupressure bands and droperidol for reducing post-operative nausea and vomiting in gynecologic surgery patients. Author(s): Schultz AA, Andrews AL, Goran SF, Mathew T, Sturdevant N. Source: Applied Nursing Research : Anr. 2003 November; 16(4): 256-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14608559
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Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Author(s): Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Berrisford SB, Wakefield CA, Issioui T, Jones SB, Jones DB. Source: Anesthesiology. 2002 December; 97(6): 1387-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12459663
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Comparison of granisetron and granisetron plus dexamethasone for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Biswas BN, Rudra A. Source: Acta Anaesthesiologica Scandinavica. 2003 January; 47(1): 79-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12492802
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Comparison of granisetron with granisetron plus droperidol combination prophylaxis in post-operative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Ozmen S, Yavuz L, Ceylan BG, Tarhan O, Aydin C. Source: J Int Med Res. 2002 September-October; 30(5): 520-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12449522
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Comparison of oral dolasetron and ondansetron in the prophylaxis of postoperative nausea and vomiting in children. Author(s): Karamanlioglu B, Turan A, Memis D, Sut N. Source: European Journal of Anaesthesiology. 2003 October; 20(10): 831-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14580054
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Comparison of three outpatient regimens in the management of nausea and vomiting in pregnancy. Author(s): Bsat FA, Hoffman DE, Seubert DE. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2003 October; 23(7): 531-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566347
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Consensus guidelines for managing postoperative nausea and vomiting. Author(s): Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, Kovac A, Philip BK, Sessler DI, Temo J, Tramer MR, Watcha M; Department of Anesthesiology, Duke University Medical Center. Source: Anesthesia and Analgesia. 2003 July; 97(1): 62-71, Table of Contents. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12818945
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Consensus guidelines for managing postoperative nausea and vomiting: is there a conflict of interest? Author(s): White PF. Source: Anesthesia and Analgesia. 2004 February; 98(2): 550; Author Reply 550-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14742406
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Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial. Author(s): Dent HE, Dewhurst NG, Mills SY, Willoughby M. Source: Complementary Therapies in Medicine. 2003 June; 11(2): 72-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801491
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Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting. Author(s): Pueyo FJ, Lopez-Olaondo L, Sanchez-Ledesma MJ, Ortega A, Carrascosa F. Source: British Journal of Anaesthesia. 2003 October; 91(4): 589-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14504165
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Cyclic vomiting syndrome, migraine, and epilepsy: a common underlying disorder? Author(s): Cupini LM, Santorelli FM, Iani C, Fariello G, Calabresi P. Source: Headache. 2003 April; 43(4): 407-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12656714
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Cyclic vomiting syndrome: a brain-gut disorder. Author(s): Li BU, Misiewicz L. Source: Gastroenterology Clinics of North America. 2003 September; 32(3): 997-1019. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14562585
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Cyclic vomiting syndrome: anticipatory stress response in migraine? Author(s): Gupta VK. Source: Headache. 2004 January; 44(1): 106-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14979896
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Dental erosion patterns from intrinsic acid regurgitation and vomiting. Author(s): Valena V, Young WG. Source: Aust Dent J. 2002 June; 47(2): 106-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12139263
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Development of a health-related quality of life instrument for nausea and vomiting of pregnancy. Author(s): Magee LA, Chandra K, Mazzotta P, Stewart D, Koren G, Guyatt GH. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S232-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011892
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Development of an instrument to measure nausea and vomiting in pregnancy. Author(s): Swallow BL, Lindow SW, Masson EA, Hay DM. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 September; 22(5): 481-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521412
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Dexamethasone 8 mg in combination with ondansetron 4 mg appears to be the optimal dose for the prevention of nausea and vomiting after laparoscopic cholecystectomy. Author(s): Elhakim M, Nafie M, Mahmoud K, Atef A. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 November; 49(9): 922-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12419717
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Dexamethasone enhances the effect of tropisetron and ondansetron against nausea and vomiting against nausea and vomiting after patient-controlled analgesia. Author(s): Wang C, Xu N, Xiong LZ, Liu HF, Yang XY, Lu ZH, Sheng PT, Wang LY. Source: Di Yi June Yi Da Xue Xue Bao. 2002 February; 22(2): 159-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390816
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Dexamethasone for the prevention of nausea and vomiting after dilatation and curettage: a randomized controlled trial. Author(s): Fujii Y, Uemura A. Source: Obstetrics and Gynecology. 2002 January; 99(1): 58-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11777511
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Dexamethasone is as effective as ondansetron for the prevention of postoperative nausea and vomiting following breast surgery. Author(s): Wattwil M, Thorn SE, Lovqvist A, Wattwil L, Gupta A, Liljegren G. Source: Acta Anaesthesiologica Scandinavica. 2003 August; 47(7): 823-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859302
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Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness. Author(s): Lee Y, Lai HY, Lin PC, Huang SJ, Lin YS. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 March; 50(3): 232-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12620944
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Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy. Author(s): Elhakim M, Ali NM, Rashed I, Riad MK, Refat M. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 April; 50(4): 392-7. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12670818
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Diarrhoea, vomiting and ACE inhibitors:--an important cause of acute renal failure. Author(s): Stirling C, Houston J, Robertson S, Boyle J, Allan A, Norrie J, Isles C. Source: Journal of Human Hypertension. 2003 June; 17(6): 419-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12764405
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Diary reports of nausea and vomiting during pregnancy. Author(s): O'Brien B, Relyea J, Lidstone T. Source: Clinical Nursing Research. 1997 August; 6(3): 239-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9281928
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Diclectin therapy for nausea and vomiting of pregnancy: effects of optimal dosing. Author(s): Boskovic R, Einarson A, Maltepe C, Wolpin J, Koren G. Source: J Obstet Gynaecol Can. 2003 October; 25(10): 830-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14532951
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Difference in risk factors for postoperative nausea and vomiting. Author(s): Stadler M, Bardiau F, Seidel L, Albert A, Boogaerts JG. Source: Anesthesiology. 2003 January; 98(1): 46-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12502978
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Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a metaanalysis of randomized controlled trials. Author(s): Kranke P, Morin AM, Roewer N, Eberhart LH. Source: Acta Anaesthesiologica Scandinavica. 2002 March; 46(3): 238-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11939912
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Does meta-analysis increase our knowledge in the management of postoperative nausea and vomiting? Author(s): Tramer MR. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 33-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574213
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Does the routine prophylactic use of antiemetics affect the incidence of postdischarge nausea and vomiting following ambulatory surgery?: A systematic review of randomized controlled trials. Author(s): Gupta A, Wu CL, Elkassabany N, Krug CE, Parker SD, Fleisher LA. Source: Anesthesiology. 2003 August; 99(2): 488-95. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12883424
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Dolasetron decreases postoperative nausea and vomiting after breast surgery. Author(s): Abou Zeid H, Al-Gahamdi A, Abdul-Hadi M. Source: The Breast Journal. 2002 July-August; 8(4): 216-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12100113
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Dolasetron for the prevention of postoperative vomiting in children undergoing strabismus surgery. Author(s): Wagner D, Pandit U, Voepel-Lewis T, Weber M. Source: Paediatric Anaesthesia. 2003 July; 13(6): 522-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12846709
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Dolasetron, but not metoclopramide prevents nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Author(s): Piper SN, Suttner SW, Rohm KD, Maleck WH, Larbig E, Boldt J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1021-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477671
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Double-blind, placebo-controlled, dose-ranging study of ramosetron for the prevention of nausea and vomiting after thyroidectomy. Author(s): Fujii Y, Tanaka H. Source: Clinical Therapeutics. 2002 July; 24(7): 1148-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12182258
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Early postoperative vomiting and volatile anaesthetics or nitrous oxide. Author(s): Verheecke G. Source: British Journal of Anaesthesia. 2003 January; 90(1): 109; Author Reply 109-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12488398
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Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. Author(s): Werntoft E, Dykes AK. Source: J Reprod Med. 2001 September; 46(9): 835-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11584487
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Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy. Author(s): Samad K, Afshan G, Kamal R. Source: J Pak Med Assoc. 2003 February; 53(2): 68-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12705488
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Effect of drainage on postoperative nausea, vomiting, and pain after laparoscopic cholecystectomy. Author(s): Nursal TZ, Yildirim S, Tarim A, Noyan T, Poyraz P, Tuna N, Haberal M. Source: Langenbeck's Archives of Surgery / Deutsche Gesellschaft Fur Chirurgie. 2003 April; 388(2): 95-100. Epub 2003 April 02. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12684804
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Effect of nitrous oxide on post-operative nausea and vomiting during propofol anaesthesia for short surgical operations. Author(s): Akhtar TM, Kerr WJ, Kenny GN. Source: European Journal of Anaesthesiology. 1993 September; 10(5): 337-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11767422
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Effect of postchemotherapy nausea and vomiting on health-related quality of life. The Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. Author(s): Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 1997 July; 5(4): 307-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9257427
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Effect of prophylactic ondansetron on postoperative nausea and vomiting after elective craniotomy. Author(s): Kathirvel S, Dash HH, Bhatia A, Subramaniam B, Prakash A, Shenoy S. Source: Journal of Neurosurgical Anesthesiology. 2001 July; 13(3): 207-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11426094
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Effect of supplemental pre-operative fluid on postoperative nausea and vomiting. Author(s): Ali SZ, Taguchi A, Holtmann B, Kurz A. Source: Anaesthesia. 2003 August; 58(8): 780-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859471
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Effects of clonidine on postoperative nausea and vomiting in breast cancer surgery. Author(s): Oddby-Muhrbeck E, Eksborg S, Bergendahl HT, Muhrbeck O, Lonnqvist PA. Source: Anesthesiology. 2002 May; 96(5): 1109-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11981150
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Efficacy of a single-dose ondansetron for preventing post-operative nausea and vomiting after laparoscopic cholecystectomy with sevoflurane and remifentanil infusion anaesthesia. Author(s): Paventi S, Santevecchi A, Ranieri R. Source: Eur Rev Med Pharmacol Sci. 2001 March-April; 5(2): 59-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11863320
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Efficacy of gastric aspiration in reducing posttonsillectomy vomiting. Author(s): Jones JE, Tabaee A, Glasgold R, Gomillion MC. Source: Archives of Otolaryngology--Head & Neck Surgery. 2001 August; 127(8): 980-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11493210
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Efficacy of haloperidol in the treatment of nausea and vomiting in the palliative patient: a systematic review. Author(s): Critchley P, Plach N, Grantham M, Marshall D, Taniguchi A, Latimer E, Jadad AR. Source: Journal of Pain and Symptom Management. 2001 August; 22(2): 631-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11503632
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Efficacy of repeat intravenous dosing of ondansetron in controlling postoperative nausea and vomiting: a randomized, double-blind, placebo-controlled multicenter trial. Author(s): Kovac AL, O'Connor TA, Pearman MH, Kekoler LJ, Edmondson D, Baughman VL, Angel JJ, Campbell C, Jense HG, Mingus M, Shahvari MB, Creed MR. Source: Journal of Clinical Anesthesia. 1999 September; 11(6): 453-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10526822
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Efficacy of single-dose intravenous dolasetron versus ondansetron in the prevention of postoperative nausea and vomiting. Author(s): Walker JB. Source: Clinical Therapeutics. 2001 June; 23(6): 932-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11440292
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Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Author(s): Rusy LM, Hoffman GM, Weisman SJ. Source: Anesthesiology. 2002 February; 96(2): 300-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11818760
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ESMO Recommendations for prophylaxis of chemotherapy-induced nausea and vomiting (NV). Author(s): ESMO. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2001 August; 12(8): 1059-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11583185
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Establishing the dose of the oral NK1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting. Author(s): Chawla SP, Grunberg SM, Gralla RJ, Hesketh PJ, Rittenberg C, Elmer ME, Schmidt C, Taylor A, Carides AD, Evans JK, Horgan KJ. Source: Cancer. 2003 May 1; 97(9): 2290-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712486
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Ethnic variation in fluorescein angiography induced nausea and vomiting. Author(s): McLauchlan R, Waterman H, Waterman C, Hillier V, Dodd C. Source: Eye (London, England). 2001 April; 15(Pt 2): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11339582
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Evaluation of nutritional status by immunologic assessment in bulimia nervosa: influence of body mass index and vomiting episodes. Author(s): Marcos A, Varela P, Toro O, Nova E, Lopez-Vidriero I, Morande G. Source: The American Journal of Clinical Nutrition. 1997 August; 66(2): 491S-497S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9250137
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Evidence-based view of safety and effectiveness of pharmacologic therapy for nausea and vomiting of pregnancy (NVP). Author(s): Magee LA, Mazzotta P, Koren G. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S256-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011897
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F-18 FDG gastric and anterior abdominal muscle uptake secondary to nausea and vomiting. Author(s): Abdel-Dayem HM, Naddaf S, El-Zeftawy H. Source: Clinical Nuclear Medicine. 1998 November; 23(11): 769-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9814567
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Factors associated with elective termination of pregnancy among Canadian and American women with nausea and vomiting of pregnancy. Author(s): Mazzotta P, Stewart DE, Koren G, Magee LA. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 2001 March; 22(1): 7-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11317613
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Failed Nissen fundoplication in two patients who had persistent vomiting and eosinophilic esophagitis. Author(s): Liacouras CA. Source: Journal of Pediatric Surgery. 1997 October; 32(10): 1504-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9349784
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Failure of prevention against postoperative vomiting by ondansetron or prochlorperazine in patients undergoing gynecological laparoscopy. Author(s): Lee TH, Lin CR, Lee TC, Buerkle H, Hsu TY, Mao CC, Yang LC. Source: Acta Anaesthesiol Sin. 2000 December; 38(4): 201-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11392068
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Failure to thrive and two weeks of persistent vomiting in an 11-month-old infant. Author(s): Rajakumar K, Hogan MB, Wilson NW. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2000 November; 85(5): 349-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11101173
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Familial cyclic vomiting syndrome. Author(s): Haan J, Kors EE, Ferrari MD. Source: Cephalalgia : an International Journal of Headache. 2002 September; 22(7): 552-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230597
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FDA “black box” warning regarding use of droperidol for postoperative nausea and vomiting: is it justified? Author(s): Gan TJ, White PF, Scuderi PE, Watcha MF, Kovac A. Source: Anesthesiology. 2002 July; 97(1): 287. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12131145
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Fetal effects of metoclopramide therapy for nausea and vomiting of pregnancy. Author(s): Berkovitch M, Elbirt D, Addis A, Schuler-Faccini L, Ornoy A. Source: The New England Journal of Medicine. 2000 August 10; 343(6): 445-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10939907
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Fifteen-year-old girl with fever, headache and vomiting. Author(s): Sherlock R, Le Saux N. Source: The Pediatric Infectious Disease Journal. 2002 May; 21(5): 439, 449-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12150184
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Food cravings and aversions during pregnancy: relationships with nausea and vomiting. Author(s): Bayley TM, Dye L, Jones S, DeBono M, Hill AJ. Source: Appetite. 2002 February; 38(1): 45-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11883917
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Food entrapped in papilla of Vater: uncommon cause of vomiting. Author(s): Falchetti D, Pedersini P, Rigamonti W, Salucci P, Caccia G. Source: Archives of Disease in Childhood. 2000 June; 82(6): 488-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10833184
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Four days of vomiting and diarrhea. Author(s): Swischuk LE. Source: Pediatric Emergency Care. 1998 June; 14(3): 227-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9655672
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Frequency of postoperative nausea and vomiting in patients undergoing laparoscopic foregut surgery. Author(s): Bradshaw WA, Gregory BC, Finley CR, Ross A, Wilds T, Still M, Smith CD. Source: Surgical Endoscopy. 2002 May; 16(5): 777-80. Epub 2002 February 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11997820
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Functional vomiting disorders in infancy: innocent vomiting, nervous vomiting, and infant rumination syndrome. Author(s): Fleisher DR. Source: The Journal of Pediatrics. 1994 December; 125(6 Pt 2): S84-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7983567
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Ganglioneuroblastoma masquerading as chronic vomiting. Author(s): Mojtahed H, Rose E, Feddersen R. Source: Clinical Pediatrics. 1995 February; 34(2): 110-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7729106
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Gastric myoelectrical activity and its relationship to the development of nausea and vomiting after intensive chemotherapy and autologous stem cell transplantation. Author(s): DiBaise JK, Brand RE, Lyden E, Tarantolo SR, Quigley EM. Source: The American Journal of Gastroenterology. 2001 October; 96(10): 2873-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11693320
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Gastrointestinal factors in nausea and vomiting of pregnancy. Author(s): Koch KL. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S198-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011886
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Gastrointestinal tract cytomegalovirus infection with prolonged vomiting and fever in an immunocompetent child. Author(s): Shinawi M, Brik R, Berkowitz D. Source: Isr Med Assoc J. 2001 August; 3(8): 621-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11519392
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Gestational trophoblastic disease: another cause of nausea and vomiting in pregnancy. Author(s): Riegert-Johnson DL, McClary D, McIver B. Source: Mayo Clinic Proceedings. 2001 May; 76(5): 566. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11357806
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Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Author(s): Eberhart LH, Mayer R, Betz O, Tsolakidis S, Hilpert W, Morin AM, Geldner G, Wulf H, Seeling W. Source: Anesthesia and Analgesia. 2003 April; 96(4): 995-8, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651648
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Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebocontrolled trial. Author(s): Vutyavanich T, Kraisarin T, Ruangsri R. Source: Obstetrics and Gynecology. 2001 April; 97(4): 577-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11275030
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Granisetron (Kytril) suppresses methotrexate-induced nausea and vomiting among patients with inflammatory arthritis and is superior to prochlorperazine (Stemetil). Author(s): Devlin J, Wagstaff K, Arthur V, Emery P. Source: Rheumatology (Oxford, England). 1999 March; 38(3): 280-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10325668
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Granisetron in the control of nausea and vomiting associated with bone marrow transplantation: a review of its efficacy and tolerability. Author(s): Prentice HG. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2003 August; 11(8): 501-8. Epub 2003 July 05. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12845514
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Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting: results of a meta-analysis of randomized controlled trials. Author(s): del Giglio A, Soares HP, Caparroz C, Castro PC. Source: Cancer. 2000 December 1; 89(11): 2301-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147601
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Granisetron plus dexamethasone versus granisetron alone in the prevention of vomiting induced by conditioning for stem cell transplantation: a prospective randomized study. Author(s): Matsuoka S, Okamoto S, Watanabe R, Mori T, Nagayama H, Hamano Y, Yokoyama K, Takayama N, Ikeda Y. Source: International Journal of Hematology. 2003 January; 77(1): 86-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12568305
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Granisetron versus granisetron/dexamethasone combination for the treatment of nausea, retching, and vomiting after major gynecologic surgery: a randomized, double-blind study. Author(s): Fujii Y, Tanaka H. Source: Clinical Therapeutics. 2003 February; 25(2): 507-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12749510
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Granisetron, droperidol, and metoclopramide for the treatment of established postoperative nausea and vomiting in women undergoing gynecologic surgery. Author(s): Fujii Y, Tanaka H, Somekawa Y. Source: American Journal of Obstetrics and Gynecology. 2000 January; 182(1 Pt 1): 13-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10649150
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Granisetron/dexamethasone combination for reducing nausea and vomiting during and after spinal anesthesia for cesarean section. Author(s): Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Source: Anesthesia and Analgesia. 1999 June; 88(6): 1346-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10357343
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Granisetron/dexamethasone combination for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Source: European Journal of Anaesthesiology. 2000 January; 17(1): 64-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10758447
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Granisetron/dexamethasone combination for the prevention of postoperative nausea and vomiting after thyroidectomy. Author(s): Fujii Y, Tanaka H, Kobayashi N. Source: Anaesthesia and Intensive Care. 2000 June; 28(3): 266-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10853207
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Granisetron: is there a dose-response effect on nausea and vomiting? Author(s): Minami M. Source: Cancer Chemotherapy and Pharmacology. 2003 August; 52(2): 89-98. Epub 2003 May 29. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12783208
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Granisetron: new insights into its use for the treatment of chemotherapy-induced nausea and vomiting. Author(s): Tan M. Source: Expert Opinion on Pharmacotherapy. 2003 September; 4(9): 1563-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12943486
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Granisetron-dexamethasone combination reduces postoperative nausea and vomiting. Author(s): Fujii Y, Tanaka H, Toyooka H. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 May; 42(5 Pt 1): 387-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7614644
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Guidelines outline strategies to reduce post-operative nausea and vomiting. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2002 April 19; 13(8): 9-10, 12. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12467270
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Hand acupressure reduces postoperative vomiting after strabismus surgery (n=50). Author(s): Cummings M. Source: Acupuncture in Medicine : Journal of the British Medical Acupuncture Society. 2001 June; 19(1): 53-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11471586
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Has the use of meta-analysis enhanced our understanding of therapies for postoperative nausea and vomiting? Author(s): White PF, Watcha MF. Source: Anesthesia and Analgesia. 1999 June; 88(6): 1200-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10357318
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Headache, nausea, and vomiting in a heavy drinker and smoker. Author(s): Dawood MM, Halperin JR. Source: Hosp Pract (Off Ed). 1995 September 15; 30(9): 28W-28X. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7559833
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Headache, vomiting and diplopia. Author(s): Canton A, Simo R, Gil L, Ortega A, Mesa J. Source: Postgraduate Medical Journal. 1997 June; 73(860): 357-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9246341
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Heterogeneity of diagnoses presenting as cyclic vomiting. Author(s): Li BU, Murray RD, Heitlinger LA, Robbins JL, Hayes JR. Source: Pediatrics. 1998 September; 102(3 Pt 1): 583-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9738180
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Historical perspectives of cyclic vomiting. Author(s): Walker-Smith J. Source: Journal of Pediatric Gastroenterology and Nutrition. 1995; 21 Suppl 1: Ix-X. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8708857
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History of postoperative nausea and vomiting. Author(s): Raeder J. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 1-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574211
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How can one apply rescue indomethacin therapy to a 1-month-old baby with antenatal Bartter syndrome in the case of severe vomiting? Author(s): Proesmans W. Source: Pediatric Nephrology (Berlin, Germany). 2001 June; 16(6): 532. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11420924
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How much are patients willing to pay to avoid postoperative nausea and vomiting? Author(s): Gan T, Sloan F, Dear Gde L, El-Moalem HE, Lubarsky DA. Source: Anesthesia and Analgesia. 2001 February; 92(2): 393-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11159239
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How to study postoperative nausea and vomiting. Author(s): Apfel CC, Roewer N, Korttila K. Source: Acta Anaesthesiologica Scandinavica. 2002 September; 46(8): 921-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12190791
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Hypnosis for nausea and vomiting in pregnancy. Author(s): Stanford JB. Source: American Family Physician. 1994 June; 49(8): 1733, 1736. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8203314
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Hypnosis in the prevention of chemotherapy-related nausea and vomiting in children: a prospective study. Author(s): Jacknow DS, Tschann JM, Link MP, Boyce WT. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1994 August; 15(4): 258-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7798371
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Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy. Author(s): Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O. Source: Oncology. 2000 August; 59(2): 100-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10971166
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Hypocaloric oral therapy during an episode of diarrhea and vomiting can lead to severe malnutrition. Author(s): Goepp JG. Source: Journal of Pediatric Gastroenterology and Nutrition. 1998 July; 27(1): 116-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9669740
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Hypocaloric oral therapy during an episode of diarrhea and vomiting can lead to severe malnutrition. Author(s): Baker SS, Davis AM. Source: Journal of Pediatric Gastroenterology and Nutrition. 1998 July; 27(1): 1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9669718
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Hypotension and intractable vomiting in the first trimester of pregnancy. Author(s): Usalan C, Ozarslan E. Source: Postgraduate Medical Journal. 1999 October; 75(888): 623-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10621910
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Hypothetical framework for a relationship between maternal thyroid function, nausea and vomiting of pregnancy, and congenital heart disease. Author(s): Vohra S, Koren G. Source: Medical Hypotheses. 2001 March; 56(3): 392-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11359368
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Ictal vomiting in association with left temporal lobe seizures in a left hemisphere language-dominant patient. Author(s): Koutroumanidis M. Source: Epilepsia. 2003 September; 44(9): 1259. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12919403
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Ictal vomiting in association with left temporal lobe seizures in a left hemisphere language-dominant patient. Author(s): Schauble B, Britton JW, Mullan BP, Watson J, Sharbrough FW, Marsh WR. Source: Epilepsia. 2002 November; 43(11): 1432-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12423396
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Idiopathic cyclic vomiting syndrome associated with gastroesophageal reflux and chronic sinusitis. Author(s): Selimoglu MA, Ertekin V, Tan H, Selimoglu E. Source: The Journal of Pediatrics. 2003 October; 143(4): 545; Author Reply 545. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14603890
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Impact of a multimodal anti-emetic prophylaxis on patient satisfaction in high-risk patients for postoperative nausea and vomiting. Author(s): Eberhart LH, Mauch M, Morin AM, Wulf H, Geldner G. Source: Anaesthesia. 2002 October; 57(10): 1022-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12358962
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Improved prevention of moderately emetogenic chemotherapy-induced nausea and vomiting with palonosetron, a pharmacologically novel 5-HT3 receptor antagonist: results of a phase III, single-dose trial versus dolasetron. Author(s): Eisenberg P, Figueroa-Vadillo J, Zamora R, Charu V, Hajdenberg J, Cartmell A, Macciocchi A, Grunberg S; 99-04 Palonosetron Study Group. Source: Cancer. 2003 December 1; 98(11): 2473-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14635083
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In the public's view. vomiting on the high seas. Author(s): Goodman NW. Source: Hosp Med. 2003 December; 64(12): 749. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14702792
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Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20 mg and ondansetron 8 mg given by the end of laparoscopic cholecystectomies. Author(s): Quaynor H, Raeder JC. Source: Acta Anaesthesiologica Scandinavica. 2002 January; 46(1): 109-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11903083
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Incidence of postoperative nausea and vomiting in paediatric ambulatory surgery. Author(s): Villeret I, Laffon M, Duchalais A, Blond MH, Lecuyer AI, Mercier C. Source: Paediatric Anaesthesia. 2002 October; 12(8): 712-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12472709
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Incidence of vomiting in burns and implications for mass burn casualty management. Author(s): Brown TL, Hernon C, Owens B. Source: Burns : Journal of the International Society for Burn Injuries. 2003 March; 29(2): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12615463
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Incidence of vomiting in susceptible children under regional analgesia with two different anaesthetic techniques. Author(s): Sarti A, Busoni P, Dell'Oste C, Bussolin L. Source: Paediatric Anaesthesia. 2004 March; 14(3): 251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14996265
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Increased incidence of postoperative nausea and vomiting without additional analgesic effects when a low dose of intravenous fentanyl is combined with a caudal block. Author(s): Kokinsky E, Nilsson K, Larsson LE. Source: Paediatric Anaesthesia. 2003 May; 13(4): 334-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12753447
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Intermittent nasogastric drainage under sedation for unresponsive vomiting in terminal bowel obstruction. Author(s): Benitez-Rosario MA, Salinas-Martin A, Martinez-Castillo LP, Martin-Ortega JJ, Feria M. Source: Journal of Pain and Symptom Management. 2003 January; 25(1): 4-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12565181
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Intractable vomiting as an early clinical symptom of cerebrospinal fluid seeding to the fourth ventricle in patients with high-grade astrocytoma. Author(s): Fujimura M, Kumabe T, Jokura H, Shirane R, Yoshimoto T, Tominaga T. Source: Journal of Neuro-Oncology. 2004 January; 66(1-2): 209-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15015789
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Intraoperative colloid administration reduces postoperative nausea and vomiting and improves postoperative outcomes compared with crystalloid administration. Author(s): Moretti EW, Robertson KM, El-Moalem H, Gan TJ. Source: Anesthesia and Analgesia. 2003 February; 96(2): 611-7, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12538221
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Intraperitoneal ondansetron hydrochloride for intractable nausea and vomiting due to diabetic gastroparesis in a patient on peritoneal dialysis. Author(s): Amin K, Bastani B. Source: Perit Dial Int. 2002 July-August; 22(4): 539-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12322834
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Intravenous fluid loading with or without supplementary dextrose does not prevent nausea, vomiting and pain after laparoscopy. Author(s): McCaul C, Moran C, O'Cronin D, Naughton F, Geary M, Carton E, Gardiner J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 May; 50(5): 440-4. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12734150
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Investigation in vomiting children. Author(s): Maclennan AC. Source: Semin Pediatr Surg. 2003 November; 12(4): 220-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655160
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Is postoperative nausea and vomiting following tonsillectomy really a problem? Author(s): Church JJ. Source: Anaesthesia. 2002 October; 57(10): 1029-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12358967
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Is there rationale to use an antiemetic in the same class for the treatment of patients who experience postoperative nausea and vomiting despite prophylaxis? Author(s): Kovac AL. Source: Anesthesia and Analgesia. 2003 December; 97(6): 1857. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14633582
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Isolation from “being alive”: coping with severe nausea and vomiting of pregnancy. Author(s): O'Brien B, Evans M, White-McDonald E. Source: Nursing Research. 2002 September-October; 51(5): 302-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12352778
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Jamaican vomiting sickness in Toledo, Ohio. Author(s): McTague JA, Forney R Jr. Source: Annals of Emergency Medicine. 1994 May; 23(5): 1116-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8185109
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Ketorolac and propofol administration for prevention of nausea and vomiting in patients undergoing minor gynecologic surgery. Author(s): Hough MP, Waugaman WR. Source: Nurse Anesth. 1993 March; 4(1): 9-17. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8499507
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Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Author(s): Boehler M, Mitterschiffthaler G, Schlager A. Source: Anesthesia and Analgesia. 2002 April; 94(4): 872-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11916788
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Korean hand acupressure reduces postoperative vomiting in children after strabismus surgery. Author(s): Schlager A, Boehler M, Puhringer F. Source: British Journal of Anaesthesia. 2000 August; 85(2): 267-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10992837
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Lack of efficacy of propofol in the treatment of early postoperative nausea and vomiting. Author(s): Harper I, Della-Marta E, Owen H, Plummer J, Ilsley A. Source: Anaesthesia and Intensive Care. 1998 August; 26(4): 366-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9743849
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Lack of relationship between infection by Helicobacter pylori and vomiting that usually occurs during pregnancy, although possible relationship with severe forms of emesis. Author(s): Larraz J, Marin N, Pineiro L, Cilla G, Perez-Trallero E. Source: Rev Esp Enferm Dig. 2002 July; 94(7): 417-22. English, Spanish. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12432838
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Laser stimulation of acupuncture point P6 reduces postoperative vomiting in children undergoing strabismus surgery. Author(s): Schlager A, Offer T, Baldissera I. Source: British Journal of Anaesthesia. 1998 October; 81(4): 529-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9924226
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L-carnitine administration reduces number of episodes in cyclic vomiting syndrome. Author(s): Van Calcar SC, Harding CO, Wolff JA. Source: Clinical Pediatrics. 2002 April; 41(3): 171-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11999680
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Let's get positive about postoperative nausea and vomiting. Author(s): Jolley S. Source: Br J Theatre Nurs. 1999 October; 9(10): 450-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10646379
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Leukocytosis, hyperglycemia, vomiting, and positive X-rays are not indicators of severity of iron overdose in adults. Author(s): Palatnick W, Tenenbein M. Source: The American Journal of Emergency Medicine. 1996 September; 14(5): 454-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8765107
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Levomepromazine for nausea and vomiting in advanced cancer. Author(s): Skinner J, Skinner A. Source: Hosp Med. 1999 August; 60(8): 568-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10621811
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Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache. Author(s): Heinrichs L. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S215-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011889
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Longitudinal change in the treatment of nausea and vomiting of pregnancy in Ontario. Author(s): Lee J, Einarson A, Gallo M, Okotore B, Koren G. Source: Can J Clin Pharmacol. 2000 Winter; 7(4): 205-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11118967
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Long-term maintenance of a behavioral alternative to surgery for severe vomiting and weight loss. Author(s): Lockwood K, Maenpaa M, Williams DE. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1997 June; 28(2): 10512. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9194007
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Low incidence of nausea and vomiting with intravenous opiate analgesia in the ED. Author(s): Paoloni R, Talbot-Stern J. Source: The American Journal of Emergency Medicine. 2002 November; 20(7): 604-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12442238
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Low incidence of the oculocardiac reflex and postoperative nausea and vomiting in adults undergoing strabismus surgery. Author(s): Tramer MR, Fuchs-Buder T, Sansonetti A, Rifat K. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1997 August; 44(8): 830-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9260010
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Low-dose dexamethasone effectively prevents postoperative nausea and vomiting after ambulatory laparoscopic surgery. Author(s): Huang JC, Shieh JP, Tang CS, Tzeng JI, Chu KS, Wang JJ. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2001 November; 48(10): 973-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11698315
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Low-dose dexamethasone reduces nausea and vomiting after epidural morphine: a comparison of metoclopramide with saline. Author(s): Tzeng JI, Hsing CH, Chu CC, Chen YH, Wang JJ. Source: Journal of Clinical Anesthesia. 2002 February; 14(1): 19-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11880017
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Low-dose dexamethasone reduces nausea and vomiting after tympanomastoid surgery: a comparison of tropisetron with saline. Author(s): Wang JJ, Wang PC, Liu YH, Chien CC. Source: American Journal of Otolaryngology. 2002 September-October; 23(5): 267-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12239690
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Low-dose droperidol reduces postoperative vomiting in paediatric day surgery. Author(s): Lunn DV, Lauder GR, Williams AR, Pickering RM, McQuillian PJ. Source: British Journal of Anaesthesia. 1995 May; 74(5): 509-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7772422
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Low-dose ondansetron with dexamethasone more effectively decreases vomiting after strabismus surgery in children than does high-dose ondansetron. Author(s): Splinter WM, Rhine EJ. Source: Anesthesiology. 1998 January; 88(1): 72-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9447858
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Magnetic resonance imaging detection of a lesion compatible with central pontine myelinolysis in a pregnant patient with recurrent vomiting and confusion. Author(s): Valiulis B, Kelley RE, Hardjasudarma M, London S. Source: Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging. 2001 October; 11(4): 441-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11677888
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Management of common symptoms in terminally ill patients: Part I. Fatigue, anorexia, cachexia, nausea and vomiting. Author(s): Ross DD, Alexander CS. Source: American Family Physician. 2001 September 1; 64(5): 807-14. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11563572
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Management of cyclic vomiting syndrome. Author(s): Fleisher DR. Source: Journal of Pediatric Gastroenterology and Nutrition. 1995; 21 Suppl 1: S52-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8708870
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Management of intractable nausea and vomiting. Author(s): Wickham R. Source: Clinical Journal of Oncology Nursing. 2004 February; 8(1): 91-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14983771
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Management of postoperative nausea and vomiting in ambulatory surgery. Author(s): Cameron D, Gan TJ. Source: Anesthesiology Clinics of North America. 2003 June; 21(2): 347-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812400
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Management of postoperative nausea and vomiting in children. Author(s): De Negri P, Ivani G. Source: Paediatric Drugs. 2002; 4(11): 717-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390043
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Management of postoperative vomiting in pediatric patients. Author(s): Olutoye O, Watcha MF. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 99-117. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574217
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Management of post-strabismus nausea and vomiting in children using ondansetron: a value-based comparison of outcomes. Author(s): Sennaraj B, Shende D, Sadhasivam S, Ilavajady S, Jagan D. Source: British Journal of Anaesthesia. 2002 September; 89(3): 473-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12402728
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Managing nausea and vomiting. Current strategies. Author(s): Garrett K, Tsuruta K, Walker S, Jackson S, Sweat M. Source: Critical Care Nurse. 2003 February; 23(1): 31-50; Quiz 51-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640958
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Managing nausea, vomiting, and diarrhea. Author(s): Highleyman L. Source: Beta. 2002 Spring; 15(2): 29-39. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12064304
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Managing post-operative nausea and vomiting. Author(s): Jolley S. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2001 June 20-26; 15(40): 47-52; Quiz 53-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12206076
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Maternal inheritance in cyclic vomiting syndrome with neuromuscular disease. Author(s): Boles RG, Adams K, Ito M, Li BU. Source: American Journal of Medical Genetics. 2003 August 1; 120A(4): 474-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12884425
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Maternal susceptibility to nausea and vomiting of pregnancy: is the vestibular system involved? Author(s): Black FO. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S204-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011887
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Medical, social, and legal implications of treating nausea and vomiting of pregnancy. Author(s): Brent R. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S262-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011898
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Metabolic etiologies of cyclic or recurrent vomiting. Author(s): Korson M. Source: Journal of Pediatric Gastroenterology and Nutrition. 1995; 21 Suppl 1: S15-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8708861
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Metoclopramide for nausea and vomiting of pregnancy: a prospective multicenter international study. Author(s): Berkovitch M, Mazzota P, Greenberg R, Elbirt D, Addis A, Schuler-Faccini L, Merlob P, Arnon J, Stahl B, Magee L, Moretti M, Ornoy A. Source: American Journal of Perinatology. 2002 August; 19(6): 311-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12357422
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Midazolam reduces vomiting after tonsillectomy in children. Author(s): Splinter WM, MacNeill HB, Menard EA, Rhine EJ, Roberts DJ, Gould MH. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 March; 42(3): 201-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7743569
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Mitochondrial disease and cyclic vomiting syndrome. Author(s): Boles RG, Williams JC. Source: Digestive Diseases and Sciences. 1999 August; 44(8 Suppl): 103S-107S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10490048
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Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Author(s): Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S228-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011891
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Motion sickness and postoperative vomiting in children. Author(s): Busoni P, Sarti A, Crescioli M, Agostino MR, Sestini G, Banti S. Source: Paediatric Anaesthesia. 2002 January; 12(1): 65-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11849578
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Nausea and vomiting after fast-track cardiac anaesthesia. Author(s): Kogan A, Eidelman LA, Raanani E, Orlov B, Shenkin O, Vidne BA. Source: British Journal of Anaesthesia. 2003 August; 91(2): 214-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12878620
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Nausea and vomiting after phacoemulsification using topical or retrobulbar anesthesia. Author(s): Chan JC, Lai JS, Lam DS. Source: Journal of Cataract and Refractive Surgery. 2002 November; 28(11): 1973-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12457672
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Nausea and vomiting associate with increasing maternal androgen levels in otherwise uncomplicated pregnancies. Author(s): Carlsen SM, Vanky E, Jacobsen G. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 March; 82(3): 225-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694117
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Nausea and vomiting during pregnancy. Author(s): Koch KL, Frissora CL. Source: Gastroenterology Clinics of North America. 2003 March; 32(1): 201-34, Vi. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635417
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Nausea and vomiting in early pregnancy. Author(s): Jewell D. Source: American Family Physician. 2003 July 1; 68(1): 143-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887120
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Nausea and vomiting in pregnancy in relation to prolactin, estrogens, and progesterone: a prospective study. Author(s): Lagiou P, Tamimi R, Mucci LA, Trichopoulos D, Adami HO, Hsieh CC. Source: Obstetrics and Gynecology. 2003 April; 101(4): 639-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12681864
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Nausea and vomiting in pregnancy: results of a survey that identified interventions used by women to alleviate their symptoms. Author(s): Chandra K, Magee L, Einarson A, Koren G. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 2003 June; 24(2): 71-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854391
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Nausea and vomiting in pregnancy: safety and efficacy of self-administered complementary therapies. Author(s): Tiran D. Source: Complementary Therapies in Nursing & Midwifery. 2002 November; 8(4): 191-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463608
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Nausea and vomiting of pregnancy. Author(s): Quinla JD, Hill DA. Source: American Family Physician. 2003 July 1; 68(1): 121-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887118
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Nausea and vomiting. Author(s): Hasler WL, Chey WD. Source: Gastroenterology. 2003 December; 125(6): 1860-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14724837
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Nutritional aspects of eating episodes followed by vomiting in Brazilian patients with bulimia nervosa. Author(s): Alvarenga MS, Negrao AB, Philippi ST. Source: Eat Weight Disord. 2003 June; 8(2): 150-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12880193
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Olanzapine as an antiemetic in refractory nausea and vomiting in advanced cancer. Author(s): Srivastava M, Brito-Dellan N, Davis MP, Leach M, Lagman R. Source: Journal of Pain and Symptom Management. 2003 June; 25(6): 578-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782438
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Oncology Patient Evidence-Based Notes (OPEN): antiemetics for chemotherapyinduced nausea and vomiting. Author(s): Cope D. Source: Clinical Journal of Oncology Nursing. 2003 July-August; 7(4): 461-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12929282
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Ondansetron and dolasetron provide equivalent postoperative vomiting control after ambulatory tonsillectomy in dexamethasone-pretreated children. Author(s): Sukhani R, Pappas AL, Lurie J, Hotaling AJ, Park A, Fluder E. Source: Anesthesia and Analgesia. 2002 November; 95(5): 1230-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12401599
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Ondansetron disintegrating tablets of 8 mg twice a day for 3 days did not reduce the incidence of nausea or vomiting after laparoscopic surgery. Author(s): Thagaard KS, Steine S, Raeder J. Source: European Journal of Anaesthesiology. 2003 February; 20(2): 153-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12622501
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Ondansetron for prevention of intrathecal opioids-induced pruritus, nausea and vomiting after cesarean delivery. Author(s): Yazigi A, Chalhoub V, Madi-Jebara S, Haddad F. Source: Anesthesia and Analgesia. 2004 January; 98(1): 264; Author Reply 264. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693635
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Ondansetron for the prevention and treatment of nausea and vomiting following pediatric strabismus surgery. Author(s): Caron E, Bussieres JF, Lebel D, Mathews S, Milot J, Jacob JL, Moride Y, Lortie L. Source: Can J Ophthalmol. 2003 April; 38(3): 214-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12733689
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Options for the prevention and management of acute chemotherapy-induced nausea and vomiting in children. Author(s): Dupuis LL, Nathan PC. Source: Paediatric Drugs. 2003; 5(9): 597-613. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956617
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Oral clonidine premedication does not reduce postoperative vomiting in children undergoing strabismus surgery. Author(s): Gulhas N, Turkoz A, Durmus M, Togal T, Gedik E, Ersoy MO. Source: Acta Anaesthesiologica Scandinavica. 2003 January; 47(1): 90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12492804
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Oral ondansetron, tropisetron or metoclopramide to prevent postoperative nausea and vomiting: a comparison in high-risk patients undergoing thyroid or parathyroid surgery. Author(s): Jokela R, Koivuranta M, Kangas-Saarela T, Purhonen S, Alahuhta S. Source: Acta Anaesthesiologica Scandinavica. 2002 May; 46(5): 519-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12027845
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Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger. Author(s): Niebyl JR, Goodwin TM. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S253-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011896
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Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Author(s): Gralla R, Lichinitser M, Van Der Vegt S, Sleeboom H, Mezger J, Peschel C, Tonini G, Labianca R, Macciocchi A, Aapro M. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2003 October; 14(10): 1570-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14504060
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Partial seizure: an unusual cause of recurrent vomiting. Author(s): Yukselen V, Yasa MH, Karaoglu AO, Bolukbasi O. Source: Int J Clin Pract. 2003 October; 57(8): 742-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14627192
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Pediatric orbital floor fractures: nausea/vomiting as signs of entrapment. Author(s): Cohen SM, Garrett CG. Source: Otolaryngology and Head and Neck Surgery. 2003 July; 129(1): 43-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12869915
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Postoperative nausea and vomiting and outcome. Author(s): Scuderi PE, Conlay LA. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 165-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574220
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Postoperative nausea and vomiting in diagnostic gynaecological laparoscopic procedures: comparison of the efficacy of the combination of dexamethasone and metoclopramide with that of dexamethasone and ondansetron. Author(s): Maddali MM, Mathew J, Fahr J, Zarroug AW. Source: Journal of Postgraduate Medicine. 2003 October-December; 49(4): 302-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14699226
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Postoperative nausea and vomiting: a review of current literature. Author(s): Ku CM, Ong BC. Source: Singapore Med J. 2003 July; 44(7): 366-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620731
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Preliminary experience with dexmedetomidine in the treatment of cyclic vomiting syndrome. Author(s): Khasawinah TA, Ramirez A, Berkenbosch JW, Tobias JD. Source: American Journal of Therapeutics. 2003 July-August; 10(4): 303-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12845396
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Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Author(s): Portnoi G, Chng LA, Karimi-Tabesh L, Koren G, Tan MP, Einarson A. Source: American Journal of Obstetrics and Gynecology. 2003 November; 189(5): 1374-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634571
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Psychological health in early pregnancy: relationship with nausea and vomiting. Author(s): Swallow BL, Lindow SW, Masson EA, Hay DM. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2004 January; 24(1): 28-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14675977
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Psychosocial factors related to nausea, vomiting, and fatigue in early pregnancy. Author(s): Chou FH, Lin LL, Cooney AT, Walker LO, Riggs MW. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2003; 35(2): 119-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854291
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Quality of emergence from anesthesia and incidence of vomiting with remifentanil in a pediatric population. Author(s): Pinsker MC, Carroll NV. Source: Anesthesia and Analgesia. 1999 July; 89(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10389781
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Ramosetron, a 5-HT3 receptor antagonist for the control of nausea and vomiting. Author(s): Rabasseda X. Source: Drugs Today (Barc). 2002 February; 38(2): 75-89. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12532186
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Randomized, double-blind trial of dolasetron versus droperidol for prophylaxis of postoperative nausea and vomiting in patients undergoing TRAM flap breast reconstruction surgery. Author(s): Loewen P, Lamb S, Clugston P. Source: Annals of Plastic Surgery. 2003 November; 51(5): 472-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14595183
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Randomized, double-blinded comparison of tropisetron and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. Author(s): Madenoglu H, Yildiz K, Dogru K, Kurtsoy A, Guler G, Boyaci A. Source: Journal of Neurosurgical Anesthesiology. 2003 April; 15(2): 82-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12657991
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Recall bias of the symptoms of nausea and vomiting of pregnancy. Author(s): Koren G, Maltepe C, Navioz Y, Wolpin J. Source: American Journal of Obstetrics and Gynecology. 2004 February; 190(2): 485-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14981394
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Recurrent vomiting and ethylmalonic aciduria associated with rare mutations of the short-chain acyl-CoA dehydrogenase gene. Author(s): Seidel J, Streck S, Bellstedt K, Vianey-Saban C, Pedersen CB, Vockley J, Korall H, Roskos M, Deufel T, Trefz KF, Sewell AC, Kauf E, Zintl F, Lehnert W, Gregersen N. Source: Journal of Inherited Metabolic Disease. 2003; 26(1): 37-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12872838
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Red eyes, reduced vision, and vomiting. Author(s): Dhingra N, Watts MT. Source: Postgraduate Medical Journal. 2003 September; 79(935): 542, 546-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13679560
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Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Author(s): Kallen B, Lundberg G, Aberg A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 October; 82(10): 916-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956841
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Reporting of clinical details in randomized controlled trials of acupuncture for the treatment of migraine/headaches and nausea/vomiting. Author(s): Elorriaga Claraco A, Hanna SE, Fargas-Babjak A. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2003 February; 9(1): 151-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676043
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Results of a prospective, randomized, double-blind, placebo-controlled, dose-ranging trial to determine the effective dose of ramosetron for the prevention of vomiting after tonsillectomy in children. Author(s): Fujii Y, Tanaka H. Source: Clinical Therapeutics. 2003 December; 25(12): 3135-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749151
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Risk assessment of postoperative nausea and vomiting. Author(s): Apfel CC, Roewer N. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 13-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574212
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Severely sustained vomiting as the main symptom in a man with thyrotoxicosis. Author(s): Chen P, Chen HF, Tan SW, Su MC, Ng KW, Jiang CF. Source: J Chin Med Assoc. 2003 May; 66(5): 311-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12908576
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Single-dose haloperidol for the prophylaxis of postoperative nausea and vomiting after intrathecal morphine. Author(s): Parlow JL, Costache I, Avery N, Turner K. Source: Anesthesia and Analgesia. 2004 April; 98(4): 1072-6, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15041601
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Small dose of propofol for preventing nausea and vomiting after third molar extraction. Author(s): Fujii Y, Uemura A, Nakano M. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2002 November; 60(11): 1246-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12420256
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Small-dose dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy: a comparison of tropisetron with saline. Author(s): Wang JJ, Ho ST, Uen YH, Lin MT, Chen KT, Huang JC, Tzeng JI. Source: Anesthesia and Analgesia. 2002 July; 95(1): 229-32, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12088975
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Spontaneous esophageal rupture following severe vomiting in pregnancy. Author(s): Eroglu A, Kurkcuoglu C, Karaoglanoglu N, Tekinbas C, Cesur M. Source: Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E. 2002; 15(3): 242-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12444998
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Strategies to reduce postoperative nausea and vomiting: does metoclopramide have a role? Author(s): Beattie WS. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1009-15. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477669
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Study of postoperative nausea and vomiting: recommending risk models for group comparisons. Author(s): Apfel CC, Koivuranta M, Sweeney B. Source: Anaesthesia. 2003 May; 58(5): 492-3; Author Reply 493. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694019
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Supplemental oxygen does not reduce postoperative nausea and vomiting after thyroidectomy. Author(s): Joris JL, Poth NJ, Djamadar AM, Sessler DI, Hamoir EE, Defechereux TR, Meurisse MR, Lamy ML. Source: British Journal of Anaesthesia. 2003 December; 91(6): 857-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14633758
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Supplemental oxygen does not reduce the incidence of postoperative nausea and vomiting after ambulatory gynecologic laparoscopy. Author(s): Purhonen S, Turunen M, Ruohoaho UM, Niskanen M, Hynynen M. Source: Anesthesia and Analgesia. 2003 January; 96(1): 91-6, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12505931
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Supplemental oxygen for prevention of nausea and vomiting after breast surgery. Author(s): Purhonen S, Niskanen M, Wustefeld M, Mustonen P, Hynynen M. Source: British Journal of Anaesthesia. 2003 August; 91(2): 284-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12878631
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The effect of mandibular nerve block on opioid consumption, nausea and vomiting in bilateral mandibular osteotomies. Author(s): Van Lancker P, Abeloos JV, De Clercq CA, Mommaerts MY. Source: Acta Anaesthesiol Belg. 2003; 54(3): 223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14598619
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The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Author(s): Roscoe JA, Morrow GR, Hickok JT, Bushunow P, Pierce HI, Flynn PJ, Kirshner JJ, Moore DF, Atkins JN. Source: Journal of Pain and Symptom Management. 2003 August; 26(2): 731-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12906958
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The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. Author(s): Pongrojpaw D, Chiamchanya C. Source: J Med Assoc Thai. 2003 March; 86(3): 244-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12757064
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The management of nausea and vomiting of pregnancy. Author(s): Craig WS. Source: J Obstet Gynaecol Can. 2003 March; 25(3): 184; Discussion 184. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12610668
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The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapyinduced nausea and vomiting: a multinational, randomized, double-blind, placebocontrolled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group. Author(s): Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R, Chawla SP, Carides AD, Ianus J, Elmer ME, Evans JK, Beck K, Reines S, Horgan KJ; Aprepitant Protocol 052 Study Group. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 November 15; 21(22): 4112-9. Epub 2003 October 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14559886
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The oral NK(1) antagonist, aprepitant, given with standard antiemetics provides protection against nausea and vomiting over multiple cycles of cisplatin-based chemotherapy: a combined analysis of two randomised, placebo-controlled phase III clinical trials. Author(s): de Wit R, Herrstedt J, Rapoport B, Carides AD, Guoguang-Ma J, Elmer M, Schmidt C, Evans JK, Horgan KJ. Source: European Journal of Cancer (Oxford, England : 1990). 2004 February; 40(3): 40310. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14746859
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The ups and downs of novel antiemetic drugs, part 1: substance P, 5-HT, and the neuropharmacology of vomiting. Author(s): Stahl SM. Source: The Journal of Clinical Psychiatry. 2003 May; 64(5): 498-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755650
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Transcutaneous acupoint electrical stimulation in preventing and treating nausea and vomiting in patients receiving electroconvulsive therapy. Author(s): Kramer BA, Kadar AG, Clark K. Source: The Journal of Ect. 2003 December; 19(4): 194-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14657771
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Treating nausea and vomiting during pregnancy: case outcome. Author(s): Harker N, Montgomery A, Fahey T. Source: Bmj (Clinical Research Ed.). 2004 February 28; 328(7438): 503; Discussion 504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14988187
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Treatment of postoperative nausea and vomiting. Author(s): Tramer MR. Source: Bmj (Clinical Research Ed.). 2003 October 4; 327(7418): 762-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14525850
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Unbalanced middle ear anaesthesia. A response to 'A comparison of total intravenous with balanced anaesthesia for middle ear surgery: effects on postoperative nausea and vomiting, pain and conditions of surgery', Mukherjee K et al., Anaesthesia 2003; 58: 176-9. Author(s): Walsh E. Source: Anaesthesia. 2003 June; 58(6): 620. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12846668
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Unexpected electrolyte changes in a vomiting man. Author(s): McNeil A. Source: Aust Fam Physician. 2001 November; 30(11): 1083. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11770486
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Unilateral retraction of eyelid on vomiting. Author(s): Hwang JM. Source: J Aapos. 1997 March; 1(1): 63-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10530987
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Ureteropelvic junction obstruction: an overlooked cause of cyclic vomiting. Author(s): Schulte-Bockholt A, Kugathasan S, Mesrobian HG, Werlin SL. Source: The American Journal of Gastroenterology. 2002 April; 97(4): 1043-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12003386
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Use of barbiturates in the treatment of cyclic vomiting during childhood. Author(s): Gokhale R, Huttenlocher PR, Brady L, Kirschner BS. Source: Journal of Pediatric Gastroenterology and Nutrition. 1997 July; 25(1): 64-7. Erratum In: J Pediatr Gastroenterol Nutr 1997 November; 25(5): 559. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9226529
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Use of clinical pictures in the management of nausea and vomiting: a prospective audit. Author(s): Bentley A, Boyd K. Source: Palliative Medicine. 2001 May; 15(3): 247-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407196
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Use of dexamethasone on the prophylaxis of nausea and vomiting after tympanomastoid surgery. Author(s): Liu YH, Li MJ, Wang PC, Ho ST, Chang CF, Ho CM, Wang JJ. Source: The Laryngoscope. 2001 July; 111(7): 1271-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11568553
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Use of reversal agents in day care procedures (with special reference to postoperative nausea and vomiting). Author(s): Fuchs-Buder T, Mencke T. Source: European Journal of Anaesthesiology. Supplement. 2001; 23: 53-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11766248
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Using diazepam and atropine before strabismus surgery to prevent postoperative nausea and vomiting: a randomized, controlled study. Author(s): Ozcan AA, Gunes Y, Haciyakupoglu G. Source: J Aapos. 2003 June; 7(3): 210-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12825062
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Utility of ondansetron in children with vomiting. Author(s): Leman P. Source: Annals of Emergency Medicine. 2002 September; 40(3): 366-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12192369
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Variation in practice patterns of anesthesiologists in California for prophylaxis of postoperative nausea and vomiting. Author(s): Macario A, Chung A, Weinger MB. Source: Journal of Clinical Anesthesia. 2001 August; 13(5): 353-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11498316
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Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design. Author(s): Apfel CC, Kranke P, Katz MH, Goepfert C, Papenfuss T, Rauch S, Heineck R, Greim CA, Roewer N. Source: British Journal of Anaesthesia. 2002 May; 88(5): 659-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12067003
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Vomiting after outpatient tonsillectomy and adenoidectomy in children: the role of nitrous oxide. Author(s): Pandit UA, Malviya S, Lewis IH. Source: Anesthesia and Analgesia. 1995 February; 80(2): 230-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7818105
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Vomiting and gastric motility in infants with cow's milk allergy. Author(s): Steffen RM. Source: Clinical Pediatrics. 2001 August; 40(8): 469. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11516057
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Vomiting and retching in Gilles de la Tourette syndrome: a report of ten cases and a review of the literature. Author(s): Rickards H, Robertson MM. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1997 July; 12(4): 531-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9251071
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Vomiting gravel. Author(s): Rosenberg M, Parsiak K. Source: The American Journal of Emergency Medicine. 2004 March; 22(2): 131-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15011237
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Vomiting in a nine-day-old infant. Author(s): Swischuk LE. Source: Pediatric Emergency Care. 1995 April; 11(2): 131-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7596875
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Vomiting in children. A comprehensive review. Author(s): Acker ME. Source: Adv Nurse Pract. 2002 January; 10(1): 51-6, 68. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12420512
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Vomiting with depression: choroid plexus papilloma. Author(s): Beith CP, Barton AL, Sobala GM. Source: Journal of the Royal Society of Medicine. 2001 October; 94(10): 526-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11581350
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Vomiting, burns, and irrational behaviour. Author(s): Auchincloss S, Pridmore S. Source: Lancet. 2001 December 1; 358(9296): 1870. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11741627
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Was late-nineteenth-century nervous vomiting an early variant of bulimia nervosa? Author(s): van Deth R, Vandereycken W. Source: History of Psychiatry. 1995 September; 6(23 Pt 3): 333-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11639851
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We still need common criteria for the assessment of nausea and vomiting. Author(s): Herrstedt J. Source: European Journal of Cancer (Oxford, England : 1990). 1994; 30A(9): 1217. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7999401
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Wernicke's encephalopathy in a child with prolonged vomiting. Author(s): Ming X, Wang MM, Zee D, Katz RM, Freeman JM. Source: Journal of Child Neurology. 1998 April; 13(4): 187-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9568765
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What can be expected from risk scores for predicting postoperative nausea and vomiting? Author(s): Apfel CC, Kranke P, Greim CA, Roewer N. Source: British Journal of Anaesthesia. 2001 June; 86(6): 822-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11573590
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Wilkie's syndrome, a rare cause of vomiting and weight loss: diagnosis and therapy. Author(s): Van Brussel JP, Dijkema WP, Adhin SK, Jonkers GJ. Source: The Netherlands Journal of Medicine. 1997 November; 51(5): 179-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9455097
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Winter vomiting. Author(s): Cowden JM. Source: Bmj (Clinical Research Ed.). 2002 February 2; 324(7332): 249-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11823342
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Withholding oral fluids from children undergoing day surgery reduces vomiting. Author(s): Kearney R, Mack C, Entwistle L. Source: Paediatric Anaesthesia. 1998; 8(4): 331-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9672932
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CHAPTER 2. NUTRITION AND VOMITING Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and vomiting.
Finding Nutrition Studies on Vomiting 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 “vomiting” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following is a typical result when searching for recently indexed consumer information on vomiting: •
Nausea and vomiting in early pregnancy. Source: Sharman, Ivan. Nutr-Food-Sci. London, Jan/February 1983. (80) page 20-22. charts. 0034-6659
Eng.
:
Forbes
Publications.
The following information is typical of that found when using the “Full IBIDS Database” to search for “vomiting” (or a synonym): •
Are we failing women? Advice for nausea and vomiting in pregnancy. Author(s): Bournemouth University. Source: Allen, R Pract-Midwife. 2001 April; 4(4): 20-2 1461-3123
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Chemotherapy-induced nausea and vomiting. Author(s): University of Pittsburgh School of Nursing, 3500 Victoria Street, Room 415, Victoria Building, Pittsburgh, PA 15261, USA.
[email protected] Source: Bender, Catherine M McDaniel, Roxanne W Murphy Ende, Kathleen Pickett, Mary Rittenberg, Cynthia N Rogers, Miriam P Schneider, Susan M Schwartz, Rowena N Clin-J-Oncol-Nurs. 2002 Mar-April; 6(2): 94-102 1092-1095
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Comparative study of low-dose oral granisetron plus dexamethasone and high-dose metoclopramide plus dexamethasone in prevention of nausea and vomiting induced by CHOP-therapy in young patients with non-Hodgkin's lymphoma. Author(s): Department of Medicine, Phramongkutklao Hospital, Bangkok 10400, Thailand. Source: Numbenjapon, T Sriswasdi, C Mongkonsritragoon, W Leelasiri, A Prayoonwiwat, W J-Med-Assoc-Thai. 2002 November; 85(11): 1156-63 0125-2208
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How can one apply rescue indomethacin therapy to a 1-month-old baby with antenatal Bartter syndrome in the case of severe vomiting? Author(s): Renal Unit, Department of Pediatrics, University Hospital Gasthuisberg, Herestraat 49, Leuven, Belgium.
[email protected] Source: Proesmans, W Pediatr-Nephrol. 2001 June; 16(6): 532 0931-041X
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Nausea and vomiting of pregnancy: endocrine basis and contribution to pregnancy outcome. Author(s): Department of Biomedical Sciences, University of Nottinhgham, Queens Medical Centre, United Kingdom. Source: Furneaux, E C Langley Evans, A J Langley Evans, S C Obstet-GynecolSurvolume 2001 December; 56(12): 775-82 0029-7828
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Pre-emptive metoclopramide and ondansetron for nausea and vomiting associated with iloprost infusions. Author(s): Royal Devon & Exeter Hospital (Wonford), Barrack Road, Exeter, England EX2 5DW, UK. Source: Roome, C Thompson, J Pharm-World-Sci. 2001 June; 23(3): 122 0928-1231
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The cannabinoids: an overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Author(s): Hebrew University, Jerusalem, Israel.
[email protected] Source: Mechoulam, R Hanu, L Pain-Res-Manag. 2001 Summer; 6(2): 67-73 1203-6765
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The management of nausea and vomiting of pregnancy. Source: Arsenault, M Y Lane, C A MacKinnon, C J Bartellas, E Cargill, Y M Klein, M C Martel, M J Sprague, A E Wilson, A K J-Obstet-Gynaecol-Can. 2002 October; 24(10): 81731; quiz 832-3 1701-2163
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The management of post-operative nausea and vomiting. Author(s): In-patient Neuroscience Center, The Medical College of Virginia Hospitals, Virginia Commonwealth University, USA. Source: Thompson, H J J-Adv-Nurs. 1999 May; 29(5): 1130-6 0309-2402
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Transderm scopolamine: a painless, noninvasive option for control of postoperative nausea and vomiting. Author(s): PACU and Presurgical Holding Unit at Southern Hills Medical Center, Nashville, TN, USA. Source: Sandlin, D J-Perianesth-Nurs. 2002 December; 17(6): 427-9 1089-9472
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Use of reversal agents in day care procedures (with special reference to postoperative nausea and vomiting). Author(s): Department of Anaesthesia and Critical Care, University of the Saarland, D66421 Homburg/Saar, Germany.
[email protected] Source: Fuchs Buder, T Mencke, T Eur-J-Anaesthesiol-Suppl. 2001; 23: 53-9 0952-1941
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/
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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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
The following is a specific Web list relating to vomiting; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Niacin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Vitamin A Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10066,00.html Vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B6 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com
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Vitamin D Alternative names: Calciferol, Calcitrol, Cholecalciferol, Erocalciferol Source: Integrative Medicine Communications; www.drkoop.com Vitamin D Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,905,00.html •
Minerals Acetyl-l-carnitine Source: Healthnotes, Inc.; www.healthnotes.com Boron Source: Healthnotes, Inc.; www.healthnotes.com Boron Source: Prima Communications, Inc.www.personalhealthzone.com Cisplatin Source: Healthnotes, Inc.; www.healthnotes.com Copper Source: Integrative Medicine Communications; www.drkoop.com Copper Source: Prima Communications, Inc.www.personalhealthzone.com Fluoxetine Source: Healthnotes, Inc.; www.healthnotes.com Iodine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,888,00.html Lecithin and Choline Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10040,00.html Magnesium Hydroxide Source: Healthnotes, Inc.; www.healthnotes.com Paroxetine Source: Healthnotes, Inc.; www.healthnotes.com Potassium Source: Healthnotes, Inc.; www.healthnotes.com
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Potassium Source: Prima Communications, Inc.www.personalhealthzone.com Potassium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10086,00.html Selenium Source: Prima Communications, Inc.www.personalhealthzone.com Selenium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10055,00.html Sulfur Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10071,00.html •
Food and Diet Basil Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Garlic Source: Prima Communications, Inc.www.personalhealthzone.com Nutritional Yeast Alternative names: Brewer's Yeast Source: Integrative Medicine Communications; www.drkoop.com Tyramine-Free Diet Source: Healthnotes, Inc.; www.healthnotes.com Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND VOMITING Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to vomiting. At the conclusion of this chapter, we will provide additional sources.
The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “vomiting” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •
NIH Consensus Conference: Acupuncture Source: JAMA. Journal of the American Medical Association. 280(17): 1518-1524. November 4, 1998. Summary: This journal article presents the findings of the consensus conference on acupuncture, sponsored by the Office of Alternative Medicine and the Office of Medical Applications of Research, National Institutes of Health. The purpose of the conference was to provide clinicians, patients, and the general public with a reliable assessment of the use and effectiveness of acupuncture for a variety of conditions. A multidisciplinary panel evaluated evidence presented by experts and in the scientific literature, and developed a consensus statement addressing five issues: the efficacy of acupuncture compared with placebo or sham acupuncture, the place of acupuncture in clinical practice, the biological effects of acupuncture, the integration of acupuncture into the health care system, and directions for future research. The panel concluded that many of the efficacy studies of acupuncture provide equivocal results because of design, sample
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size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls. However, promising results have emerged showing the efficacy of acupuncture for adult postoperative and chemotherapy nausea and vomiting, and in postoperative dental pain. In other conditions such as addiction, stroke rehabilitation, headache, menstrual cramps, fibromyalgia, myofascial pain, osteoarthritis, tennis elbow, low back pain, carpal tunnel syndrome, and asthma, acupuncture may be useful as an adjunct treatment, an acceptable alternative, or part of a comprehensive management plan. This article has 66 references. •
Acceptance of Some Acupuncture Applications Source: JAMA. Journal of the American Medical Association. 278(21): 1725-1727. December 3, 1997. Summary: This journal article summarizes the findings of the National Institutes of Health consensus panel on acupuncture. After evaluating current evidence for the efficacy of acupuncture, the 12-member panel concluded that there is clear evidence of efficacy in the control of postoperative nausea and vomiting, nausea and vomiting associated with chemotherapy and postoperative dental pain, and probably for nausea in early pregnancy. The panelists also found that the use of acupuncture, by itself or as an adjunct therapy, results in satisfactory treatment for a number of other conditions, although firm evidence of efficacy has not yet been established. The panelists concluded that more research is needed linking the use of acupuncture to physiological changes known to be associated with pain relief, and that more attention should be given to the issues involved in expanding the use of acupuncture into the health care system. In addition, the panelists noted that acupuncture has fewer side effects than many of the drugs or accepted medical procedures used for the same conditions. Finally, the panelists commended the progress the acupuncture educational community has made in establishing training and credentialing programs.
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 vomiting 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 “vomiting” (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 vomiting: •
A 16-month-old with persistent vomiting. Author(s): Palumbo M, Dolen WK, Good RA. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2003 April; 90(4): 380-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12722957
•
A pilot study of the use of progressive muscle relaxation training in the management of post-chemotherapy nausea and vomiting. Author(s): Molassiotis A.
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Source: European Journal of Cancer Care. 2000 December; 9(4): 230-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11829370 •
A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. Author(s): Sripramote M, Lekhyananda N. Source: J Med Assoc Thai. 2003 September; 86(9): 846-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649969
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A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Author(s): Smith C, Crowther C, Willson K, Hotham N, McMillian V. Source: Obstetrics and Gynecology. 2004 April; 103(4): 639-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15051552
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A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. Author(s): Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. Source: Obstetrics and Gynecology. 2003 July; 102(1): 129-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850618
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A systematic approach to the management of postoperative nausea and vomiting. Author(s): Golembiewski JA, O'Brien D. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2002 December; 17(6): 364-76. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476402
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Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Agarwal A, Bose N, Gaur A, Singh U, Gupta MK, Singh D. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 JuneJuly; 49(6): 554-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12067865
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Acupressure wristbands for the prevention of postoperative nausea and vomiting in adults undergoing cardiac surgery. Author(s): Klein AA, Djaiani G, Karski J, Carroll J, Karkouti K, McCluskey S, Poonawala H, Shayan C, Fedorko L, Cheng D. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2004 February; 18(1): 68-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14973803
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Acupuncture and acupressure for the management of chemotherapy-induced nausea and vomiting. Author(s): Collins KB, Thomas DJ. Source: Journal of the American Academy of Nurse Practitioners. 2004 February; 16(2): 76-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15055425
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Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial. Author(s): Streitberger K, Diefenbacher M, Bauer A, Conradi R, Bardenheuer H, Martin E, Schneider A, Unnebrink K. Source: Anaesthesia. 2004 February; 59(2): 142-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14725517
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Acupuncture for postoperative nausea and vomiting prophylaxis: where's the point? Author(s): Cohn AI. Source: Anesthesiology. 2002 October; 97(4): 1038-9; Author Reply 1039. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12357192
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Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Author(s): Smith C, Crowther C, Beilby J. Source: Birth (Berkeley, Calif.). 2002 March; 29(1): 1-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11843784
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Acupuncture versus ondansetron in the prevention of postoperative vomiting. A study of children undergoing dental surgery. Author(s): Somri M, Vaida SJ, Sabo E, Yassain G, Gankin I, Gaitini LA. Source: Anaesthesia. 2001 October; 56(10): 927-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11576093
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Are we failing women? Advice for nausea and vomiting in pregnancy. Author(s): Allen R. Source: Pract Midwife. 2001 April; 4(4): 20-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12026609
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Capsicum plaster at the korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Author(s): Kim KS, Koo MS, Jeon JW, Park HS, Seung IS. Source: Anesthesia and Analgesia. 2002 October; 95(4): 1103-7, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12351304
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Chemotherapy-induced nausea and vomiting. Author(s): Bender CM, McDaniel RW, Murphy-Ende K, Pickett M, Rittenberg CN, Rogers MP, Schneider SM, Schwartz RN. Source: Clinical Journal of Oncology Nursing. 2002 March-April; 6(2): 94-102. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11889684
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Chemotherapy-related nausea and vomiting - past reflections, present practice and future management. Author(s): Miller M, Kearney N. Source: European Journal of Cancer Care. 2004 March; 13(1): 71-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14961778
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Cisplatin-induced vomiting depends on circadian timing. Author(s): Kobayashi M, To H, Tokue A, Fujimura A, Kobayashi E. Source: Chronobiology International. 2001 September; 18(5): 851-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11763992
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Clinical observations on postoperative vomiting treated by auricular acupuncture. Author(s): Kim Y, Kim CW, Kim KS. Source: The American Journal of Chinese Medicine. 2003; 31(3): 475-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12943178
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Comparative efficacy of acustimulation (ReliefBand) versus ondansetron (Zofran) in combination with droperidol for preventing nausea and vomiting. Author(s): White PF, Issioui T, Hu J, Jones SB, Coleman JE, Waddle JP, Markowitz SD, Coloma M, Macaluso AR, Ing CH. Source: Anesthesiology. 2002 November; 97(5): 1075-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12411789
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Comparative study of low-dose oral granisetron plus dexamethasone and high-dose metoclopramide plus dexamethasone in prevention of nausea and vomiting induced by CHOP-therapy in young patients with non-Hodgkin's lymphoma. Author(s): Numbenjapon T, Sriswasdi C, Mongkonsritragoon W, Leelasiri A, Prayoonwiwat W. Source: J Med Assoc Thai. 2002 November; 85(11): 1156-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12546311
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Comparison of acupressure bands and droperidol for reducing post-operative nausea and vomiting in gynecologic surgery patients. Author(s): Schultz AA, Andrews AL, Goran SF, Mathew T, Sturdevant N. Source: Applied Nursing Research : Anr. 2003 November; 16(4): 256-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14608559
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Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Author(s): Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Berrisford SB, Wakefield CA, Issioui T, Jones SB, Jones DB. Source: Anesthesiology. 2002 December; 97(6): 1387-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12459663
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Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial. Author(s): Dent HE, Dewhurst NG, Mills SY, Willoughby M. Source: Complementary Therapies in Medicine. 2003 June; 11(2): 72-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801491
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Cyclical vomiting syndrome. A disease they couldn't name: our battle with CVS. Author(s): Ryan C. Source: Nurs Times. 2000 June 29-July 5; 96(26): 10-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11962907
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Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. Author(s): Werntoft E, Dykes AK. Source: J Reprod Med. 2001 September; 46(9): 835-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11584487
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Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy. Author(s): Samad K, Afshan G, Kamal R. Source: J Pak Med Assoc. 2003 February; 53(2): 68-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12705488
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Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Author(s): Rusy LM, Hoffman GM, Weisman SJ. Source: Anesthesiology. 2002 February; 96(2): 300-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11818760
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Gastric electrical stimulation with short pulses reduces vomiting but not dysrhythmias in dogs. Author(s): Chen JD, Qian L, Ouyang H, Yin J. Source: Gastroenterology. 2003 February; 124(2): 401-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12557146
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Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Author(s): Eberhart LH, Mayer R, Betz O, Tsolakidis S, Hilpert W, Morin AM, Geldner G, Wulf H, Seeling W. Source: Anesthesia and Analgesia. 2003 April; 96(4): 995-8, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651648
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Guidelines outline strategies to reduce post-operative nausea and vomiting. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2002 April 19; 13(8): 9-10, 12. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12467270
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Hand acupressure reduces postoperative vomiting after strabismus surgery (n=50). Author(s): Cummings M. Source: Acupuncture in Medicine : Journal of the British Medical Acupuncture Society. 2001 June; 19(1): 53-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11471586
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Interventions for nausea and vomiting in early pregnancy. Author(s): Jewell D, Young G. Source: Cochrane Database Syst Rev. 2003; (4): Cd000145. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583914
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Interventions for nausea and vomiting in early pregnancy. Author(s): Jewell D, Young G. Source: Cochrane Database Syst Rev. 2002; (1): Cd000145. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869567
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Is ginger root effective for decreasing the severity of nausea and vomiting in early pregnancy? Author(s): Jackson EA. Source: The Journal of Family Practice. 2001 August; 50(8): 720. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11509171
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Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Author(s): Boehler M, Mitterschiffthaler G, Schlager A. Source: Anesthesia and Analgesia. 2002 April; 94(4): 872-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11916788
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Management of postoperative nausea and vomiting in children. Author(s): De Negri P, Ivani G.
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Source: Paediatric Drugs. 2002; 4(11): 717-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390043 •
Managing nausea and vomiting. Current strategies. Author(s): Garrett K, Tsuruta K, Walker S, Jackson S, Sweat M. Source: Critical Care Nurse. 2003 February; 23(1): 31-50; Quiz 51-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640958
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Managing nausea, vomiting, and diarrhea. Author(s): Highleyman L. Source: Beta. 2002 Spring; 15(2): 29-39. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12064304
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Medical, social, and legal implications of treating nausea and vomiting of pregnancy. Author(s): Brent R. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S262-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011898
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Nausea and vomiting in early pregnancy. Author(s): Jewell D. Source: American Family Physician. 2003 July 1; 68(1): 143-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887120
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Nausea and vomiting in early pregnancy. Author(s): Jewell D. Source: Clin Evid. 2002 June; (7): 1277-83. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230746
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Nausea and vomiting in pregnancy: safety and efficacy of self-administered complementary therapies. Author(s): Tiran D. Source: Complementary Therapies in Nursing & Midwifery. 2002 November; 8(4): 191-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463608
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Nausea and vomiting of pregnancy. Author(s): Quinla JD, Hill DA. Source: American Family Physician. 2003 July 1; 68(1): 121-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887118
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Nausea and vomiting. Author(s): Hanna L. Source: Beta. 1997 June; : 23-6, 58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11364536
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Options for the prevention and management of acute chemotherapy-induced nausea and vomiting in children. Author(s): Dupuis LL, Nathan PC. Source: Paediatric Drugs. 2003; 5(9): 597-613. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956617
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Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger. Author(s): Niebyl JR, Goodwin TM. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S253-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011896
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P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children. Author(s): Wang SM, Kain ZN. Source: Anesthesiology. 2002 August; 97(2): 359-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12151925
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P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Author(s): Alkaissi A, Evertsson K, Johnsson VA, Ofenbartl L, Kalman S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1034-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477673
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Postoperative nausea and vomiting--can it be eliminated? Author(s): Gan TJ. Source: Jama : the Journal of the American Medical Association. 2002 March 13; 287(10): 1233-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11886298
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Pregnancy outcome following women's participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy. Author(s): Smith C, Crowther C, Beilby J. Source: Complementary Therapies in Medicine. 2002 June; 10(2): 78-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12481955
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Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Author(s): Kotani N, Hashimoto H, Sato Y, Sessler DI, Yoshioka H, Kitayama M, Yasuda T, Matsuki A. Source: Anesthesiology. 2001 August; 95(2): 349-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11506105
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Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Author(s): Portnoi G, Chng LA, Karimi-Tabesh L, Koren G, Tan MP, Einarson A. Source: American Journal of Obstetrics and Gynecology. 2003 November; 189(5): 1374-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634571
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Psychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy. Author(s): Buckwalter JG, Simpson SW. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S210-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011888
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Randomized, double-blind, crossover, placebo-controlled trial of intravenous ondansetron for the prevention of intrathecal chemotherapy-induced vomiting in children. Author(s): Parker RI, Prakash D, Mahan RA, Giugliano DM, Atlas MP. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2001 December; 23(9): 578-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11902300
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Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Author(s): Kallen B, Lundberg G, Aberg A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 October; 82(10): 916-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956841
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Reporting of clinical details in randomized controlled trials of acupuncture for the treatment of migraine/headaches and nausea/vomiting. Author(s): Elorriaga Claraco A, Hanna SE, Fargas-Babjak A. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2003 February; 9(1): 151-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676043
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Taking ginger for nausea and vomiting during pregnancy. Author(s): Chandra K, Einarson A, Koren G.
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Source: Can Fam Physician. 2002 September; 48: 1441-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12371300 •
The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial. Author(s): Molassiotis A, Yung HP, Yam BM, Chan FY, Mok TS. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2002 April; 10(3): 237-46. Epub 2001 December 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11904789
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The effects of acupressure on the incidence of postoperative nausea and vomiting in postsurgical patients. Author(s): Windle PE, Borromeo A, Robles H, Ilacio-Uy V. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2001 June; 16(3): 158-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11395836
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The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Author(s): Roscoe JA, Morrow GR, Hickok JT, Bushunow P, Pierce HI, Flynn PJ, Kirshner JJ, Moore DF, Atkins JN. Source: Journal of Pain and Symptom Management. 2003 August; 26(2): 731-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12906958
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The efficacy of acupressure to prevent nausea and vomiting in post-operative patients. Author(s): Ming JL, Kuo BI, Lin JG, Lin LC. Source: Journal of Advanced Nursing. 2002 August; 39(4): 343-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12139646
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The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. Author(s): Pongrojpaw D, Chiamchanya C. Source: J Med Assoc Thai. 2003 March; 86(3): 244-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12757064
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The management of nausea and vomiting of pregnancy. Author(s): Arsenault MY, Lane CA, MacKinnon CJ, Bartellas E, Cargill YM, Klein MC, Martel MJ, Sprague AE, Wilson AK.
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Source: J Obstet Gynaecol Can. 2002 October; 24(10): 817-31; Quiz 832-3. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12405123 •
The placebo response and effect of time in a trial of acupuncture to treat nausea and vomiting in early pregnancy. Author(s): Smith C, Crowther C. Source: Complementary Therapies in Medicine. 2002 December; 10(4): 210-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12594971
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The use of CAM by women suffering from nausea and vomiting during pregnancy. Author(s): Hollyer T, Boon H, Georgousis A, Smith M, Einarson A. Source: Bmc Complementary and Alternative Medicine [electronic Resource]. 2002 May 17; 2(1): 5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12033990
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Transcutaneous acupoint electrical stimulation in preventing and treating nausea and vomiting in patients receiving electroconvulsive therapy. Author(s): Kramer BA, Kadar AG, Clark K. Source: The Journal of Ect.
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/
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The following is a specific Web list relating to vomiting; 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 Abdominal Wall Inflammation Source: Integrative Medicine Communications; www.drkoop.com Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Allergies and Sensitivities Source: Healthnotes, Inc.; www.healthnotes.com Alzheimer's Disease Source: Integrative Medicine Communications; www.drkoop.com Anaphylaxis Source: Integrative Medicine Communications; www.drkoop.com Angioedema Source: Integrative Medicine Communications; www.drkoop.com Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Appendicitis Source: Integrative Medicine Communications; www.drkoop.com Ascariasis Source: Integrative Medicine Communications; www.drkoop.com Asthma Source: Prima Communications, Inc.www.personalhealthzone.com Bladder Infection Alternative names: Urinary Tract Infection [UTI] Source: Prima Communications, Inc.www.personalhealthzone.com Brain Cancer Source: Integrative Medicine Communications; www.drkoop.com Breast Cancer Source: Integrative Medicine Communications; www.drkoop.com Bronchitis Source: Healthnotes, Inc.; www.healthnotes.com Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com
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Bursitis Source: Integrative Medicine Communications; www.drkoop.com Cancer Prevention (Reducing the Risk) Source: Prima Communications, Inc.www.personalhealthzone.com Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.drkoop.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Cough Source: Integrative Medicine Communications; www.drkoop.com Cystic Fibrosis Source: Healthnotes, Inc.; www.healthnotes.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Diarrhea Source: Healthnotes, Inc.; www.healthnotes.com Diarrhea Source: Integrative Medicine Communications; www.drkoop.com Diverticular Disease Source: Healthnotes, Inc.; www.healthnotes.com Diverticular Disease Source: Integrative Medicine Communications; www.drkoop.com Dysmenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Dysmenorrhea Source: Integrative Medicine Communications; www.drkoop.com Ear Infection Source: Integrative Medicine Communications; www.drkoop.com Eating Disorders Source: Healthnotes, Inc.; www.healthnotes.com Epstein-Barr Virus Source: Integrative Medicine Communications; www.drkoop.com
Alternative Medicine 97
Fainting Source: Integrative Medicine Communications; www.drkoop.com Flu Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Gallbladder Disease Source: Integrative Medicine Communications; www.drkoop.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Gastritis Source: Integrative Medicine Communications; www.drkoop.com Guinea Worm Disease Source: Integrative Medicine Communications; www.drkoop.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Integrative Medicine Communications; www.drkoop.com Heat Exhaustion Source: Integrative Medicine Communications; www.drkoop.com Hemorrhoids Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com High Cholesterol Source: Prima Communications, Inc.www.personalhealthzone.com Hookworm Source: Integrative Medicine Communications; www.drkoop.com Hyperparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypoparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Infection Source: Healthnotes, Inc.; www.healthnotes.com
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Influenza Source: Healthnotes, Inc.; www.healthnotes.com Influenza Source: Integrative Medicine Communications; www.drkoop.com Intestinal Parasites Source: Integrative Medicine Communications; www.drkoop.com Iron-Deficiency Anemia Source: Healthnotes, Inc.; www.healthnotes.com Kidney Stones Source: Integrative Medicine Communications; www.drkoop.com Loiasis Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com Lymphatic Filariasis Source: Integrative Medicine Communications; www.drkoop.com Ménière's Disease Source: Healthnotes, Inc.; www.healthnotes.com Measles Source: Integrative Medicine Communications; www.drkoop.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com Menstrual Pain Source: Integrative Medicine Communications; www.drkoop.com Migraine Headache Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Migraine Headaches Source: Prima Communications, Inc.www.personalhealthzone.com Mononucleosis Source: Integrative Medicine Communications; www.drkoop.com Morning Sickness Source: Healthnotes, Inc.; www.healthnotes.com
Alternative Medicine 99
Motion Sickness Source: Healthnotes, Inc.; www.healthnotes.com Motion Sickness Source: Integrative Medicine Communications; www.drkoop.com MSG Sensitivity Source: Healthnotes, Inc.; www.healthnotes.com Mumps Source: Integrative Medicine Communications; www.drkoop.com Myocardial Infarction Source: Integrative Medicine Communications; www.drkoop.com Nausea Source: Prima Communications, Inc.www.personalhealthzone.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Otitis Media Source: Integrative Medicine Communications; www.drkoop.com Pancreatitis Source: Integrative Medicine Communications; www.drkoop.com Parasites Source: Healthnotes, Inc.; www.healthnotes.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com Peritonitis Source: Integrative Medicine Communications; www.drkoop.com Pertussis Source: Integrative Medicine Communications; www.drkoop.com Pinworm Source: Integrative Medicine Communications; www.drkoop.com Pregnancy and Postpartum Support Source: Healthnotes, Inc.; www.healthnotes.com Pyloric Stenosis Source: Integrative Medicine Communications; www.drkoop.com
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Radiation Damage Source: Integrative Medicine Communications; www.drkoop.com River Blindness Source: Integrative Medicine Communications; www.drkoop.com Roundworms Source: Integrative Medicine Communications; www.drkoop.com Rubella Source: Integrative Medicine Communications; www.drkoop.com Shock Source: Integrative Medicine Communications; www.drkoop.com Stomach Inflammation Source: Integrative Medicine Communications; www.drkoop.com Stroke Source: Healthnotes, Inc.; www.healthnotes.com Syncope Source: Integrative Medicine Communications; www.drkoop.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Threadworm Source: Integrative Medicine Communications; www.drkoop.com Trichinosis Source: Integrative Medicine Communications; www.drkoop.com Urinary Tract Infection Source: Healthnotes, Inc.; www.healthnotes.com Varicose Veins Source: Prima Communications, Inc.www.personalhealthzone.com Vertigo Source: Healthnotes, Inc.; www.healthnotes.com Visceral Larva Migrans Source: Integrative Medicine Communications; www.drkoop.com Whipworm Source: Integrative Medicine Communications; www.drkoop.com Whooping Cough Source: Integrative Medicine Communications; www.drkoop.com
Alternative Medicine 101
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Alternative Therapy Acupuncture Source: Integrative Medicine Communications; www.drkoop.com Aromatherapy Source: Integrative Medicine Communications; www.drkoop.com Ayurveda Source: Integrative Medicine Communications; www.drkoop.com Guided Imagery Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,699,00.html Panchakarma Alternative names: Pancha Karma therapy rejuvenation therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html
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Chinese Medicine Baibiandou Alternative names: White Hyacinth Bean; Semen Lablab Album Source: Chinese Materia Medica Baiiaohuixiang Alternative names: Chinese Star Anise; Fructus Anisi Stellati Source: Chinese Materia Medica Banxia Alternative names: Pinellia Tuber; Rhizoma Pinelliae Source: Chinese Materia Medica Baolong Wan Alternative names: Baolong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Bibo Alternative names: Long Pepper; Fructus Piperis Longi Source: Chinese Materia Medica Bichengqie Alternative names: Mountain Spicy Fruit; Fructus Litseae Source: Chinese Materia Medica
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Biwen San Alternative names: Biwen Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Caodoukou Alternative names: Katsumada Galangal Seed; Semen Alpiniae Katsumadai Source: Chinese Materia Medica Caoguo Alternative names: Fructus Tsaoko Source: Chinese Materia Medica Chansu Alternative names: Toad Venom; Venenum Bufonis Source: Chinese Materia Medica Chenpi Alternative names: Dried Tangerine Peel; Pericarpium Citri Reticulatae Source: Chinese Materia Medica Chenxiang Alternative names: Chinese Eaglewood Wood; Lignum Aquilariae Resinatum Source: Chinese Materia Medica Dangshen Alternative names: Medicinal Changium Root; Mingdangshen; Radix Changii Source: Chinese Materia Medica Daodou Alternative names: Jack Bean; Semen Canavaliae Source: Chinese Materia Medica Dingxiang Alternative names: Clove; Flos Caryophylli Source: Chinese Materia Medica Doukou Alternative names: Round Cardamon Fruit; Fructus Amomi Rotundus Source: Chinese Materia Medica Erchen Wan Alternative names: rchen; Erchen Wan (Er Chen Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Foshou Alternative names: Finger Citron; Fructus Citri Sarcodactylis Source: Chinese Materia Medica
Alternative Medicine 103
Fuzi Alternative names: Beivedere Fruit; Difuzi; Fructus Kochiae Source: Chinese Materia Medica Fuzi Lizhong Wan Alternative names: Fuzi Lizhong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Ganjiang Alternative names: ingiber (Dried Ginger); Rhizoma Zingiberi Source: Chinese Materia Medica Gansong Alternative names: Nardostachys Root; Radix seu Rhizoma Nardostachyos Source: Chinese Materia Medica Gaoliangjiang Alternative names: Lesser Galangal Rhizome; Rhizoma Alpiniae Officinarum Source: Chinese Materia Medica Guanghuoxiang Alternative names: Cablin Patchouli Herb; Herba Pogostemonis Source: Chinese Materia Medica Guifu Lizhong Wan Alternative names: Guifu Lizhong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Heshi Alternative names: Wild Carrot Fruit; Nanheshi; Fructus Carotae Source: Chinese Materia Medica Hongdoukou Alternative names: Galanga Galangal Fruit; Fructus Galangae Source: Chinese Materia Medica Hongling San Alternative names: Hongling Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Houpo Alternative names: Officinal Magnolia Bark; Cortex Magnoliae Officinalis Source: Chinese Materia Medica Huaijiao Alternative names: Pricklyash Peel; Huajiao; Pericarpium Zanthoxyli Source: Chinese Materia Medica
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Huajiao Alternative names: Pricklyash Peel; Pericarpium Zanthoxyli Source: Chinese Materia Medica Huajuhong Alternative names: Pummelo Peel; Exocarpium Citri Grandis Source: Chinese Materia Medica Huanglian Alternative names: Golden Thread; Rhizoma Coptidis Source: Chinese Materia Medica Huangqi Alternative names: Milkvetch; Radix Astragali Source: Chinese Materia Medica Huangqin Alternative names: Baical Skullcap Root; Radix Scutellariae Source: Chinese Materia Medica Hujiao Alternative names: Pepper Fruit; Fructus Piperis Source: Chinese Materia Medica Huoxiang Zhengqi Shui Alternative names: Huoxiang Zhengqi Solution Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Jianpi Wan Alternative names: Jianpi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Jiebai Wan Alternative names: Jiebai Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Jineijin Alternative names: Chicken's Gizzard-skin; Endothelium Corneum Gigeriae Galli Source: Chinese Materia Medica Juhong Alternative names: Pummelo Peel; Huajuhong; Exocarpium Citri Grandis Source: Chinese Materia Medica Liuhe Dingzhong Wan Alternative names: Liuhe Dingzhong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China
Alternative Medicine 105
Lugen Alternative names: Reed Rhizome; Rhizoma Phragmitis Source: Chinese Materia Medica Lujiaoshuang Alternative names: Degelatined Deer-horn; Cornu Cervi Degelatinatum Source: Chinese Materia Medica Meiguihua Alternative names: Rose Flower; Flos Rosae Rugosae Source: Chinese Materia Medica Mingdangshen Alternative names: Medicinal Changium Root; Radix Changii Source: Chinese Materia Medica Mugua Alternative names: Common Floweringquince Fruit; Fructus Chaenomelis Source: Chinese Materia Medica Muxiang Alternative names: Slender Dutchmanspipe Root; Qingmuxiang; Radix Aristolochiae Source: Chinese Materia Medica Muxiang Fenqi Wan Alternative names: Muxiang Fenqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Pipaye Alternative names: Loquat Leaf; Folium Eriobotryae Source: Chinese Materia Medica Qiwei Ketengzi Wan Alternative names: Qiwei Ketengzi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Renshen Jianpi Wan Alternative names: enshen Jianpi Pills; Renshen Jianpi Wan(Ren Shen Jian Pi Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Roudoukou Alternative names: Nutmeg; Semen Myristicae Source: Chinese Materia Medica Rougui Alternative names: Cassia Bark; Cortex Cinnamomi Source: Chinese Materia Medica
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Sharen Alternative names: Villous Amomum Fruit; Fructus Amomi Source: Chinese Materia Medica Shayao Alternative names: hayao Pills; Shayao (Sha Yao Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shedan Chenpi San Alternative names: hedan Chenpi Powder; Shedan Chenpi San (She Dan Chen Pi San Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shengjiang Alternative names: Fresh Ginger; Rhizoma Zingiberis Recens Source: Chinese Materia Medica Shensu Wan Alternative names: hensu Pills; Shensu Wan (Shen Su Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shugan Hewei Wan Alternative names: hugan Hewei Pills; Shugan Hewei Wan (Shu Gan He Wei Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Sizheng Wan Alternative names: izheng Pills; Sizheng Wan (Si Zheng Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Tumuxiang Alternative names: Inula Root; Radix Inulae Source: Chinese Materia Medica Wumei Alternative names: Smoked Plum; Fructus Mume Source: Chinese Materia Medica Wuzhuyu Alternative names: Medicinal Evodia Fruit; Fructus Evodiae Source: Chinese Materia Medica Xiangru Alternative names: Haichow Elsholtzia Herb; Herba Mosiae Source: Chinese Materia Medica
Alternative Medicine 107
Xiangyuan Alternative names: Citron Fruit; Fructus Citri Source: Chinese Materia Medica Xiaohuixiang Alternative names: Fennel; Fructus Foeniculi Source: Chinese Materia Medica Xuanfuhua Alternative names: Inula Flower; Flos Inulae Source: Chinese Materia Medica Zhuru Alternative names: Bamboo Shavings; Caulis Bambusae in Taeniam Source: Chinese Materia Medica Zisugeng Alternative names: Perilla Stem; Caulis Perillae Source: Chinese Materia Medica Zisuye Alternative names: Perilla Leaf; Folium Perillae Source: Chinese Materia Medica •
Herbs and Supplements Activated Charcoal Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,832,00.html Adrenal Extract Source: Healthnotes, Inc.; www.healthnotes.com Amino Acids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10003,00.html Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com Ananas Comosus Source: Integrative Medicine Communications; www.drkoop.com Arctostaphylos Alternative names: Bearberry; Arctostaphylos uva-ursi (L.) Spreng. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Aristolochia Alternative names: Snakeroot, Guaco; Aristolochia sp Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
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Arnica Alternative names: Arnica montana Source: Integrative Medicine Communications; www.drkoop.com Arnica Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,753,00.html Arnica Montana Source: Integrative Medicine Communications; www.drkoop.com Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Black Cohosh Alternative names: Cimicifuga racemosa (actea), Black Snakeroot Source: Integrative Medicine Communications; www.drkoop.com Black Cohosh Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10009,00.html Black Snakeroot Source: Integrative Medicine Communications; www.drkoop.com Blackberry Alternative names: Rubus fructicosus Source: Healthnotes, Inc.; www.healthnotes.com Bloodroot Alternative names: Sanguinaria canadensis Source: Healthnotes, Inc.; www.healthnotes.com Bloodroot Source: Prima Communications, Inc.www.personalhealthzone.com Blue Flag Alternative names: Iris versicolor Source: Healthnotes, Inc.; www.healthnotes.com Boneset Alternative names: Eupatorium perfoliatum Source: Healthnotes, Inc.; www.healthnotes.com Borago Alternative names: Borage; Borago officinalis Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Boric Acid Source: Healthnotes, Inc.; www.healthnotes.com
Alternative Medicine 109
Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Bromelain Alternative names: Ananas comosus, Bromelainum Source: Integrative Medicine Communications; www.drkoop.com Bromelain Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,760,00.html Bromelainum Source: Integrative Medicine Communications; www.drkoop.com Calciferol Source: Integrative Medicine Communications; www.drkoop.com Calcitrol Source: Integrative Medicine Communications; www.drkoop.com Camellia Sinensis Source: Integrative Medicine Communications; www.drkoop.com Cascara Sagrada Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10013,00.html Chamaemelum Nobile Source: Integrative Medicine Communications; www.drkoop.com Chemotherapy Source: Healthnotes, Inc.; www.healthnotes.com Cholecalciferol Source: Integrative Medicine Communications; www.drkoop.com Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com Cimicifuga racemosa (Actea) Source: Integrative Medicine Communications; www.drkoop.com Cyclophosphamide Source: Healthnotes, Inc.; www.healthnotes.com Cysteine Source: Integrative Medicine Communications; www.drkoop.com
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Dimenhydrinate Source: Healthnotes, Inc.; www.healthnotes.com Docetaxel Source: Healthnotes, Inc.; www.healthnotes.com Elderberry Alternative names: Sambucus nigra Source: Healthnotes, Inc.; www.healthnotes.com Elderberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10024,00.html Elecampane Alternative names: Inula helenium Source: Healthnotes, Inc.; www.healthnotes.com Ephedra Alternative names: Ephedra sinica, Ephedra intermedia, Ephedra equisetina Source: Healthnotes, Inc.; www.healthnotes.com Ephedra (Ma huang) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,777,00.html Erocalciferol Source: Integrative Medicine Communications; www.drkoop.com Eucalyptus Alternative names: Eucalyptus globulus Source: Healthnotes, Inc.; www.healthnotes.com Eucalyptus Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,778,00.html False Unicorn Alternative names: Chamaelirium luteum Source: Healthnotes, Inc.; www.healthnotes.com False Unicorn Root Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10075,00.html Feverfew Alternative names: Tanacetum parthenium, Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com
Alternative Medicine 111
Feverfew Source: Prima Communications, Inc.www.personalhealthzone.com Feverfew Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,780,00.html Fluorouracil Source: Healthnotes, Inc.; www.healthnotes.com Gamma-oryzanol Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10028,00.html General Anesthetics Source: Healthnotes, Inc.; www.healthnotes.com German Chamomile Alternative names: Matricaria recutita Source: Integrative Medicine Communications; www.drkoop.com Ginger Alternative names: Zingiber officinale Source: Healthnotes, Inc.; www.healthnotes.com Ginger Alternative names: Zingiber officinale Source: Integrative Medicine Communications; www.drkoop.com Ginger Source: Prima Communications, Inc.www.personalhealthzone.com Ginger Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,787,00.html Ginkgo Biloba Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,788,00.html Goldenseal Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,791,00.html Green Tea Alternative names: Camellia sinensis Source: Integrative Medicine Communications; www.drkoop.com
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Vomiting
Green Tea Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10032,00.html Horse Chestnut Source: Prima Communications, Inc.www.personalhealthzone.com Horseradish Alternative names: Cochlearia armoracia Source: Healthnotes, Inc.; www.healthnotes.com Humulus Alternative names: Hops; Humulus lupulus L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Huperzia Source: Healthnotes, Inc.; www.healthnotes.com Huperzine A Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10038,00.html Hypericum Perforatum Source: Integrative Medicine Communications; www.drkoop.com Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Ipecac Alternative names: Cephaelis ipecacuanha Source: Healthnotes, Inc.; www.healthnotes.com Ivy Leaf Alternative names: Hedera helix Source: Healthnotes, Inc.; www.healthnotes.com Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Lobelia Alternative names: Lobelia inflata L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Lobelia Alternative names: Lobelia inflata Source: Healthnotes, Inc.; www.healthnotes.com Lobelia Alternative names: Lobelia inflata, Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com
Alternative Medicine 113
Lobelia Inflata Source: Integrative Medicine Communications; www.drkoop.com Matricaria Recutita Source: Integrative Medicine Communications; www.drkoop.com Meclizine Source: Healthnotes, Inc.; www.healthnotes.com Mentha X Piperita Source: Integrative Medicine Communications; www.drkoop.com Methotrexate Source: Healthnotes, Inc.; www.healthnotes.com Metoclopramide Source: Healthnotes, Inc.; www.healthnotes.com Milk Thistle Alternative names: Silybum marianum, Carduus marianus Source: Healthnotes, Inc.; www.healthnotes.com Mistletoe Alternative names: Viscum album Source: Healthnotes, Inc.; www.healthnotes.com Mistletoe Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10109,00.html NAC (N-Acetyl Cysteine) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,809,00.html N-Acetyl Cysteine Source: Healthnotes, Inc.; www.healthnotes.com N-Acetyl Cysteine (NAC) Source: Prima Communications, Inc.www.personalhealthzone.com Nitrous Oxide Source: Healthnotes, Inc.; www.healthnotes.com Organ Mountain Crape Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca PABA Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10049,00.html Paclitaxel Source: Healthnotes, Inc.; www.healthnotes.com Passion Flower Alternative names: Passiflora incarnata Source: Healthnotes, Inc.; www.healthnotes.com Pau D’arco Alternative names: Tabebuia avellanedae, Tabebuia impestiginosa Source: Healthnotes, Inc.; www.healthnotes.com Pau D'arco Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,811,00.html Pennyroyal Alternative names: Hedeoma pulegoides, Mentha pulegium Source: Healthnotes, Inc.; www.healthnotes.com Peppermint Alternative names: Mentha x piperita Source: Integrative Medicine Communications; www.drkoop.com Peppermint Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,812,00.html Perphenazine Source: Healthnotes, Inc.; www.healthnotes.com Phytolacca Alternative names: Poke root, Endod; Phytolacca dodecandra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Prochlorperazine Source: Healthnotes, Inc.; www.healthnotes.com Promethazine Source: Healthnotes, Inc.; www.healthnotes.com Quinidine Source: Healthnotes, Inc.; www.healthnotes.com Roman Chamomile Alternative names: Chamaemelum nobile Source: Integrative Medicine Communications; www.drkoop.com
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Rosemary Alternative names: Rosmarinus officinalis Source: Integrative Medicine Communications; www.drkoop.com Rosmarinus Officinalis Source: Integrative Medicine Communications; www.drkoop.com Sanguinaria Alternative names: Bloodroot; Sanguinaria canadensis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Sertraline Source: Healthnotes, Inc.; www.healthnotes.com Sotalol Source: Healthnotes, Inc.; www.healthnotes.com St. John's Wort Alternative names: Hypericum perforatum, Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Tanacetum Parthenium Source: Integrative Medicine Communications; www.drkoop.com Thiazide Diuretics Source: Integrative Medicine Communications; www.drkoop.com Thyme Alternative names: Thymus vulgaris Source: Healthnotes, Inc.; www.healthnotes.com Trace Minerals Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10061,00.html Tylophora Alternative names: Tylophora indica, Tylophora asthmatica Source: Healthnotes, Inc.; www.healthnotes.com Tyrosine Source: Prima Communications, Inc.www.personalhealthzone.com Uricosuric Agents Source: Integrative Medicine Communications; www.drkoop.com Uva Ursi Alternative names: Arctostaphylos uva-ursi Source: Healthnotes, Inc.; www.healthnotes.com Uva Ursi Source: Prima Communications, Inc.www.personalhealthzone.com
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Uva Ursi Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10063,00.html White Willow Source: Prima Communications, Inc.www.personalhealthzone.com Wild Indigo Alternative names: Baptisia tinctoria Source: Healthnotes, Inc.; www.healthnotes.com Wild Yam Alternative names: Dioscorea villosa Source: Healthnotes, Inc.; www.healthnotes.com Willow Bark Alternative names: There are several species of willow includingSalix alba, Salix nigra, Salix fragilis, Salix purpurea, Salix babylonica, White Willow, European Willow, Black Willow, Pussy Willow, Crack Willow, Purple Willow, Weeping Willow, Liu-zhi Source: Integrative Medicine Communications; www.drkoop.com Wormwood Alternative names: Artemisia absinthium Source: Healthnotes, Inc.; www.healthnotes.com Yohimbe Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,830,00.html Zanthoxylum Alternative names: Prickly Ash; Zanthoxylum sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Zingiber Alternative names: Ginger; Zingiber officinale Roscoe Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Zingiber Officinale Source: Integrative Medicine Communications; www.drkoop.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 VOMITING Overview In this chapter, we will give you a bibliography on recent dissertations relating to vomiting. 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 “vomiting” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on vomiting, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Vomiting 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 vomiting. 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: •
AN INVESTIGATION OF RELAPSE AMONG CLIENTS WHO BINGE EAT AND PURGE (BULIMIA, SELF-INDUCED VOMITING) by WINSTEAD, MADELYNN LEWIS, PHD from University of Denver, 1986, 226 pages http://wwwlib.umi.com/dissertations/fullcit/8626362
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EARLY PREGNANCY ASSOCIATED NAUSEA AND VOMITING: MATERNAL RISK FACTORS, FETAL OUTCOME, AND REPRODUCTIVE SUCCESS (MORNING SICKNESS, BIOLOGICAL FITNESS, ESTROGEN SENSITIVITY, EMETIC CENTER, MULTIPLE REGRESSION) by WEIGEL, MARY-MARGARET, PHD from University of California, Los Angeles, 1985, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8603999
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The assessment and treatment of nausea and vomiting associated with cancer chemotherapy by Rosberger, Zeev; PhD from Concordia University (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL44883
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THE EFFECTS OF A BEHAVIORAL ANALYSIS PROCEDURE ON BULIMIC BEHAVIORS OF BINGING AND VOMITING (DEPRESSION, STRESS, ANXIETY) by LAURENZA, SHARON ALYS, EDD from University of San Francisco, 1985, 149 pages http://wwwlib.umi.com/dissertations/fullcit/8628338
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. PATENTS ON VOMITING Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “vomiting” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on vomiting, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Vomiting By performing a patent search focusing on vomiting, 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
8Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on vomiting: •
.DELTA.9 Tetrahydrocannabinol (.DELTA.9 THC) solution metered dose inhaler Inventor(s): Byron; Peter R. (Richmond, VA), Lichtman; Aron H. (Richmond, VA), Martin; Billy R. (Richmond, VA), Peart; Joanne (Richmond, VA) Assignee(s): Virginia Commonwealth University (richmond, Va) Patent Number: 6,509,005 Date filed: March 22, 1999 Abstract: The present invention provides therapeutic formulations for solutions of.DELTA.sup.9 -tetrahydrocannabinol (.DELTA.sup.9 THC) to be delivered by metered dose inhalers. The formulations, which utilize non-CFC propellants, provide a stable aerosol-deliverable source of.DELTA.sup.9 THC for the treatment of various medical conditions, such as: nausea and vomiting associated with chemotherapy; muscle spasticity; pain; anorexia associated with AIDS wasting syndrome; epilepsy; glaucoma; bronchial asthma; and mood disorders. Excerpt(s): The invention is generally related to the therapeutic use of.DELTA.sup.9 Tetrahydrocannabinol (.DELTA.sup.9 THC). In particular, the invention provides a metered dose inhaler (MDI) for the aerosol administration of.DELTA.sup.9 THC to patients suffering from nausea and vomiting associated with cancer chemotherapy, muscle spasticity, pain, anorexia associated with AIDS wasting syndrome, epilepsy, glaucoma, bronchial asthma, mood disorders, and the like. When marijuana is used illegally as a recreational psychoactive drug, the active ingredient.DELTA.sup.9 THC is usually delivered to the lungs as an impure non-pharmaceutical aerosol in the form of marijuana smoke. Aerosolized.DELTA.sup.9 THC in the inhaled smoke is absorbed within seconds and delivered to the brain efficiently. Table 2 and references 19-20 describe the pharmacokinetics of the administration of.DELTA.sup.9 THC. As can be seen, inhalation is the preferred route of delivery for.DELTA.sup.9 THC. When compared to oral delivery, inhalation provides a more rapid onset of pharmacological action and peak plasma levels. The effects achieved via inhalation are comparable to those achieved when the drug is administered intravenously, but inhalation is a much less invasive technique. Currently, the sources of.DELTA.sup.9 THC for patients who could benefit from the drug are very limited. An oral form of.DELTA.sup.9 THC (MARINOL) is marketed as a treatment for nausea and vomiting related to cancer chemotherapy, and as an appetite stimulant in patients suffering from AIDS wasting syndrome. In MARINOL, pharmaceutical grade.DELTA.sup.9 THC is dissolved in sesame oil, encapsulated in gelatin capsules and delivered orally. However, when the drug is taken orally, the absorption is slower and more variable than when inhaled, with an onset of action between 30 minutes and 2 hours (Table 2). Alternatively, some cancer patients do manage to obtain and smoke marijuana in order to alleviate such conditions as nausea and vomiting due to chemotherapy. This is, however, technically illegal and is thus obviously a less than ideal treatment protocol. There is no currently available pharmaceutically acceptable aerosol form of.DELTA.sup.9 THC. Web site: http://www.delphion.com/details?pn=US06509005__
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Amelioration of apomorphine adverse effects Inventor(s): El-Rashidy; Ragab (Deerfield, IL), Ronsen; Bruce (River Forest, IL) Assignee(s): Pentech Pharmaceuticals, Inc. (buffalo Grove, Il) Patent Number: 5,994,363 Date filed: August 24, 1998 Abstract: Symptoms of Parkinson's disease and psychogenic male erectile dysfunction (MED) can be ameliorated through the use of apomorphine. The adverse side effects of apomorphine administration, such as nausea, vomiting, yawning, and cardiovascular effects, can be significantly reduced by a dose escalating method of acclimatization. An initial dose of apomorphine is administered to the patient, and subsequently increased over a period of time until a final apomorphine dose in excess of a desired therapeutic dose has been received by the patient. Thereafter a therapeutic dose of apomorphine, less than the final apomorphine dose, is administered to the patient with attendant reduced side effects. Excerpt(s): This invention relates to amelioration of the adverse effects, such as nausea, yawning, vomiting, and cardiovascular effects, caused to human patients when taking apomorphine for Parkinson's disease, psychogenic male erectile dysfunction (MED), and female sexual dysfunction, or the like afflictions. Apomorphine has been used to treat Parkinsonian patients. See, for example, Deffond et al., J. Neurology, Neurosurgery, and Psychiatry 56:101-103 (1993) and Durif et al., Clinical Neuropharmacology 16(2):157-166 (1993). Additionally, apomorphine has been considered for the treatment of alcoholism, schizophrenia, dystonia musculorum deformans, hallucinations, migraine headaches, hiccups, Huntington's chorea, tardative dyskinesia, and more recently male erectile dysfunction. Administration of large doses of apomorphine to mammals such as humans, dogs and the like usually results in nausea and vomiting, and is believed to be due to the action of apomorphine on the chemoreceptor trigger zone (CTZ) of the medulla oblongata, a structure of the mammalian central nervous system. It is also believed that additional chemoreceptors triggering emesis are present in the gastrointestinal tract as well. Web site: http://www.delphion.com/details?pn=US05994363__
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Anti-emetic composition Inventor(s): Naeger; David M. (8 Gladiola Center, Newtown, PA 18940-4224) Assignee(s): None Reported Patent Number: 5,661,142 Date filed: April 17, 1996 Abstract: The invention relates to an anti-emetic composition that comprises dexamethasone (DEX), metoclopramide (MTC) and an antihistamine or an anticholinergic agent. In a particular embodiment, a composition containing DEX:MTC:diphenhydramine in a relative weight ratio of about 1:1:2.5, respectively, is found to be effective in providing relief from the discomfort caused by symptoms of both vomiting and nausea in all patients receiving the composition. Alternatively, an effective composition may contain DEX:MTC:scopolamine in a relative weight ratio of about 1:1:0.025, respectively. Other effective compositions and methods of their use are also disclosed.
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Excerpt(s): The present invention relates to both a therapeutic composition comprising a combination of antiemetic drugs and to a method for treating emesis, including nausea. Nausea and vomiting can follow the administration of many drugs, particularly anticancer or chemotherapeutic agents. The symptoms also often accompany infectious and non-infectious gastrointestinal disorders. The initial manifestations of the vomiting response often involves nausea, in which gastric tone is reduced, gastric peristalsis is reduced or absent and the tone of the duodenum and upper jejunum is increased, such that their contents reflux. Ultimately, the upper portion of the stomach relaxes while the pylorus constricts, and the coordinated contraction of the diaphragm and abdominal muscles leads to expulsion of gastric contents. Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th Edition, Pergamon Press, New York, pp. 925928 (1990). Web site: http://www.delphion.com/details?pn=US05661142__ •
Anti-nausea compositions and methods Inventor(s): Hermelin; Marc S. (Glendale, MO), Kirschner; Mitchell I. (St. Louis, MO), Levinson; R. Saul (Chesterfield, MO) Assignee(s): Drugtech Corporation (wilmington, De) Patent Number: 6,197,329 Date filed: May 3, 1999 Abstract: The present disclosure is directed to novel nutritional anti-nausea compositions, anti-emetic compositions, and methods of using same. The compositions provide improved relief from nausea and/or vomiting. The compositions are particularly useful for pregnant women. Excerpt(s): The present invention is directed to novel nutritional anti-nausea compositions, anti-emetic compositions and methods of using the same to provide relief from nausea and/or vomiting. The present compositions are also nonteratogenic and are therefore highly useful to pregnant women. Nausea and vomiting are two of the most common symptoms of illness and are also commonly experienced as side effects of numerous medical treatments. Both nausea and vomiting are also commonly experienced as a result of various external factors (e.g., travel) and during various conditions (e.g., pregnancy). Nausea and vomiting can occur individually or in conjunction with one another. A common cause of nausea and vomiting is motion sickness. Motion sickness typically occurs when humans are subjected to long-lasting external movement or transportation accompanied by unusual movements such as shaking, waving, atmospheric changes (e.g., flying in an airplane), great acceleration, and uneven road conditions, etc. Motion sickness is not viewed as a disease but as a physiological symptom complex wherein the symptoms experienced, of which nausea and vomiting are common, depend on the individual in question. When the individual experiences motion sickness in a work environment, i.e., truck drivers, air pilots, air craft staff members and the like, the potential for a disadvantageous and dangerous condition result. Such individuals are often required to exhibit high level concentration and intellect, and the presence of motion sickness symptoms can severely detract from their ability to do so. Web site: http://www.delphion.com/details?pn=US06197329__
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Arginine/ascorbic acid mixed powder as an oral supplement Inventor(s): Kimoto; Eiji (Jonan-ku, JP), Morishige; Fukumi (2-10-13, Miyakono, Oamishirasato-machi, Sanbu-gun, Chiba-ken, JP) Assignee(s): Kimoto; Sachiko (jonan-ku, Jp), Morishige; Fukumi (sanbu-gun, Jp) Patent Number: 6,552,074 Date filed: November 13, 2001 Abstract: A mixture obtained by mixing ascorbic acid powder with arginine powder in a weight ratio (ascorbic acid/arginine) of 1/5 to 20, especially 1/5 to 1/4; and a supplement such as a nutrient preparation and a health-care food containing the mixture. Mixing of arginine powder and ascorbic acid powder in the weight ratios eliminates stringent taste specific to arginine and alleviates stringent feeling in the stomach (heartburn, nausea or vomiting) after oral intake thereof. The mixture prevents also peroxidative injuries of cells caused by an administration of a great amount of arginine alone. Further, mixing of arginine powder with ascorbic acid powder prevents browning of the mixture after long-term storage. Excerpt(s): The present invention relates to a method for eliminating the stringent taste and alleviating stringent feeling in the stomach of L-arginine (hereinafter referred to as arginine) by mixing L-ascorbic acid (hereinafter referred to as ascorbic acid) and for alleviating the toxicity of arginine-derived NO radical by arginine-ascorbic acidcombined treatment. From late 1970's to 1980's, a research group of Illinois University reevaluated that dietary arginine is indispensable for optimal health of adult and especially aged humans. (see E. Kimoto, "Nutritional Chemistry of L-Arginine", Kaisei Publishing Co. Ltd., Tokyo, 1999 (Literature 2), page 93). In 1987, it was reported that NO radical participating in a wide variety of physiological functions such as blood pressure control and prevention of infections is derived from arginine as a source. This led to increased attention paid to arginine in the field of amino acid nutrition science (see Literature 2, page 57). Web site: http://www.delphion.com/details?pn=US06552074__
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Autogenic-feedback training exercise (AFTE) method and system Inventor(s): Cowings; Patricia S. (Saratoga, CA) Assignee(s): The United States of America AS Represented by the Administrator of the (washington, Dc) Patent Number: 5,694,939 Date filed: October 3, 1995 Abstract: The autogenic-feedback training exercise (AFTE) method of the present invention is a combined application of physiologic and perceptual training techniques, such as autogenic therapy and biofeedback. This combined therapy approach produces a methodology that is appreciably more effective than either of the individual techniques used separately. The AFTE method enables sufficient magnitude of control necessary to significantly reduce the behavioral and physiologic reactions to severe environmental stressors. It produces learned effects that are persistent over time and are resistant to extinction and it can be administered in a short period of time. The AFTE method may be used efficiently in several applications, among which are the following: to improve pilot and crew performance during emergency flying conditions; to train
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people to prevent the occurrence of nausea and vomiting associated with motion and sea sickness, or morning sickness in early pregnancy; as a training method for preventing or counteracting air-sickness symptoms in high-performance military aircraft; for use as a method for cardiovascular training, as well as for multiple other autonomic responses, which may contribute to the alleviaton of space motion sickness (SMS) in astronauts and cosmonauts; training people suffering from migraine or tension headaches to control peripheral blood flow and reduce forehead and/or trapezius muscle tension; training elderly people suffering from fecal incontinence to control their sphincter muscles; training cancer patients to reduce the nauseagenic effects of chemotherapy; and training patients with chronic intestinal pseudo-obstruction (CIP). Excerpt(s): The present invention generally relates to a multi-parameter physiological conditioning method and apparatus, and particularly to an autogenic-feedback training exercise method for training people to gain better control of specific physiological responses. More particularly, the present invention combines two self-regulatory techniques, biofeedback and autogenic exercises, and permits subjects to voluntarily control several of their own autonomic responses simultaneously. Space motion sickness, also referred to as Space Adaptation Syndrome (SAS), is a disorder which produces symptoms similar to those of motion sickness on Earth. This syndrome has affected a significant number of astronauts and cosmonauts exposed to microgravity in space, but it differs from what is commonly known as motion sickness in a number of critical ways. There is currently no ground-based method for predicting susceptibility to motion sickness in space. Biomedical data from past space missions indicate that some individuals who have had wide exposure to motion devices and acceleratory forces on Earth or in an aircraft, and who have never previously shown any tendency to develop motion sickness symptoms, were severely debilitated in the microgravity environment. Conversely, some individuals who had a history of susceptibility to motion sickness were unaffected by symptoms in space. Symptom episodes vary from mild discomfort to repeated vomiting, and sometimes occur suddenly, with little or no vomiting. The earliest recorded episode began within only seven minutes of orbit insertion, and malaise has been reported to last anywhere from one to five days. Two types of countermeasures have been tested extensively, anti-motion sickness drugs and preflight protective adaptation (i.e., repeated exposures to motion-sickness-inducing stimuli). Anti-motion sickness drugs have had limited success in preventing or counteracting SAS, and frequently have caused debilitating side effects. Some of the disadvantages of protective adaptation training are: (1) it is expensive and presents practical scheduling (of crewmen) difficulties because of requirements for other training during the preflight period, (2) individuals who are highly susceptible to motion sickness tend to adapt slowly (if at all), and (3) there is relatively little transfer of "protection" across different types of stimuli. Finding a solution to this biomedical problem has become a very high priority goal of the manned space-flight program because of its potential impact on crew safety, comfort, and operational efficiency during shuttle missions. Web site: http://www.delphion.com/details?pn=US05694939__
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Bromo-tryptophan conopeptides Inventor(s): Craig; A. Grey (Solana Beach, CA), Cruz; Lourdes J. (Salt Lake City, UT), England; Laura (Alameda, CA), Jimenez; Elsie (Quezon, PH), Julius; David (San Francisco, CA), McIntosh; J. Michael (Salt Lake City, UT), Olivera; Baldomero M. (Salt Lake City, UT), Rivier; Jean A. (La Jolla, CA) Assignee(s): Regents of the University of California (oakland, Ca), Salk Institute (la Jolla, Ca), University of Utah Research Foundation (salt Lake City, Ut) Patent Number: 5,889,147 Date filed: January 17, 1997 Abstract: The present invention is directed to conopeptides having 6-45 amino acids, including one or more bromo-tryptophan residues. More specifically, the present invention is directed to conopeptides having the general formula: R-(Cys).sub.n -R.sup.1 -B-R.sup.2 -Cys-R.sup.3, wherein R is a peptide chain of 0-24 amino acids, R.sup.1 is a peptide chain of 0 to 31 amino acids, R.sup.2 is a peptide chain of 0-29 amino acids, R.sup.3 is a peptide chain of 0 to 26 amino acids, B is 6-bromo-tryptophan, n is 0 or 1 and the total length of the conopeptide is from about 6 to about 45 amino acids. The invention also includes pharmaceutically acceptable salts of the conopeptides. These bromo-tryptophan containing conopeptides invention are useful as antihelminthic agents, anti-vomiting agents, sleep-inducing agents, adjuncts to anesthesia, anticonvulsant or neuroprotective agents. Excerpt(s): This invention relates to relatively short peptides about 6-45 residues in length, which are naturally available in minute amounts in the venom of the cone snails or analogs to the naturally available peptides, and which include one or more bromotryptophan residues. The publications and other materials used herein to illuminate the background of the invention, and in particular, cases to provide additional details respecting the practice, are incorporated by reference, and for convenience are referenced in the following text by author and date and are listed alphabetically by author in the appended bibliography. Mollusks of the genus Conus produce a highly toxic venom that enables them to carry out their unique predatory lifestyle. Prey are immobilized by the venom that is injected by means of a highly specialized venom apparatus, a disposable hollow tooth that functions both in the manner of a harpoon and a hypodermic needle. Web site: http://www.delphion.com/details?pn=US05889147__
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Derivatives of amide analogs of certain methano bridged quinolizines Inventor(s): Gittos; Maurice W. (Plobsheim, FR) Assignee(s): Merrell Pharmaceuticals, Inc. (cincinnati, Oh) Patent Number: 5,955,470 Date filed: October 29, 1998 Abstract: This invention relates to novel amide derivatives of certain 2,6-methano-2Hquinolizine-type compounds, to the intermediates and processes for their preparation, to their ability to antagonize the effects of serotonin at the 5HT.sub.3 receptors, and to their end-use application in the treatment of chemotherapeutically-induced nausea and vomiting, as anti-anxiety agents, in the symptomatic treatment of pain associated with migraine, as anti-arrhythmic agents, in the treatment of cognitive disorders, in treating
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hallucinatory endogenous psychoses of the type manifested in patients suffering from schizophrenia, and mania, in the treatment of glaucoma, for stimulating gastric motility, to combat drug abuse, to treat sleep apnea and to treat irritable bowel syndrome. Excerpt(s): This invention relates to novel amide derivatives of certain 2,6-methano-2Hquinolizines-type compounds, to the intermediates and processes for their preparation, to their ability to antagonize the effects of serotonin at the 5HT.sub.3 receptors, and to their end-use application in the treatment of chemotherapeutically-induced nausea and vomiting, as anti-anxiety agents, in the symptomatic treatment of pain associated with migraine, as anti-arrhythmic agents, in the treatment of cognitive disorders, in treating hallucinatory endogenous psychoses of the type manifested in patients suffering from schizophrenia, and mania, in the treatment of glaucoma, for stimulating gastric motility, to combat drug abuse, to treat sleep apnea and to treat irritable bowel syndrome. (g) R.sub.2 substituted-1H-benzotriazoles. The pharmaceutically acceptable acid addition salts referred to above can be non-toxic salts with suitable acids such as those with inorganic acids, for example, hydrochloric, hydrobromic, nitric, sulfuric or phosphoric acids; or with organic acids such as organic carboxylic acids, for example, acetic, propionic, glycolic, maleic, hydroxymaleic, malic, tartaric, citric, salicylic, 2acetyloxybenzoic, nicotinic or isonicotinic; or organic sulfonic acids, for example, methanesulfonic, ethanesulfonic, 2-hydroxyethanesulfonic, 4-toluenesulfonic or 2naphthalenesulfonic. Quaternary ammonium salts are formed with alkyl halides such as methyl chloride, methyl bromide, methyl iodide or ethyl bromide; or with sulfate esters such as methyl 4-toluenesulfonate or methyl 2-naphthalenesulfonate. Web site: http://www.delphion.com/details?pn=US05955470__ •
Device and method for decreasing nausea and vomiting Inventor(s): Langevin; Paul B. (Gainesville, FL) Assignee(s): University of Florida (gainesville, Fl) Patent Number: 6,030,631 Date filed: February 18, 1998 Abstract: The subject invention relates to devices that are specifically designed to safely and efficiently administer alcohol vapor for innocuous insufflation or inhalation, and to related methods of administering alcohol in this manner. The subject invention is preferably used to treat a patient suffering from post-operative nausea or vomiting that are side effects that often accompany the use of anesthetics for surgical applications. Excerpt(s): Nausea and emesis are often induced by stimulation of either the chemoreceptor trigger zone or the emesis (or vomiting) center in the central nervous system. Such stimulation can be caused by afferent stimulation (e.g., tactile pharyngeal impulses, labrynthine disturbances, motion, increased intracranial pressure, pain, distention of viscera or psychologic factors) or blood born emetic substances (e.g., as seen during pregnancy, cancer chemotherapy, uremia, radiation therapy, electrolyte and endocrine disturbances, or the presence of chemical emetic substances). Nausea and vomiting are also common post-operative side effects that result from the use of anesthetics. These symptoms are known as post-operative nausea and vomiting (PONV). A series of medication alternatives are currently used to combat PONV. The drugs used most frequently are benzamides (e.g. Metoclopramide),phenothiazines(e.g. Phenergan) and Serotonin inhibitors (e.g. Ondancetron). In order to minimize the side effects, these drugs are most often administered in this sequence. If Metroclopramide
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fails to produce adequate relief, Phenergan is administered. If sufficient relief is still not experienced, Ondancetron is given to the patient. In efforts to control cost and potential side effects, these medications are usually given in sequence at 30 minute intervals. This methodology can significantly prolong the time the patient remains in the recovery room, an area of the hospital where every additional minute represents enormous expense. The most common side effects of metroclopramide, which are experienced by about 10% of treated patients involve the central nervous system (CNS) and include restlessness, fatigue, drowsiness and lassitude. Insomnia, headache and dizziness occur less frequently. Delirium, severe dysphoria, obsessive rumination, mania, depression, and suicidal indication have also been reported. Extrapyramidal effects also result from dopaminergic blockage. This usually presents in the form of akathisia and occurs most often in children and young adults. Dystonic reactions resembling acute dyskinesia occur in less than 1% of young patients receiving low doses of Metroclopramide, but occur as often as in 25% of patients receiving higher doses. Web site: http://www.delphion.com/details?pn=US06030631__ •
Extended release formulation of venlafaxine hydrochloride Inventor(s): Clark; John C. (Peru, NY), Lamer; John U. (St. Albans, VT), Sherman; Deborah M. (Plattsburgh, NY), White; Steven A. (Champlain, NY) Assignee(s): American Home Products Corporation (madison, Nj) Patent Number: 6,274,171 Date filed: January 20, 2000 Abstract: This invention relates to a 24 hour extended release dosage formulation and unit dosage form thereof of venlafaxine hydrochloride, an antidepressant, which provides better control of blood plasma levels than conventional tablet formulations which must be administered two or more times a day and further provides a lower incidence of nausea and vomiting than the conventional tablets. More particularly, the invention comprises an extended release formulation of venlafaxine hydrochloride comprising a therapeutically effective amount of venlafaxine hydrochloride in spheroids comprised of venlafaxine hydrochloride, microcrystalline cellulose and, optionally, hydroxypropylmethylcellulose coated with a mixture of ethyl cellulose and hydroxypropylmethylcellulose. Excerpt(s): Extended release drug formulations are conventionally produced as compressed tablets by hydrogel tablet technology. To produce these sustained release tablet drug dosage forms, the active ingredient is conventionally compounded with cellulose ethers such as methyl cellulose, ethyl cellulose or hydroxypropylmethylcellulose with or without other excipients and the resulting mixture is pressed into tablets. When the tablets are orally administered, the cellulose ethers in the tablets swell upon hydration from moisture in the digestive system, thereby limiting exposure of the active ingredient to moisture. As the cellulose ethers are gradually leached away by moisture, water more deeply penetrates the gel matrix and the active ingredient slowly dissolves and diffuses through the gel, making it available for absorption by the body. An example of such a sustained release dosage form of the analgesic/anti-inflammatory drug etodolac (Lodine.RTM.) appears in U.S. Pat. No. 4,966,768. U.S. Pat. No. 4,389,393 discloses sustained release therapeutic compressed solid unit dose forms of an active ingredient plus a carrier base comprised of a high molecular weight hydroxypropylmethylcellulose, methyl cellulose, sodium carboxymethylcellulose and or other cellulose ether. Where the production of tablets is
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not feasible, it is conventional in the drug industry to prepare encapsulated drug formulations which provide extended or sustained release properties. In this situation, the extended release capsule dosage forms may be formulated by mixing the drug with one or more binding agents to form a uniform mixture which is then moistened with water or a solvent such as ethanol to form an extrudable plastic mass from which small diameter, typically 1 mm, cylinders of drug/matrix are extruded, broken into appropriate lengths and transformed into spheroids using standard spheronization equipment. The spheroids, after drying, may then be film-coated to retard dissolution. The film-coated spheroids may then be placed in pharmaceutically acceptable capsules, such as starch or gelatin capsules, in the quantity needed to obtain the desired therapeutic effect. Spheroids releasing the drug at different rates may be combined in a capsule to obtain desired release rates and blood levels. U.S. Pat. No. 4,138,475 discloses a sustained release pharmaceutical composition consisting of a hard gelatin capsule filled with film-coated spheroids comprised of propanolol in admixture with microcrystalline cellulose wherein the film coating is composed of ethyl cellulose, optionally, with hydroxypropylmethylcellulose and/or a plasticizer. Venlafaxine, 1-[2dimethylamino)-1-(4-methoxyphenyl)ethyl]cyclohexanol, is an important drug in the neuropharmacological arsenal used for treatment of depression. Venlafaxine and the acid addition salts thereof are disclosed in U.S. Pat. No. 4,535,186. Venlafaxine hydrochloride is presently administered to adults in compressed tablet form in doses ranging from 75 to 350 mg/day, in divided doses two or three times a day. In therapeutic dosing with venlafaxine hydrochloride tablets, rapid dissolution results in a rapid increase in blood plasma levels of the active compound shortly after administration followed by a decrease in blood plasma levels over several hours as the active compound is eliminated or metabolized, until subtherapeutic plasma levels are approached after about twelve hours following administration, thus requiring additional dosing with the drug. With the plural daily dosing regimen, the most common side effect is nausea, experienced by about forty five percent of patients under treatment with venlafaxine hydrochloride. Vomiting also occurs in about seventeen percent of the patients. Web site: http://www.delphion.com/details?pn=US06274171__ •
Foods for preventing vomiting Inventor(s): Hamachiyo; Yoshinori (Hino, JP), Ito; Hiroko (Musashino, JP), Kaneda; Kazuhiko (Setagaya-Ku, JP), Tanaka; Hiroshi (Hino, JP), Yamagata; Norimitsu (Tama, JP) Assignee(s): Kewpie Kabushiki Kaisha (tokyo-to, Jp) Patent Number: 6,187,334 Date filed: May 9, 2000 Abstract: The present invention relates to an antiemetic food product comprising a solution containing one or more thickeners selected from low-methoxyl pectin, sodium alginate, alginic acid, kappa carrageenan, iota carrageenan, lambda carrageenan and gellan gum, to an antiemetic food product comprising, as one set, a solution containing any of these thickeners, and typically a calcium solution, and to a method for preventing a patient from suffering from emesis associated with the ingestion of liquid food, comprising feeding the antiemetic food product to the patient. Excerpt(s): The present invention relates to antiemetic food products. More particularly, the present invention relates to food products useful for preventing "emesis", a typical
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adverse effect that afflicts those patients who are ingesting nutrition from liquid food. The present invention also relates to a method for preventing patients from suffering from emesis associated with the ingestion of liquid food, comprising feeding the above antiemetic food products to the patients. Most patients who are ingesting nutrition from liquid food or a liquid diet are weak, and this inhibits the delivery of food contained in the stomach to the small intestine. Therefore, they tend to vomit when their stomachs are filled with a certain amount of liquid food. In order to prevent these patients from suffering from emesis of this type, the following methods have conventionally been adopted: a method in which the rate of feeding liquid food to the patients is decreased; a method in which the amount of liquid food to be fed is decreased; a method in which liquid food is diluted to promote its flow from the stomach to the small intestine; and a method in which the patients are encouraged to sit in a position considered to be ideal. Other methods have also been adopted in which medicines are used to assist the delivery of liquid food from the stomach to the small intestine and in which pregelatinized liquid food is fed to the patients. Web site: http://www.delphion.com/details?pn=US06187334__ •
Intravaginal rings with insertable drug-containing core Inventor(s): Bardin; C. Wayne (New York, NY), Harmon; Troy (Lansdale, PA), Nash; Harold A. (Harrington Park, NJ), Saleh; Saleh Ismail (Assuit, EG) Assignee(s): The Population Council, Inc. (new York, Ny) Patent Number: 5,972,372 Date filed: May 2, 1997 Abstract: Disclosed is a vaginal ring intended for the release of at least one drug over a prolonged time period. The vaginal ring contains a ring body made of a first polymeric material having at least one hollow internal channel defining an opening to the exterior of the ring body and which channel is adapted to receive a, drug-containing core through the opening, and an intravaginally administerable drug-containing core disposed in the channel. The core is positioned in the vaginal ring body suitably prior to use in order to substantially avoid initial bursts of drug into the tissues of the subject and resultant side effects such as nausea and vomiting. The core contains a pharmaceutically effective amount of at least one intravaginally administerable drug dispersed in a second polymeric material. The first and second polymeric materials may be the same or different. Representative drugs include contraceptive agents and other steroidal substances for use in hormone replacement therapy. Also disclosed are methods for preparing the vaginal rings, kits for assembling the vaginal rings, and methods of using the vaginal rings to achieve intravaginal delivery of drugs to a female. Excerpt(s): The present invention is directed to intravaginal drug delivery devices and methods for the intravaginal administration of drugs, and more particularly, the intravaginal administration of contraceptive agents and agents for hormone replacement therapy. Vaginal rings are torous shaped devices designed to deliver a relatively constant dose of drug to the vagina usually over a period of weeks to months. Typically, they are made of a silicone elastomer and contain a drug released by diffusion though the elastomer. The most common commercial applications have been to deliver low doses of steroids for post-menopausal vaginal conditions. They have also been under development for use in contraception and hormone replacement therapy. Vaginal rings have also been used to administer spermicides, as well as a variety of locally or systematically active medicaments. Vaginal rings have provided several advantages in
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that their use is controlled by the female; they allow for a better regulated dose of drug without attention by the user; and they avoid the destruction (by the intestine and by first pass through the liver) of an appreciable portion of the daily dosage of some steroids compared to their orally delivered counterparts. The use of a vaginal ring to deliver drugs requires a ring design that regulates the release rate so as to provide the user with the appropriate daily dose. Among the important factors governing release are the solubility of the drug in the ring elastomer, the surface area of the drug reservoir, the distance the drug must diffuse through the ring body to reach its surface and the molecular weight of the drug. If very high release rates are desired, they can be attained by a drug load at the ring surface as is characteristic of the homogeneous matrix ring design. This design, however, suffers from rapidly declining release rates as the distance the drug must travel to reach the ring surface increases as the drug load near the surface is depleted. If moderately high release rates are needed to provide the appropriate dose, a design which modulates release rate by imposing a layer of drug-free elastomer between the drug reservoir and the ring exterior is appropriate. This may be attained by coating a homogeneous ring, or to conserve drug, by incorporating a drug-free core, a shell design may be used. If an even lower release rate is desired, the drug may be confined to a small diameter at the center of the ring ("core ring"). Finally, the drugloaded core may not encircle the ring but instead be of short length. Numerous types of vaginal rings have been described in the patent and non-patent literature alike. See, e.g., U.S. Pat. Nos. 4,012,496 and 4,155,991 (both to Schopflin et al.), 4,292,965 (Nash), 3,545,439 (Duncan), 3,920,805 (Roseman), 3,991,760 and 3,995,634 (both to Drobish et al.), 3,995,633 (Gougen), 4,250,611 and 4,286,587 (both to Wong), 4,596,576 (de Nijs); W095/00199 (Lehtinen et al.), NL 8500-470-A; and Apter et al., Contraception 42:285-295 (1990), Burton et al., Contraception 17:221-230 (1978), Burton et al., contraception 19:507516 (1979), Jackanicz, Contraception 24:323-339 (1981), Sivin et al., Contraception 24:341358 (1981), Timmer et al., Contraception 43:629-642 (1990), and Toivonen, Contraception 20:511-518 (1979). Web site: http://www.delphion.com/details?pn=US05972372__ •
Medical container with electrolyte solution stored therein Inventor(s): Isono; Keinosuke (Kawaguchi, JP), Motobayashi; Hiroshi (Tokyo, JP), Shichi; Hiroyuki (Tokyo, JP) Assignee(s): Material Engineering Technology Laboratory, Incorporated (tokyo, Jp) Patent Number: 5,871,477 Date filed: November 27, 1996 Abstract: A medical container with an electrolyte solution stored therein is disclosed. It is formed of a resinmade container main body, a base solution compartment, at least one isolated compartment or connected compartment, and an openable portion. The base solution compartment is arranged in the container main body and is filled with the electrolyte solution in a state steamsterilized together with the container main body. The isolated compartment or connected compartment is arranged in the container main body, is isolated from the base solution compartment by an isolation wall interposed therebetween, and is filled with a bicarbonate. The openable portion permits aseptic communication between the base solution compartment and the isolated compartment or connected compartment by an operation from an outside of the container main body at the time of use. The openable portion is formed at at least a part of the isolation wall. This medical container makes it possible to store an electrolyte solution, dialysate or the
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like at a pH value close to that of the body fluid without inducing kidney problems, diarrhea, vomiting or the like due to acidosis or the like upon use. Excerpt(s): This invention relates to a medical container with an electrolyte stored therein, and more specifically to a medical container which stores therein a body fluid replenisher to be administered through a peripheral vein or a central vein, such as an infusion solution, a dialysate for a circulatory system, such as an artificial kidney dialysate, or an electrolyte solution as a preserving solution for an organ or the like. Despite the inclusion of bicarbonate ions (HCO.sub.3.sup.-) at a certain specific concentration in the blood or tissue cells of the human body, either absolutely or practically no bicarbonate salt, carbonate salt or the like (hereinafter simply referred to as "bicarbonate" for the sake of brevity) is contained in an infusion solution for use in the treatment or the like of the human body, a dialysate or an organ (tissue) preserving solution, although certain particular electrolytes are contained therein. For example, the concentration of bicarbonate ions in the plasma of the human body is generally around 24 mEq/l or so. When directly administering a bicarbonate into the body by infusion or when indirectly administering it by a blood dialysis or peritoneal dialysis, it is desired to add the bicarbonate in an amount such that the concentration of bicarbonate ions in the solution conforms with that of bicarbonate ions in the plasma. It is however to be noted that an infusion solution or the like is filled in a plastic-made medical container and is supplied to a hospital generally in a state completely sterilized by autoclave sterilization or the like. Bicarbonate ions are therefore caused to decompose substantially into carbon dioxide gas upon autoclave sterilization if a bicarbonate is added beforehand in the electrolyte in the container. Further, a bicarbonate, when filled as a diluted solution in a conventional plastic-made medical container, decomposes into carbon dioxide gas and is hence lost, even when the medical container is not subjected to autoclave sterilization. Web site: http://www.delphion.com/details?pn=US05871477__ •
Medicaments for gastrointestinal disorders Inventor(s): Challoner; Teresa Elizabeth (Regents Park, GB), Tyers; Michael Brian (Welwyn, GB) Assignee(s): Glaxo Group Limited (brentford, Gb) Patent Number: 6,544,550 Date filed: November 24, 1993 Abstract: The invention relates to the co-administration in human or veterinary medicine of 1,2,3,9-tetrahydro-9-methyl-3-[(2-methyl-1H-imidazol-1-yl)methyl]-4Hcarba zol-4-one or a physiologically acceptable salt or solvate thereof and dexamethasone or a physiologically acceptable salt or ester thereof. The two active ingredients, which may be administered separately either simultaneously or sequentially, or may be combined in a single pharmaceutical preparation, are useful in the relief and/or prevention of nausea and vomiting. Excerpt(s): This invention relates to improvements in the treatment of gastrointestinal disorders. More particularly it relates to the use of a compound having antagonist activity at 5HT.sub.3 receptors and dexamethasone in the treatment of emesis, and to pharmaceutical compositions containing the two compounds. and physiologically acceptable salts, solvates and physiologically acceptable equivalents thereof. In the aforementioned specification the compounds are described as potent and selective antagonists of 5- hydroxytryptamine (5HT) at `neuronal` 5HT receptors of the type
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located on terminals of primary afferent nerves, and which are also present in the central nervous system. Receptors of this type are now designated 5HT.sub.3 receptors. The compounds are described as being of use in the treatment of a human or animal subject suffering from a condition caused by a disturbance of neuronal 5HT function, for example in the treatment of migraine pain or a psychotic disorder such as schizophrenia. The compounds may also be useful in the treatment of conditions such as anxiety, obesity and mania. Web site: http://www.delphion.com/details?pn=US06544550__ •
Method treating cognitive disorders using optically pure R(+) ondansetron Inventor(s): Young; James W. (Still River, MA) Assignee(s): Sepracor Inc. (marlborough, Ma) Patent Number: 5,629,333 Date filed: March 2, 1995 Abstract: Methods and compositions are disclosed utilizing the optically pure R(+) isomer of ondansetron. This compound is a potent drug for the treatment of nausea and vomiting associated with chemotherapy and radiation therapy, while avoiding the concomitant liability of adverse effects associated with the racemic mixture of ondansetron. The R(+) isomer of ondansetron is also useful for the treatment of behavioral disorders such as mood anxiety and schizophrenia, and such other conditions as may be related to R(+) ondansetron's activity as a competitive antagonist of serotonin receptor subtype 5-HT.sub.3 such as disorders of gastrointestinal motility, depression, migraine, and as an aid for alcohol withdrawal, nicotine withdrawal, and drug (benzodiazepine et al.) withdrawal, without the concomitant liability of adverse effects associated with the racemic mixture of ondansetron. Furthermore, the R(+) isomer of ondansetron is also useful for the treatment of cognitive disorders such as dementia or age-associated memory impairment, while avoiding the concomitant liability of adverse effects associated with the racemic mixture of ondansetron. Excerpt(s): This invention relates to novel compositions of matter containing optically pure R(+) ondansetron. These novel compositions have potent antiemetic activity and are useful in ameliorating the nausea and vomiting otherwise induced by cancer chemotherapeutic agents and higher dose radiotherapeutic treatment procedures while avoiding adverse effects including but not limited to headache, constipation and increases in transeminase levels, which are associated with the administration of the racemic mixture of ondansetron. Additionally, these novel compositions of matter containing optically pure R(+) ondansetron are useful in treating behavioral disorders such as mood anxiety and schizophrenia, and such other conditions as may relate to R(+) ondansetron's activity as a competitive antagonist of serotonin receptor subtype 5HT.sub.3, including but not limited to disorders of gastrointestinal motility, depression, migraine, alcohol, nicotine or drug (benzodiazepine et al.) withdrawal, while avoiding adverse effects associated with the administration of the racemic mixture of ondansetron. Furthermore, these novel compositions of matter containing optically pure R(+) ondansetron are useful in treating cognitive disorders such as dementia and ageassociated memory impairment, while avoiding the adverse effects associated with the administration of the racemic mixture of ondansetron. Also disclosed are methods for treating the above described conditions in a human while avoiding the adverse effects that are associated with the racemic mixture of ondansetron, by administering the R(+) isomer of ondansetron to said human. The active compound of this composition, and
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method is an optical isomer of the compound, ondansetron which is described in U.S. Pat. No. 4,695,578. Chemically, the active compound is the R(+) isomer of 1,2,3,9tetrahydro-9-methyl-3-[(2-methyl-1H-imidazol-1-yl)methyl]-4H-carba zol-4-one. This isomer will hereinafter be referred to as R(+) ondansetron. Many organic compounds exist in optically active forms, i.e., they have the ability to rotate the plane of planepolarized light. In describing an optically active compound, the prefixes D and L or R and S are used to denote the absolute configuration of the molecule about its chiral center(s). The prefixes (+) and (-) or d and l are employed to designate the sign of rotation of plane-polarized light by the compound, with (-) or l meaning that the compound is levorotatory. A compound prefixed with (+) or d is dextrorotatory. For a given chemical structure, these compounds, called stereoisomers, are identical except that they are mirror images of one another. A specific stereoisomer may also be referred to as an enantiomer, and a mixture of such isomers is often called an enantiomeric or racemic mixture. Web site: http://www.delphion.com/details?pn=US05629333__ •
Methods and compositions involving opioids and antagonists thereof Inventor(s): Farrar; John J. (Chester Springs, PA) Assignee(s): Adolor Corporation (exton, Pa) Patent Number: 6,451,806 Date filed: November 29, 2000 Abstract: Novel methods and compositions comprising opioids In preferred embodiments, the methods and compositions peripheral mu opioid antagonist compounds. The methods particularly suitable for treating and/or preventing side effects including, for example, constipation, vomiting and/or nausea.
and opioid antagonists. comprise opioids and and compositions are associated with opioids
Excerpt(s): The present invention relates to novel methods and compositions comprising opioids and opioid antagonists. More particularly, the present invention relates to novel methods and compositions comprising opioids and peripheral mu opioid antagonist compounds. It is well known that opioid drugs target three types of endogenous opioid receptors (i.e., mu, delta and kappa receptors) in biological systems. Most opioids, such as morphine, are mu opioid agonists that are often used as analgesics for the treatment of severe pain due to their activation of mu opioid receptors in the brain and central nervous system (CNS). Opioid receptors are, however, not limited to the CNS, and may be found in other tissues throughout the body. A number of side effects of opioid drugs may be caused by activation of these peripheral receptors. Administration of mu opioid agonists often results in intestinal dysfunction due to the large number of receptors in the wall of the gut (Wittert, G., Hope, P. and Pyle, D., Biochemical and Biophysical Research Communications 1996, 218, 877-881; Bagnol, D., Mansour, A., Akil, A. and Watson, S. J., Neuroscience 1997, 81, 579-591). Specifically, opioids are generally known to cause nausea and vomiting as well as inhibition of normal propulsive gastrointestinal function in animals and man (Reisine, T., and Pasternak, G., Goodman & Gilman's The Pharmacological Basis of Therapeutics Ninth Edition 1996, 521-555) resulting in side effects such as, for example, constipation. It has been reported that acute nausea or vomiting may occur in up to about 33% of patients who receive oral narcotic analgesics and in up to about 80% of patients who receive injectable narcotics following surgery or trauma. This is due, at least in part, to direct effects of narcotics on the gastrointestinal (GI) tract. Opioid-induced side effects, such as nausea, vomiting, and inhibited
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gastrointestinal propulsive activity remain serious problems for patients being administered opioid analgesics for both short term and long term pain management. Opioid antagonist compounds that do not readily cross the blood-brain barrier (peripherally acting drugs) have been tested for use in curbing opioid-induced side effects. For instance, the peripheral mu opioid antagonist compound methylnaltrexone and related compounds have been suggested for use in curbing opioid-induced side effects in patients. U.S. Pat. Nos. 5,972,954, 5,102,887, 4,861,781, and 4,719,215 disclose the use of methylnaltrexone and related compounds in controlling opioid-induced pruritus, nausea, and/or vomiting. Additionally, methylnaltrexone has been shown to effectively reduce the incidence of opioid-induced nausea and pruritus as disclosed by Yuan, C. -S. et al. Drug and Alcohol Dependence 1998, 52, 161. Similarly, U.S. Pat. Nos. 5,250,542, 5,434,171, 5,159,081, and 5,270,328, disclose peripherally selective piperidineN-alkylcarboxylate opioid antagonists as being useful for the treatment of the opioid side effects constipation, nausea or vomiting, as well as irritable bowel syndrome and idiopathic constipation. Web site: http://www.delphion.com/details?pn=US06451806__ •
Methods of screening for agonists and antagonists of the interaction between the human KIAA0001 receptor and ligands thereof Inventor(s): Ames; Robert S. (Havertown, PA), Arnold; Anne Romanic (Wynnewood, PA), Chambers; Jonathan K. (Haslingfield, GB), Foley; James Joseph (Radnor, PA), Sarau; Henry M. (Harleysville, PA), Stewart; Brian R. (Welwyn, GB) Assignee(s): Smithkline Beecham Corporation (philadelphia, Pa) Patent Number: 6,238,873 Date filed: April 30, 1999 Abstract: Disclosed are methods for discovering agonists and antagonists of the interaction between UDP-glucose, UDP-galactose, UDP-glucuronic acid, UDP-N-acetyl glucosamine, as well as related UDP sugars, and their cellular receptor, human KIAA0001, which may have utility in the treatment of several human diseases and disorders, including, but not limited to: infections such as bacterial, fungal, protozoan and viral infections, particularly infections caused by HIV-1 or HIV-2; pain; cancers; diabetes, obesity; anorexia; bulimia; asthma; Parkinson's disease; acute heart failure; hypotension; hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; restenosis; atherosclerosis; diseases characterized by excessive smooth muscle cell proliferation; aneurysms; wound healing; diseases characterized by loss of smooth muscle cells or reduced smooth muscle cell proliferation; stroke; ischemia; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic and neurological disorders, including anxiety, schizophrenia, manic depression, depression, delirium, dementia, and severe mental retardation; degenerative diseases, such as neurodegenerative diseases and dyskinesias, such as Huntington's disease or Gilles dela Tourett's syndrome, among others. Excerpt(s): This invention relates to methods for discovering agonists and antagonists of the interaction between UDP-sugars (e.g.,UDP-glucose, UDP-galactose, UDP-glucuronic acid, and UDP-N-acetyl glucosamine) and their cellular receptor, human KIAA0001 receptor. The invention also relates to the use of the identified agonists, antagonists and/or inhibitors, which are potentially useful in the treatment of human diseases/disorders, including, but not limited to: infections such as bacterial, fungal, protozoan and viral infections, particularly infections caused by HIV-1 or HIV-2; pain;
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cancers; diabetes, obesity; anorexia; bulimia; asthma; Parkinson's disease; acute heart failure; hypotension; hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; restenosis; atherosclerosis; diseases characterized by excessive smooth muscle cell proliferation; aneurysms; wound healing; diseases characterized by loss of smooth muscle cells or reduced smooth muscle cell proliferation; stroke; ischemia; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic and neurological disorders, including anxiety, schizophrenia, manic depression, depression, delirium, dementia, and severe mental retardation; degenerative diseases, such as neurodegenerative diseases and dyskinesias, such as Huntington's disease or Gilles dela Tourett's syndrome, among others. It is well established that many medically significant biological processes are mediated by proteins participating in signal transduction pathways that involve G-proteins and/or second messengers, e.g., cAMP (Lefkowitz, Nature, 1991, 351:353-354). Herein these proteins are referred to as proteins participating in pathways with G-proteins or PPG proteins. Some examples of these proteins include the G-protein coupled (GPC) receptors, such as those for adrenergic agents and dopamine (Kobilka, B. K., et al., Proc. Natl Acad. Sci., USA, 1987, 84:46-50; Kobilka, B. K., et al., Science, 1987, 238:650-656; Bunzow, J. R., et al., Nature, 1988, 336:783-787), G-proteins themselves, effector proteins, e.g., phospholipase C, adenyl cyclase, and phosphodiesterase, and actuator proteins, e.g., protein kinase A and protein kinase C (Simon, M. I., et al., Science, 1991, 252:802-8). For example, in one form of signal transduction, the effect of hormone binding is activation of the enzyme, adenylate cyclase, inside the cell. Enzyme activation by hormones is dependent on the presence of the nucleotide GTP. GTP also influences hormone binding. A G-protein connects the hormone receptor to adenylate cyclase. G-protein was shown to exchange GTP for bound GDP when activated by a hormone receptor. The GTP-carrying form then binds to activated adenylate cyclase. Hydrolysis of GTh to GDP, catalyzed by the G-protein itself, returns the G-protein to its basal, inactive form. Thus, the G-protein serves a dual role, as an intermediate that relays the signal from receptor to effector, and as a clock that controls the duration of the signal. Web site: http://www.delphion.com/details?pn=US06238873__ •
Modulation of substance P by compounds containing calcium sulfate and methods relating thereto Inventor(s): Hebert; Rolland F. (Bellevue, WA), Malik; Sohail (Seattle, WA), Yee; Min (Bellevue, WA) Assignee(s): Biofrontiers, Inc. (bellevue, Wa) Patent Number: 5,683,725 Date filed: May 25, 1995 Abstract: Modulation of substance P by compounds containing calcium sulfate is disclosed. Preferred calcium sulfate compounds include syngenite, gorgeyite and gypsum. Methods of this invention include the modulation of substance P, as well as methods for preventing or treating conditions associated with substance P, by administering to an animal an effective amount of a calcium sulfate compound. Conditions associated with substance P include headaches and migraine, neurogenic inflammation, emesis, nausea and vomiting, cough and bronchitis, obesity, allergy, asthma, hemorrhoids and anal fissures, ulcer, fever, infertility and periodontal disease. Excerpt(s): The present invention relates generally to a method of modulating substance P by compounds containing calcium sulfate, particularly syngenite, gorgeyite and
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gypsum, and more specifically, to the synthesis of such compounds as well as their use to treat a variety of conditions associated with substance P. Substance P, along with neurokinin A and neurokinin B, are members of the tachykinin family of mammalian regulatory peptides (Dockray, Gut Peptides: Biochemistry and Physiology, Walsh and Dockray, editors, Raven Press, Ltd, New York, N.Y., pp. 401-422, 1994). In 1931, substance P was the first of the gut neuropeptides to be discovered (von Euler and Gaddum, J. Physiol. 72:74-87, 1931). Nearly 40 years later, substance P was isolated and sequenced from bovine hypothalamus, and determined to be an undecapeptide (Chang and Leeman, J. Biol. Chem. 245:4784-4790, 1970; Chang and Leeman, Nature 232:86-87, 1971). More recently, multiple receptor subtypes (i.e., NK1, NK2 and NK3) for the various tachykinin neuropeptides have been cloned and sequenced, with substance P being considered the natural ligand for receptors of the NK1 subtype (Dockray, pp. 408409). Substance P is stored in the secretory granules of substance P immunoreactive nerves, which are afferent, small diameter, unmyelinated polymodal, C-type fibers with dual functions. Upon orthodromic stimulation by noxious stimuli, substance P is released from the spinal tract for central transmission of nociceptive information. A secondary function involves release of substance P and other neuropeptides from collateral nerve terminals and peripheral tissue following antidromic noxious stimulation, resulting in "neurogenic inflammation." Such peripheral release of substance P has been implicated as a neurogenic promoter of various inflammatory processes, including asthma, rhinitis, conjunctivitis, and inflammation of the skin and mucosa (see Bartold et al., J. Periodontol 65:1113-21, 1994). Substance P has also been found to be a potent vasodilator and increases vascular permeability, and has proinflammatory effects on neutrophils, macrophages, mast cells, lymphocytes, and endothelial cells (Bartold et al.). In addition to the central and peripheral nervous system, substance P immunoreactive nerves, and thus substance P itself, have been found in a variety of different mammalian tissues, including smooth muscles of the arteries and veins, pulmonary, urinary and gastrointestinal tracts, basal ganglia, substantia nigra, striatonigral pathways, hypothalamus, retina, hair follicles, gingival tissues, prostate gland, and even in spermatozoa. Web site: http://www.delphion.com/details?pn=US05683725__ •
Nucleic acid encoding a bovine calcitonin receptor-like receptor (BECRLR) Inventor(s): Aiyar; Nambi V. (Berwyn, PA), Disa; Jyoti (King of Prussia, PA) Assignee(s): Smithkline Beecham Corporation (philadelphia, Pa) Patent Number: 6,074,845 Date filed: January 28, 1999 Abstract: BECRLR polypeptides and polynucleotides and methods for producing such polypeptides by recombinant techniques are disclosed. Also disclosed are methods for utilizing BECRLR polypeptides and polynucleotides in screening assays to discover compounds that either agonize or antagonize the biological activity of the receptor. Such compounds are expected to be useful in treatment of human diseases, including, but not limited to: infections such as bacterial, fungal, protozoan and viral infections, particularly infections caused by HIV-1 or HIV-2; pain; cancers; diabetes, obesity; anorexia; bulimia; asthma; Parkinson's disease; acute heart failure; hypotension; hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; stroke; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic and neurological disorders, including anxiety, schizophrenia, manic
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depression, depression, delirium, dementia, and severe mental retardation; and dyskinesias, such as Huntington's disease or Gilles dela Tourett's syndrome. Excerpt(s): This invention relates to newly identified polypeptides and polynucleotides encoding such polypeptides, to their use in therapy and in identifying compounds that may be agonists or antagonists that are potentially useful in therapy, and to production of such polypeptides and polynucleotides. The drug discovery process is currently undergoing a fundamental revolution as it embraces `functional genomics`, that is, high throughput genome- or gene-based biology. This approach is rapidly superseding earlier approaches based on `positional cloning`. A phenotype, that is a biological function or genetic disease, would be identified and this would then be tracked back to the responsible gene, based on its genetic map position. Functional genomics relies heavily on the various tools of bioinformatics to identify gene sequences of potential interest from the many molecular biology databases now available. There is a continuing need to identify and characterize further genes and their related polypeptides/proteins, as targets for drug discovery. Web site: http://www.delphion.com/details?pn=US06074845__ •
Pharmaceutical compositions containing granisetron and dexamethasone Inventor(s): Dott; Christopher Stuart (Redhill, GB), Sanger; Gareth John (Sawbridgeworth, GB) Assignee(s): Smithkline Beecham P.l.c. (brentford, Gb) Patent Number: 5,929,059 Date filed: July 28, 1997 Abstract: A method of treatment of nausea and vomiting is disclosed which comprises administering to a human or animal subject granisetron and an antiemetic corticosteroid. Excerpt(s): This invention relates to a method of treatment and/or prophylaxis of nausea and vomiting, comprising the administration of a compound having 5-HT.sub.3 receptor antagonist activity. The anti-emetic properties of granisetron are potentially enhanced by administering the compound in conjunction with systemic corticosteroids, such as dexamethasone. Dexamethasone is a systemic anti-inflammatory corticosteroid, which is known to have anti-emetic properties and to be useful in the treatment of emesis resulting from chemotherapy, especially cancer chemotherapy involving the use of, for example, cisplatin. Accordingly, the present invention provides a pharmaceutical product comprising granisetron and steroid such as dexamethasone as a combined preparation for simultaneous, separate or sequential use in the treatment and/or prevention of nausea and vomiting. Web site: http://www.delphion.com/details?pn=US05929059__
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Polynucleotides that encode the calcitonin gene-related peptide receptor coponent factor (HOUNDC44) Inventor(s): Adamou; John E. (Exton, PA), Elshourbagy; Nabil (West Chester, PA) Assignee(s): Smithkline Beecham Corporation (philadelphia, Pa) Patent Number: 5,710,024 Date filed: July 23, 1996 Abstract: Human CGRP-RCF polypeptides and DNA (RNA) encoding such CGRP-RCF and a procedure for producing such polypeptides by recombinant techniques is disclosed. Also disclosed are methods for utilizing such CGRP-RCF for the treatment of diabetes, migrane, pain and inflammation, Parkinson's disease, acute heart failure, hypotension, urinary retention, osteoporosis, hypertension, angina pectoris, myocardial infarction, ulcers, asthma, allergies, psychosis, depression, vomiting, benign prostatic hypertrophy, Paget's disease, obesity, cancer, gigantism and the like. Antagonists against such CGRP-RCF and their use as a therapeutic to treat diabetes, migrane, pain and inflammation, Parkinson's disease, acute heart failure, hypotension, urinary retention, osteoporosis, hypertension, angina pectoris, myocardial infarction, ulcers, asthma, allergies, psychosis, depression, vomiting, benign prostatic hypertrophy, Paget's disease, obesity, cancer, gigantism and the like are also disclosed. Also disclosed are diagnostic assays for detecting diseases related to mutations in the nucleic acid sequences and altered concentrations of the polypeptides. Also disclosed are diagnostic assays for detecting mutations in the polynucleotides encoding the CGRP-RCF and for detecting altered levels of the polypeptide in a host. Excerpt(s): This invention relates, in part, to newly identified polynucleotides and polypeptides; variants and derivatives of the polynucleotides and polypeptides; processes for making the polynucleotides and the polypeptides, and their variants and derivatives; agonists and antagonists of the polypeptides; and uses of the polynucleotides, polypeptides, variants, derivatives, agonists and antagonists. In particular, in these and in other regards, the invention relates to polynucleotides and polypeptides of human Calcitonin Gene-related Peptide Receptor Component Factor, hereinafter referred to as "CGRP-RCF". Calcitonin gene related peptide (CGRP) is a 37 amino acid carboxyl-amidated neuropeptide secreted by the nerves of the central and peripheral nervous systems and exists as highly homologous.alpha. or.beta. isoforms in both human and rat (Amara, et al. Nature 298:240-244 (1982); Amara, et al. Science 229:1094-1097 (1985)).alpha.-and.beta.-CGRP display very similar biological activities, including peripheral and cerebral vasodilation (Brain, et al., Nature 313:54-56 (1985)), cardiac acceleration, (Sigrist, et al., Endocrinology 119:381-389 (1986)), regulation of calcium metabolism (Grunditz, et al., Endocrinology 119:2313-2324 (1986)), reduction of intestinal motility (Fargeas, et al., Peptides 6:1167-1171(1985)), regulation of glucose metabolism (reduction of insulin secretion and insulin sensitivity) (Hermansen, et al., Reg. Peptides 27:149-157) (1990)), diminution of appetite (Molina, et al., Diabetes 39:260265 (1990)) and reduction of growth hormone release (Tannenbaum, et al., Endocrinology 116:2685-2687 (1985)). The two CGRP peptides differ by three amino acids in humans and one amino acid in rats. The amino acid sequences of CGRP peptides are well conserved among species and can be considered as members of a family of peptides including the related peptides amylin (46% homology), salmon calcitonin (32% homology), and adrenomedullin (24% homology). These peptides in general have N-terminal ring structures of 6-7 amino acids involving a disulfide bridge and an amidated C-terminal end (Muff, et al., Eur J Endocrinol. 133:17-20 (1995); Goodman, et al., Life Sci. 38:2169-2178 (1986); Poyner, D. R. Pharmac. Ther. 56:23-51
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(1992)). As indicated above, CGRP has a plethora of functions in the body and is known to be the most potent vasodilator and neuromodulator. Although we recently reported the cDNA encoding the human CGRP-type I receptor (Aiyar et al., Journal of Biological Chemistry 271:11325-11329 (1996)), we observed during our characterization studies that the receptor did not confer CGRP responsiveness in Xenopus oocytes, in transiently expressing COS cells, and in stably expressing Baculovirus and Drosophila cells. In contrast to these observations, we are able to confer reasonable levels of CGRP responsiveness in stably transfected human embyonic kidney 293 cells. These observations suggest the requirement of an additional human complementary factor for functional coupling of the CGRP receptor in all of these heterologous systems. Web site: http://www.delphion.com/details?pn=US05710024__ •
Release system for treatment of a broken jaw Inventor(s): Casey; Kevin M. (5028 NW. Woodridge Dr., Parkville, MO 64151) Assignee(s): None Reported Patent Number: 5,842,856 Date filed: February 5, 1996 Abstract: A release system for treatment of a broken jaw comprises an upper and lower arch bar conformable to the curvature of the dental arches. The upper arch bar presents a series of interaligned loops which presents a channel for supporting a release bar extending therethrough. Upon wiring the arch bars to the respective dental arches, the lower arch bar is wired to the release bar so as to immobilize the dental arches and associated jaw. Upon imminent vomiting the user removes the release bar from its channel so as to disengage the release bar wiring from the associated upper arch bar. The loop channel supports the release bar so as to prevent kinking and bending of the release bar during wiring and wear. Various arch bars with releasable loops attached thereto are disclosed. Hanger elements for use with individual teeth are also disclosed which define courses for the release bar in lieu of the use of the loop channel on an arch bar. Caps cover the twisted ends of ligature wires to preclude oral abrasion. Excerpt(s): This invention relates to an intermaxillary fracture splint/orthodontic appliance for treatment of a broken jaw, and more particularly, to an improved orthodontic appliance allowing for a quick, unobstructed release of the ligatures which immobilize the broken jaw. The basic principle of intermaxillary ligation comprises the wiring of the upper and lower dental arches together so as to immobilize the jaw allowing for the fracture to heal. Various means of ligation have been utilized including the use of elastic materials, such as rubber bands, extending between upper and lower arch bars wired to the teeth. Also, wires extending between upper and lower arch bars, as wired to the teeth, have been used. The arch bars present tabs about which the wires or elastics are wound. Web site: http://www.delphion.com/details?pn=US05842856__
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Remedies for eating disturbance Inventor(s): Hashizume; Kiyoshi (Matsumoto, JP) Assignee(s): Sumitomo Pharmaceuticals Company, Limited (osaka, Jp) Patent Number: 6,225,283 Date filed: January 8, 1999 Abstract: This invention provides a therapeutic agent for the treatment of an abnormal eating behavior. The psychotic symptoms characteristic of anorexia nervosa such as apocleisis, intentional vomiting, eating in secret and the like have been treated with a tranquilizer and the like, but the effectiveness was only limited. By administration of a therapeutic agent according to the present invention, i.e., a human growth hormone (hGH) formulation, a will to eat can spontaneously be developed in a patient who previously received a nutrition only passively by means of a forcible nutrition program or a nasal nutrition supply. It is effective especially against the eating disorder in anorexia nervosa attributable possible to an increased central growth hormone releasing factor (GRH)-hGH secretion system. Excerpt(s): The present invention relates to a therapeutic agent for the treatment of a psychotic symptom accompanying anorexia nervosa. More particularly, the present invention relates to a therapeutic agent for the treatment of an abnormal eating behavior in anorexia nervosa attributable to an abnormally increased central GRH level. Anorexia nervosa (or nervous asitia, apocleisis) is a disease exhibiting psychotic symptoms such as a characteristic desire for emaciation and an abnormal eating behavior as well as somatic symptoms such as an extreme leptosome observed as a weight loss by 20% or more of the standard body weight as well as amenorrhea, and develops frequently in juvenile women. It is diagnosed generally based on the following clinical findings. It is a serious, sometimes fatal disease with no insight in a patient. Web site: http://www.delphion.com/details?pn=US06225283__
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Semen storage container and its stopper Inventor(s): Lee; Won Ku (203-2004 Garak Ssangyon, Apt. 140 Garak-don, Songpa-ku, Seoul, KR) Assignee(s): None Reported Patent Number: 6,149,579 Date filed: November 30, 1998 Abstract: A semen storage container containing the semen of a male pig is sealed with a stopper having a cone-shape vomiting portion whose point is closed at one end when the semen is used for artificial insemination, a predetermined portion of the cone-shape vomiting portion of the stopper is cut inserted into an insertion tube which is then inserted into the womb of female pig, thereby easily and cleanly carrying out artificial insemination. A window for confirming the amount of semen stored is added to the semen storage pack who se exterior is shading-printed to block a harmful ray of light such as direct ray of light, protecting the semen from deterioration. Excerpt(s): The present invention relates to a semen storage container for storing the semen of a male pig, and in particular, to a semen storage container and its stopper, which stores the semen of a male pig and allows the stored semen to be cleanly put into the womb of female pig without difficulty when the stored semen is used for artificial
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insemination. However, when the sealed inlet 110 of the semen storage pack is opened and the insertion tube 120 is put into the womb of female pig if the diameter of the insertion tube is different from that of the inlet 110 of the semen storage pack, the insertion tube cannot be fitted into the inlet. In other words, various kinds of insertion tubes whose diameters are different cannot be used for the inlet having a fixed diameter. That is, the semen storage pack is not compatible with various types of insertion tubes. Furthermore, the conventional semen storage pack produces unsanitary problems because the semen may leak from the gap between the inlet and insertion tube. Moreover, the semen storage pack is made of transparent vinyl, resulting in deterioration of semen due to its exposure to harmful rays of light. An object of the present invention is to provide a semen storage container and its stopper, for improving the semen storage pack's compatibility with various kinds of insertion tubes having different diameters, sanitation and economic effect. Web site: http://www.delphion.com/details?pn=US06149579__ •
Simple examination method of infection with Helicobacter pylori and device therefor Inventor(s): Ito; Masaharu (Ibaraki-ken, JP), Kanemaki; Susumu (Kanagawa-ken, JP), Kobashi; Kyoichi (Toyama-ken, JP), Matsunobu; Kunitoshi (Kanagawa-ken, JP), Uono; Masanori (Kanagawa-ken, JP) Assignee(s): Gastec Corporation (kanagawa-ken, Jp) Patent Number: 5,719,052 Date filed: January 11, 1996 Abstract: There are described a simple examination method of infection with Helicobacter pylori possibly presenting in a gastric mucosa, and a device therefor. The examination is conducted by collecting gas in gastric cavity, and measuring mainly ammonia and additionally organic amines which are generated due to activities of the bacilli. The measurement is carried out by leading the gas in gastric cavity into oral cavity by vomiting-reflex, and sucking the gas by a metering suction pump through a gas detection tube to read-out a length of color-changed area in the gas detection tube. Excerpt(s): The present invention relates to a simple examination method of infection with Helicobacter pylori (hereinafter may also be abbreviated as "H.p.") which is a bacillus and may present in gastric mucosa, and a device therefor. According to the invention, the information on H.p.-infection and the activity of H.p. at the time of examination can be easily obtained. Because of the strongly acidic environment of the inside of the stomach, the gastric cavity had been considered unsuitable for the survival of bacilli since old times; however, about 100 years ago, the existence of spiral bacillus was observed and reported. The bacilli were formally discovered in the second half of the 1970's. In 1983, the bacilli were firstly isolated from gastric mucosa by Waren et al., and was named at first as "Campylobacter pyloridis, because it morphologically and biologically resembled Campylobacter which is one of Salmonella enteritidis, in addition to the fact that it was isolated from gastric antral mucosa in the vicinity of the pylorus. Later, the name was once changed to Campylobacter pylori. The genetic name has been changed to "Helicobacter" based on its form, since the difference from Campylobacter became clear in 1989. Continuous effort has been made against investigating the correlation between H.p. and diseases of the upper alimentary tract even since the bacilli were isolated at a high rate by Marshall et al. from patients with gastric ulcer, duodenal ulcer or chronic gastritis in 1984, and the association between the
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presence of the bacilli and these diseases has been reported ›"The lancet", No. 8390, pages 1311-1314 (Jun. 1984)!. Web site: http://www.delphion.com/details?pn=US05719052__ •
Therapeutic use and formulation Inventor(s): Huckle; Richard Michael (Cambridge, GB) Assignee(s): Darwin Discovery, Ltd. (gb) Patent Number: 6,297,286 Date filed: November 8, 2000 Abstract: Substantially single-enantiomer(-)-tramadol, and its metabolites and structural and/or functional analogues, are useful for the prevention and/or treatment of one or more symptoms selected from nausea, vomiting, dizziness, blurred vision, drowsiness, somnolence, hallucinations, respiratory depression, constipation and euphoria. In particular, substantially single enantiomer (-)-tramadol, and its o-desmethyl metabolite, have been found to be potent anti-emetics. Excerpt(s): This invention relates to new therapeutic uses of tramadol and its structural and/or functional analogues, and to new formulations thereof. Tramadol has the chemical name (+/-)-trans (RR,SS)-2-[(di-methylamino)methyl]-1-(3-methoxyphenyl) cyclohexanol, and which is generally, and erroneously, referred to in literature as the cis(RS,SR) diastereomer, is a centrally acting, binary analgesic that is neither opiatederived, nor is a non-steroidal, anti-inflammatory drug (NSAID). It is used to control moderate pain in chronic pain settings, such as osteoarthritis and postoperative cases, and acute pain, such as dental pain. Used in therapy as a racemic mixture, the (+)enantiomer binds to the.mu.-opioid receptor, and both enantiomers inhibit 5hydroxytryptamine (serotonin) and noradrenaline (norepinephrine) reuptake. Tramadol's major active metabolite, O-desmethyltramadol (M1), shows higher affinity for the.mu.-opioid receptor and has at least twice the analgesic potency of the parent drug. Web site: http://www.delphion.com/details?pn=US06297286__
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Treatment of diarrhea Inventor(s): Casas; Ivan A. (Raleigh, NC), Mollstam; Bo (Lerum, SE) Assignee(s): Biogaia Biologics AB (stockholm, Se) Patent Number: 5,837,238 Date filed: June 5, 1996 Abstract: A therapeutic method of treating diarrhea of a patient, such as that caused by rotavirus in which a liquid suspension of one or more strains of Lactobacillus reuteni is administered to the patient. Preferably the L. reuteri is isolated from an animal of the same species as the animal to which the therapy is being given. Preferably at least about 10.sup.7 cells of L. reuteri, and most preferably, at least 10.sup.8 cells, are administrated per day, over a period of one to seven days, depending on the severity of the gastroenteritis. The result is a rapid, dramatic reduction in animal's diarrhea and vomiting, previously not found using other therapies.
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Excerpt(s): This invention relates to therapeutic treatment of infectious gastroenteritis. Normal microflora is important in the protection of the host against diseases of the gastrointestinal (GI) tract (Fuller, R., Gut 1991;32:439-42; Salminen, S. et al., Dig Dis Sci 1992;10:227-38). During periods of acute diarrhea, the normal gastrointestinal microflora is radically changed. These changes include decreasing numbers of Lactobacilli, Bacteroides and Bifidobacteria (Saiminen S. et al., Dig Dis Sci 1992;10:227-38; Tazume S. et al., Clin Infect Dis 1993;16(2 suppl):77-82S; Mitsuoka T., in Wood B J B, London:Elsevier Applied Science 1992, 1:69-114; Salminen S. et al., Chemotherapy, in press.). Lactobacillus reuteri is the most commonly occurring Lactobacillus species found in the GI tract of humans and animals (Kandler O. et al., Zbl Bakt Abt Orig 1980; C1:264-9). Like other Lactobacilli, L. reuteri produces acidic metabolic end-products (lactic and acetic acids) which have considerable antimicrobial activity (Axelson L. T. et al., Microb Ecology Health Dis 1989;2: 131-6). Use of L. reuteri cell therapy for other than probiotic purposes, i.e., benefitting the host by improving the indigenous microflora, or antibiotic purposes, is not known. Web site: http://www.delphion.com/details?pn=US05837238__ •
Use of orexin receptor antagonists Inventor(s): Irving; Elaine Alison (Bengeo, GB), Sanger; Gareth John (Sawbridgeworth, GB) Assignee(s): Smithkline Beecham P.l.c. (brentford, Gb) Patent Number: 6,506,774 Date filed: November 30, 2001 Abstract: The use of orexin receptor antagonists as neuroprotectants, and in the treatment of nausea and vomiting, irritable bowel syndrome and other conditions associated with visceral pain. Excerpt(s): The present invention relates to the use of orexin receptor antagonists as neuroprotectants, and in the treatment of nausea and vomiting, irritable bowel syndrome and other conditions associated with visceral pain. Many medically significant biological processes are mediated by proteins participating in signal transduction pathways that involve G-proteins and/or second messengers. Polypeptides and polynucleotides encoding the human 7-transmembrane G-protein coupled neuropeptide receptor, orexin-1 (HFGAN72), have been identified and are disclosed in U.S. Pat. Nos. 5,935,814, 6,020,157 and 6,410,701. Polypeptides and polynucleotides encoding a second human orexin receptor, orexin-2 (HFGANP), have been identified and are disclosed in U.S. Pat. No. 6,166,193. Web site: http://www.delphion.com/details?pn=US06506774__
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Wall mounted waste receptacle Inventor(s): Kizhnerman; Samuil (19 Blythe Pl., Staten Island, NY 10306) Assignee(s): None Reported Patent Number: 5,822,806 Date filed: April 4, 1997
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Abstract: A wall mounted waste receptacle including a housing having an enlarged opening extending into a hollow interior thereof mounted to a wall area at least four feet above a ground area. The hollow interior has an upper opening and a lower opening. The lower opening has a threaded pipe extending downwardly therefrom. A free end of the threaded pipe extends within an existing drain pipe. A water dispenser is coupled with the upper opening of the housing and with a water supply. The enlarged opening is dimensioned for a user's face to be placed therein for vomiting. The water dispenser will wash away the vomit. Excerpt(s): The present invention relates to a wall mounted waste receptacle and more particularly pertains to providing a convenient place for a person to vomit with a wall mounted waste receptacle. The use of wall mounted urinal is known in the prior art. More specifically, wall mounted urinal heretofore devised and utilized for the purpose of receiving urinary waste are known to consist basically of familiar, expected and obvious structural configurations, notwithstanding the myriad of designs encompassed by the crowded prior art which have been developed for the fulfillment of countless objectives and requirements. By way of example, U.S. Pat. No. 5,206,961 to Ruegg discloses a all-mounted urinal. Web site: http://www.delphion.com/details?pn=US05822806__
Patent Applications on Vomiting As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to vomiting: •
3-Azabicyclo[3.1.0]hexane derivatives useful in therapy Inventor(s): Banks, Bernard Joseph; (County of Kent, GB), Critcher, Douglas James; (County of Kent, GB), Fenwick, Ashley Edward; (County of Kent, GB), Gethin, David Morris; (County of Kent, GB), Gibson, Stephen Paul; (County of Kent, GB) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030207876 Date filed: April 8, 2002 Abstract: Compounds of formula I, 1where the substituents are as defined herein, and the pharmaceutically or veterinarily acceptable derivatives or prodrugs thereof, are pharmaceutically and veterinarily useful, in particular they bind to opiate receptors (e.g. mu, kappa and delta opioid receptors). They are likely to be useful in the treatment of diseases or conditions modulated by opiate receptors, for example irritable bowel syndrome; constipation; nausea; vomiting; pruritic dermatoses, such as allergic dermatitis and atopy; eating disorders; opiate overdoses; depression; smoking and alcohol addiction; sexual dysfunction; shock; stroke; spinal damage; and head trauma. Excerpt(s): This claims application claims priority under 35 U.S.C. 120 of U.S. Ser. No. 09/883,567, filed Jun. 18, 2001. This invention relates to pharmaceutically useful compounds, in particular compounds that bind to opiate receptors (e.g. mu, kappa and
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This has been a common practice outside the United States prior to December 2000.
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delta opioid receptors). Compounds that bind to such receptors are likely to be useful in the treatment of diseases modulated by opiate receptors, for example irritable bowel syndrome; constipation; nausea; vomiting; and pruritic dermatoses, such as allergic dermatitis and atopy in animals and humans. Compounds that bind to opiate receptors have also been indicated in the treatment of eating disorders, opiate overdoses, depression, smoking and alcohol addiction, sexual dysfunction, shock, stroke, spinal damage and head trauma. There is a particular need for an improved treatment of itching. Itching, or pruritus, is a common dermatological symptom that can give rise to considerable distress in both humans and animals. Pruritus is often associated with inflammatory skin diseases which may be caused by hypersensitivity reactions, including reactions to insect bites, such as flea bites, and to environmental allergens, such as house dust mite or pollen; by bacterial and fungal infections of the skin; or by ectoparasite infections. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Antiemetic, anti-motion sustained release drug delivery system Inventor(s): Drizen, Alan; (Downsview, CA), Nath, Gary M.; (Bethesda, MD) Correspondence: Nath & Associates Pllc; 6th Floor; 1030th 15th Street, N.W.; Washington; DC; 20005; US Patent Application Number: 20020172712 Date filed: March 19, 2001 Abstract: This invention relates to a stable, sterilized, purified composition having a polymer matrix and a therapeutically effective amount of a drug, wherein the drug can be used to prevent or treat drug-induced, alcohol-induced, biologically-induced, trauma-induced or pain-induced nausea, vomiting, dizziness and other adverse effects arising from but not limited to motion sickness, cancer therapy, and pregnancy. In particular, the polymer matrix may be conformable to topical application on animal skin. Excerpt(s): This invention relates to a dermal dressing for conformable topical application and sustained release of a polymer matrix containing a drug or combinations of drugs to animal skin. The drug can be any pharmaceutically effective amount useful for preventing and treating nausea, vomiting, dizziness and other adverse effects arising from but not limited to motion sickness, cancer therapy, and pregnancy in an animal. Over the years, methods have been developed to achieve the efficient delivery of a therapeutic drug to a mammalian body part requiring pharmaceutical treatment. Intravenous delivery and oral ingestion are two examples of current delivery techniques. While these techniques are generally effective, they suffer from several pharmacokinetic limitations and often result in substantial non-compliance by patients. For example, the therapeutic benefit from conventional methods often wear off within several hours after the initial dosing while the pain and discomfort associated with injections and intravenous lines often lead to difficulties in administration and maintenance of intravenous lines. Even oral administration can be ineffective where a patient cannot ingest due to nausea and/or vomiting. Topical administration of a pharmaceutically effective agent may avoid the problems associated with known drug delivery methods. One known method of topical administration uses an aqueous liquid that is applied at room temperature but forms a semi-solid gel when warmed to body temperature. This technique has the reported benefit of being easier to use and improving drug retention at the treatment site. For example, U.S. Pat. No. 4,188,373 uses
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PLURONIC.RTM. polyols in aqueous compositions to thermally gel aqueous systems. A sol-gel transition temperature is adjusted by varying the concentration of the polyols. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Anti-nausea and anti-vomiting activity of cannabidiol compounds Inventor(s): Breuer, Aviva; (Jerusalem, IL), Mechoulam, Raphael; (Jerusalem, IL), Parker, Linda; (Waterloo, CA) Correspondence: John R. Van Amsterdam, PH.D., ESQ.; 600 Atlantic Avenue; Boston; MA; 02210; US Patent Application Number: 20030225156 Date filed: February 19, 2003 Abstract: The present invention relates the use of certain cannabidiol derivatives and of their dimethyl heptyl homologs (CBD-DMH) in the treatment of nausea, in particular chemotherapy-induced nausea, and of anti vomiting activity. The present invention relates also to the use of said cannabidiol derivatives being part of a pharmaceutical composition. Excerpt(s): The present invention relates the use of certain cannabidiol derivatives and of their dimethyl heptyl homologs (CBD-DMH) in the treatment of nausea and of anti vomiting activity. c. a group --(CH.sub.2).sub.n--O-alkyl, where n is an integer from 1 to 7 and the alkyl group contains 1 to 5 carbon atoms, are antiiflammatory agents and have analgesic, antianxiety, anticonvulsive, neuroprotective, antipsychotic and anticancer activity. There are known many compounds being present in marihuana which have anti-nausea and anti-vomiting activity. However, many of them are psychoactive which is undesired for this purpose. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Aromatic and heteroaromatic substituted amides Inventor(s): Ballard, Theresa Maria; (Basle, CH), Hoffmann, Torsten; (Weil am Rhein, DE), Poli, Sonia Maria; (Basle, CH), Schnider, Patrick; (Oberwil, CH), Sleight, Andrew; (Riedisheim, FR) Correspondence: Hoffmann-la Roche INC.; Patent Law Department; 340 Kingsland Street; Nutley; NJ; 07110 Patent Application Number: 20030064983 Date filed: July 17, 2002 Abstract: The invention is the compounds2-(3,5-bis-trifluoromethyl-phenyl)-N-[6-(1,1dioxo-1.lambda.sup.6-thiomorpholin-4-yl)-4-o-tolyl-pyridin-3-yl]-N-methylisobutyramide and2-(3,5-bis-trifluoromethyl-phenyl)-N-[6-(1,1-dioxo-1.lambda.sup.6thiomor- pholin-4-yl)-4-(4-fluoro-2-methyl-phenyl)-pyridin-3-yl]-N-methyl-isobutyramide.Compounds of the invention are useful in pharmaceutical compositions for the treatment of migraine, rheumatoid arthritis, asthma, bronchial hyperreactivity, inflammatory bowel disease or for the treatment of disorders including Parkinson's disease, anxiety, depression, pain, headache, Alzheimer's disease, multiple sclerosis, edema, allergic rhinitis, Crohn's disease, ocular injury, ocular inflammatory diseases, psychosis, motion sickness, induced vomiting, emesis, urinary incontinence,
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psychoimmunologic or psychosomatic disorders, cancer, withdrawal symptoms of addictive drugs from opiates or nicotine, traumatic brain injury or benign prostatic hyperplasia. Excerpt(s): R.sup.1 is selected from the group consisting of hydrogen and fluoro. Compounds of formula 1, and pharmaceutically acceptable acid addition salts thereof, have been shown to mediate the Neurokinin 1 (NK-1, substance P) receptor. The neuropeptide receptor for substance P (NK-1) is widely distributed throughout the mammalian nervous system (especially brain and spinal ganglia), the circulatory system and peripheral tissues (especially the duodenum and jejunum) and are involved in regulating a number of diverse biological processes. The receptor for substance P is a member of the superfamily of G protein-coupled receptors. The central and peripheral actions of the mammalian tachykinin substance P have been associated with numerous inflammatory conditions including migraine, rheumatoid arthritis, asthma, and inflammatory bowel disease as well as mediation of the emetic reflex and the modulation of central nervous system (CNS) disorders such as Parkinson's disease (Neurosci. Res., 1996, 7, 187-214), anxiety (Can. J. Phys., 1997, 75, 612-621) and depression (Science, 1998, 281, 1640-1645). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Carbamic acid derivatives Inventor(s): Bleicher, Konrad; (Freiburg, DE), Mutel, Vincent; (Mulhouse, FR), Vieira, Eric; (Allschwil, CH), Wichmann, Jurgen; (Steinen, DE), Woltering, Thomas Johannes; (Weil am Rhein, DE) Correspondence: Hoffmann-la Roche INC.; Patent Law Department; 340 Kingsland Street; Nutley; NJ; 07110 Patent Application Number: 20020091150 Date filed: December 10, 2001 Abstract: The present invention is a compound of formula 1wherein R.sup.1, R.sup.2, R.sup.2', X, A.sup.1/A.sup.2 and B are as defined in the specification.These compounds may be used in the control or prevention of acute and/or chronic neurological disorders such as restricted brain function caused by bypass operations or transplants, poor blood supply to the brain, spinal cord injuries, head injuries, hypoxia caused by pregnancy, cardiac arrest, hypoglycaemia, Alzheimer's disease, Huntington's chorea, ALS, dementia caused by AIDS, eye injuries, retinopathy, cognitive disorders, memory deficits, schizophrenia, idiopathic parkinsonism or parkinsonism caused by medicaments as well as conditions which lead to glutamate deficiency functions, such as e.g. muscle spasms, convulsions, migraine, urinary incontinence, nicotine addiction, psychoses, opiate addiction, anxiety, vomiting, acute and chronic pain, dyskinesia and depression. Excerpt(s): This application is a divisional application of U.S. patent application Ser. No. 09/545,622, filed Apr. 10, 2000. In the central nervous system (CNS) the transmission of stimuli takes place by the interaction of a neurotransmitter, which is sent out by a neuron, with a neuroreceptor. L-glutamic acid, the most commonly occurring neurotransmitter in the CNS, plays a critical role in a large number of physiological processes. The glutamate-dependent stimulus receptors are divided into two main groups. The first main group forms ligand-controlled ion channels. The metabotropic glutamate receptors (mGluR) belong to the second main group and, furthermore, belong to the family of G-protein-coupled receptors.
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Compositions and methods for enhancing analgesic potency of tramadol and attenuating its adverse side effects Inventor(s): Barbier, Remi; (San Francisco, CA), Crain, Stanley M.; (State College, PA), Friedmann, Nadav; (Lafayette, CA), Remien, Mary; (San Francisco, CA), Shen, Ke-Fei; (Flushing, NY), Sherman, Barry; (Hillsborough, CA) Correspondence: Mcandrews Held & Malloy, Ltd; 500 West Madison Street; Suite 3400; Chicago; IL; 60661 Patent Application Number: 20030148941 Date filed: March 12, 2002 Abstract: The invention generally relates to compositions and methods with tramadol and an opioid antagonist to enhance analgesic potency and/or attenuate one or more adverse effects of tramadol, including adverse side effect(s) in humans such as nausea, vomiting, dizziness, headache, sedation (somnolence) or pruritis. This invention relates to compositions and methods for selectively enhancing the analgesic potency of tramadol and simultaneously attenuating anti-analgesia, hyperalgesia, hyperexcitability, physical dependence and/or tolerance effects associated with the administration of tramadol. The methods of the present invention comprise administering to a subject an analgesic or subanalgesic amount of tramadol and an amount of excitatory opioid receptor antagonist such as naltrexone or nalmefene effective to enhance the analgesic potency of tramadol and attenuate the anti-analgesia, hyperalgesia, hyperexcitability, physical dependence and/or tolerance effects of tramadol. Excerpt(s): This is a continuation-in-part of co-pending application Ser. No. 09/306,164 filed May 6, 1999, the content of which is hereby incorporated by reference in its entirety. Morphine or other bimodally-acting opioid agonists are administered to relieve severe pain due to the fact that they have analgesic effects mediated by their activation of inhibitory opioid receptors on nociceptive neurons (see North, Trends Neurosci., Vol. 9, pp. 114-117 (1986) and Crain and Shen, Trends Pharmacol. Sci., Vol. 11, pp. 77-81 (1990)). However, morphine and other bimodally-acting opioid agonists also activate opioid excitatory receptors on nociceptive neurons, which attenuate the analgesic potency of the opioids and result in the development of physical dependence and increased tolerance (see Shen and Crain, Brain Res., Vol. 597, pp. 74-83 (1992)), as well as hyperexcitability, hyperalgesia and other undesirable (excitatory) side effects. As a result, a long-standing need has existed to develop a method of both enhancing the analgesic (inhibitory) effects of bimodally-acting opioid agonists and blocking or preventing undesirable (excitatory) side effects caused by such opioid agonists. Tramadol is an orally active, clinically effective, centrally acting analgene compound with opioid and non-opioid activity. This synthetic analgesic has a novel mechanism of action involving a complementary and synergistic interaction between inhibition of neuronal monamine uptake and weak affinity for opioid receptors (Raffa et al., Rev. Contemp. Pharmacother. 6:485-497 (1995)). Tramadol is generally well tolerated, with dizziness, nausea, constipation, headache, somnolence (sedation), vomiting, pruritis, CNS stimulation, sezures, asthenia, dyspepsia, diarrhea, dry mouth and/or sweating as adverse side effects. Respiratory depression is uncommon (Lee et al., Drugs 46: 313-340 (1993); Vickers et al., Anaesthesia 47: 291-296 (1992)). Tramadol is marketed in the United States as ULTRAM.RTM. Data from a double-blind, crossover study suggest that oral tramadol 120 mg is equipotent to oral morphine 30 mg (Wilder et al., Ann. Oncol. 5:
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141-146 (1994)). A need thus exists for compositions and methods that could enhance the analgesic potency of tramadol and/or block or prevent its adverse side effects, particularly its principal adverse effects in humans. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Compositions and Methods for Reducing Respiratory Depression and Attendant SIde Effects of Mu Opioid Compounds Inventor(s): Bishop , Michael J.; ( Durham, NC), Chang , Kwen-Jen; ( Chapel Hill, NC), McNutt , Robert W. Jr.; ( Durham, NC), Pettit , Hugh O.; ( Cary, NC) Correspondence: Steven J. Hultquist; Marianne Fuierer; 6320 Quadrangle, Suite 110; Chapel Hill; NC; 27517; US Patent Application Number: 20020111359 Date filed: October 9, 2001 Abstract: A method of reducing, treating or preventing drug-mediated respiratory depression, muscle rigidity, or nausea/vomiting in an animal, incident to the administration to said animal of a mixed delta/mu opioid agonist or a respiratory depression-mediating drug, comprising administering to the animal receiving said drug an effective amount of a delta receptor agonist compound. Preferred examples of such delta receptor agonist compound include diarylmethyl piperazine compounds and diarylmethyl piperidine compounds, and pharmaceutical compositions thereof, having utility in medical therapy for reducing respiratory depression associated with certain analgesics, such as mu opiates. Excerpt(s): This is a divisional application of United States patent application no. 09/352,308 filed July 12, 1999 and issued October 9, 2001 as U.S. Patent 6,300,332, which claims priority to United States patent application 08/887,312 filed July 3, 1997, which is a continuation-in-part of United States patent application no. 08/658,726, filed June 5, 1996. The disclosures of the following applications are hereby incorporated herein by reference in their entirety: United States patent application no. 08/658,726 filed June 5, 1996; United States patent application no. 08/169,879 filed December 17, 1993; United States patent application no. 08/098,333 filed July 30, 1993; United States patent application no. 08/430,677 filed April 28, 1995; International Patent Application no. PCT/GB93/00216 filed February 2, 1993; Great Britain patent application 9202238.3 filed 3 February 1992; and all applications from which they claim priority, or from which priority is claimed. This invention relates generally to methods for reducing, treating, reversing or preventing drug-mediated respiratory depression, such as may be directly or indirectly caused by use of various bioactive compositions, including anaesthetics, barbiturates, analgesics, etc. The invention further relates to diarylmethyl piperazine compounds and diarylmethyl piperidine compounds, and pharmaceutical compositions thereof, having utility in medical therapy especially for reducing respiratory depression associated with certain analgesics, such as mu opiates. This invention additionally relates to diarylmethyl piperazine compounds and diarylmethyl piperidine compounds having utility in assays for determining the respiratory reducing characteristics of other bioactive compounds, including other diarylmethyl piperazine compounds and other diarylmethyl piperidine compounds. In the study of opioid biochemistry, a variety of endogenous opioid compounds and non-endogenous opioid compounds has been identified. In this effort, significant research has been focused on understanding the mechanism of opioid drug action, particularly as it relates to cellular and differentiated tissue opiate receptors.
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Co-therapy for the treatment of migraine comprising anticonvulsant derivatives and anti-migraine agents Inventor(s): Livingstone, Ian R.; (Princeton, NJ) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030225002 Date filed: February 25, 2003 Abstract: The present invention describes a method for the treatment and/or prevention of migraine and associated symptoms (nausea, vomiting, photophobia, phonophobia, etc.) comprising co-therapy with a therapeutically effective amount of one or more antimigraine agents and one or more anticonvulsant derivatives. Excerpt(s): This application claims the benefit of U.S. Provisional Application 60/359,894, filed on Feb. 26, 2002, which is incorporated by reference herein in its entirety. Migraine is a chronic, episodic and debilitating clinical condition that is diagnosed by the presence of moderate to severe pulsating unilateral headaches lasting between 4 and 72 h. Additionally, the headache is sometimes associated with temporary sensory (photophobia and phonophobia) and/or gastrointestinal (nausea, vomiting) disturbances. Migraine headaches can present without or with aura. Migraine without aura is defined by at least five attacks fulfilling the following criteria: (a) the headache attacks lasting 4-72 hours with the headache having at least two of the following features: unilateral location, pulsating quality, moderate or severe intensity with a direct influence on activities of daily living, and aggravation by walking up stairs or similar routines; (b) during the headache at least one of the following occurs: nausea and/or vomiting, photophobia or phonophobia (Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia 1988;8 Suppl 7:1-96). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Disposable personal urinal with heat-sealed anti-backflow tri-valve and folded-in edge mouth Inventor(s): Sun, Robert; (Fremont, CA) Correspondence: Robert Sun; 2900 Sanderling DR.; Fremont; CA; 94555; US Patent Application Number: 20040064112 Date filed: September 27, 2002 Abstract: A collection device for human bodily fluids includes a conventional bag constructed of a soft plastic, waterproof material. The bag consists of a hard plastic supporting mouth, proper volume of hydrophilic material such as polymer and a heatsealed anti-backflow tri-valve in the interior of a front trunk portion of the bag. The supporting mouth is located as to cover the genitourinary area or mouth of an individual in use for urinal or vomiting purposes. This hydrophilic material allows quick absorption of human fluids and turns it into a gelled material. The gelled material is then trapped inside the heat-sealed tri-valve bag to prevent possible spillage and
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backflow. The versatility of the heat-sealed funnel design bag helps the direct engagement with the hydrophilic material to speed up absorption time with the human fluid and preventing spillage or backflow. It also simplifies the manufacturing process and reduces overall production costs. Excerpt(s): This invention relates to a method of producing a low-cost and versatile human bodily fluid collection device serving as a car sick storage bag or a portable urinal, it is excellent in its ease of use for men and women, and more particularly to a portable urinal provided with a folded-in edge mouth element so located as to cover the mouth or genitourinary area of the user and for the prevention of accident spillage or backflow. This device encloses a proper volume of hydrophilic powder or granular material for absorbing the fluid. This hydrophilic powder or granule serves the purpose of absorbing any incoming fluid to the device and turns them into an expanding pile of soft gel. A tri-valve heated seal urine bag constructed of a waterproof material serves to prevent the hydrophilic material from leaking out of the collection device. The improvement of this invention is directed to the conventional urine bag as disclosed in U.S. Pat. No. 5,007,116. The conventional urine bag has a urine impermeable bag body made of a soft plastic, a support made of a hard plastic, and an absorbing pouch made of an absorbent material which can absorb urine. The bag body has an accommodating chamber and an open upper end hot sealed on the support. The support has a central hole formed therethrough and is communicated with the accommodating chamber. The absorbing body is received in the accommodating chamber of the bag body. (a) Because the urine bag contains a pouch which is constructed of a water-permeable material that is filled with a water-absorbing agent which is swollen with urine to form a gel when it is brought into contact with said urine to absorb the same, said pouch being broken into fragments when said water-absorbing agent is swollen with said urine, this process will slow down the overall absorbent time in comparison to the direct engagement with the water absorbent agent, said hydrophilic material. Furthermore, it is cost effective to omit the pouch inside the urine bag, which would also substantially increase the efficiency of the manufacturing process and cut down the overall production cost. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Efficacious dosage regimen of galantamine that reduces side effects Inventor(s): Parys, Wim Louis Julien; (Gaithersburg, MD), Pontecorvo, Michael; (Lawrenceville, NJ) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030139391 Date filed: October 3, 2002 Abstract: Galantamine has be used in the treatment of a number of chronic diseases. The use of this drug is associated with side effects such as, nausea or vomiting, and headaches. It has been demonstrated that by slowly introducing the patient to the drug these side effects can be reduced. It has also been shown that this slower titration results in the ability to use a lower effective dose of the drug. Excerpt(s): The present invention relates to a slower titration regimen that results in a safe and effective use of galantamine at from about 16 mg/day to about 24 mg/day for the treatment of galantamine responsive conditions, with improved tolerability of the drug. Galantamine is a reversible cholinesterase inhibitor that can be isolated from a
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number of different plant sources, including daffodil bulbs. Galantamine interacts competitively with the enzyme, acetylcholinesterase, and demonstrates a 10 to 50 fold selectivity for acetyl vs. butyryl cholinesterase. Galantamine has been used for the treatment of a number of chronic diseases, where life-long treatment may be necessary. Galantamine has been shown to be effective in the treatment of arthritic disorders (Canadian Patent application 2,251,114); fatigue syndromes (Canadian Patent application 2,108,880); mania (Canadian Patent application 2,062,094);schizophrenia (Canadian Patent application 2,108,880); memory dysfunction, including Alzheimer's Disease (U.S. Pat. No. 4,663,318); alcoholism (Canadian Patent 2,039,197); nicotine dependence (Canadian Patent application 2,153,570); disorders of attention (PCT published application WO 99/21561) and jet lag (Canadian Patent application 2,193,473). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Extended release formulation Inventor(s): Clark, John C.; (Peru, NY), Lamer, John U.; (St. Albans, VT), Sherman, Deborah M.; (Plattsburgh, NY), White, Stephen A.; (Champlain, NY) Correspondence: Wyeth; Patent Law Group; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20020197307 Date filed: May 21, 2002 Abstract: This invention relates to a 24 hour extended release dosage formulation and unit dosage form thereof of venlafaxine hydrochloride, an antidepressant, which provides better control of blood plasma levels than conventional tablet formulations which must be administered two or more times a day and further provides a lower incidence of nausea and vomiting than the conventional tablets. More particularly, the invention comprises an extended release formulation of venlafaxine hydrochloride comprising a therapeutically effective amount of venlafaxine hydrochloride in spheroids comprised of venlafaxine hydrochloride, microcrystalline cellulose and, optionally, hydroxypropylmethylcellulose coated with a mixture of ethyl cellulose and hydroxypropylmethylcellulose. Excerpt(s): This application continuation-in-part of application Ser. No. 08/964,328, filed Nov. 5, 1997, which is a continuation-in-part of copending application Ser. No. 08/821,137, filed Mar. 20, 1997, which, in turn, claims priority from Provisional Application No. 60/014,006 filed Mar. 25, 1996. Extended release drug formulations are conventionally produced as compressed tablets by hydrogel tablet technology. To produce these sustained release tablet drug dosage forms, the active ingredient is conventionally compounded with cellulose ethers such as methyl cellulose, ethyl cellulose or hydroxypropylmethylcellulose with or without other excipients and the resulting mixture is pressed into tablets. When the tablets are orally administered, the cellulose ethers in the tablets swell upon hydration from moisture in the digestive system, thereby limiting exposure of the active ingredient to moisture. As the cellulose ethers are gradually leached away by moisture, water more deeply penetrates the gel matrix and the active ingredient slowly dissolves and diffuses through the gel, making it available for absorption by the body. An example of such a sustained release dosage form of the analgesic/anti-inflammatory drug etodolac (Lodine.RTM.) appears in U.S. Pat. No. 4,966,768. U.S. Pat. No. 4,389,393 discloses sustained release therapeutic compressed solid unit dose forms of an active ingredient plus a carrier base comprised of a high molecular weight hydroxypropyhnethylcellulose, methyl cellulose, sodium
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carboxymethylcellulose and or other cellulose ether. Where the production of tablets is not feasible, it is conventional in the drug industry to prepare encapsulated drug formulations which provide extended or sustained release properties. In this situation, the extended release capsule dosage forms may be formulated by mixing the drug with one or more binding agents to form a uniform mixture which is then moistened with water or a solvent such as ethanol to form an extrudable plastic mass from which small diameter, typically 1 mm, cylinders of drug/matrix are extruded, broken into appropriate lengths and transformed into spheroids using standard spheronization equipment. The spheroids, after drying, may then be film-coated to retard dissolution. The film-coated spheroids may then be placed in pharmaceutically acceptable capsules, such as starch or gelatin capsules, in the quantity needed to obtain the desired therapeutic effect. Spheroids releasing the drug at different rates may be combined in a capsule to obtain desired release rates and blood levels. U.S. Pat. No. 4,138,475 discloses a sustained release pharmaceutical composition consisting of a hard gelatin capsule filled with film-coated spheroids comprised of propanolol in admixture with microcrystalline cellulose wherein the film coating is composed of ethyl cellulose, optionally, with hydroxypropylmethylcellulose and/or a plasticizer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Fentanyl composition for nasal administration Inventor(s): Grarup, Jesper; (Roskilde, DK), Nielsen, Hanne Wulf; (Svenborg, DK) Correspondence: Wenderoth, Lind & Ponack, L.L.P.; 2033 K Street N. W.; Suite 800; Washington; DC; 20006-1021; US Patent Application Number: 20040034059 Date filed: July 14, 2003 Abstract: The treatment of acute pain with a sufficient dosage by intranasal administration of fentanyl results in a time to onset of action comparable to intravenous administration and a significantly faster onset of action than nasal titration of fentanyl. The nasal administration of a sufficient amount of fentanyl to obtain pain relief has lower maximum plasma concentrations comparable to intravenous administration and results in lower rates of adverse events like respiratory depression, nausea and vomiting. Compositions fur use in the method are also disclosed. Excerpt(s): The present invention relates to a pharmaceutical composition for use in the treatment of acute pain such as breakthrough pain by means of a non-invasive administration of fentanyl or a pharmaceutically acceptable salt thereof, said composition being such that at least 70.mu.g of fentanyl is delivered in a dosage unit. The method comprises administration of a treatment dosage sufficient to treat the acute pain with time to onset of action comparable to intravenous administration. The treatment typically comprises intranasal administration of a relatively concentrated composition of fentanyl citrate. In addition, the invention relates to a pharmaceutical kit comprising a treatment dosage of fentanyl for nasal administration for treatment of acute pain together with a delivery system of an analgesic for a continuous treatment of chronic pain. Fentanyl is a potent narcotic analgesic with pharmacological effects similar to morphine. Fentanyl is 50 to 100 times more potent than morphine on a weight basis. Fentanyl is a mu-receptor agonist acting on receptors distributed in the brain, spinal cord and other tissues. Opioids produce both analgesia and sedation. Opiate agonists appear to prevent the release of beta-endorphin, possibly by altering the patients perceived level of pain and anxiety, although the presence of pain may still be
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recognised (1). Parenteral fentanyl is indicated for anaesthesia, treating postoperative pain, and as a premedicant. Transdermal fentanyl is used for managing chronic pain in patients requiring opioids. Fentanyl lozenge/sucker (Oralet.RTM.) is indicated to induce anxiolysis and analgesia prior to surgery in pediatric and adult patients. Oral transmucosal fentanyl (Actiq.RTM.) is indicated for the management of breakthrough cancer pain in adults with malignancies who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. Fentanyl Oralet.RTM. is only indicated for use in a hospital setting as an anaesthetic pre-medication in the operating room setting or to induce conscious sedation prior to a diagnostic or therapeutic procedure in other monitored anaesthesia care settings in the hospital. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Galenical preparations of dapsone and related sulphones, and method of therapeutic and preventative treatment of disease Inventor(s): Aberg, A K Gunnar; (Sarasota, FL), Bain, Allen I; (Vancouver, CA), Zolotoy, Alexander; (Richmond, CA) Correspondence: Kevin S Lemack; Neilds & Lemack; 176 E Main Street; Westboro; MA; 01581; US Patent Application Number: 20030092635 Date filed: August 26, 2002 Abstract: Dapsone and related sulfones are known to have therapeutic activity against leprosy, dermatitis herpetiformis, actinomycotic mycetoma, asthma, malaria, rheumatoid arthritis, Kaposis sarcoma, pneumocystis carini (pneumonia), subcorneal pustular dermatosis and cystic acne, in patients in need of such therapy. These sulfones are also known to have therapeutic activity against memory loss in patients in need of such therapy, including patients suffering from Alzheimer's disease and related neurodegenerative disorders. It has now been found that new, modified-release formulations of dapsone and related sulfones may also be used that decrease side effects and increase effectiveness of the drugs. New methods are disclosed utilizing certain formulations of dapsone and related sulfones that improve the therapeutic index of said drugs. Side effects of these drugs are known to those skilled in the art and include, but are not restricted to anorexia, psychosis, agranulocytosis, peripheral neuritis, hemolysis, methemoglobinemia, nausea, vomiting, headache, dizziness, tachycardia, nervousness, insomnia and skin disorders. Modified-release (as defined herein) formulations of dapsone have now been found to avoid some or all of these side effects, and to have more efficacy on potency. Excerpt(s): The object of the present invention pertains to a method of treating or preventing certain diseases in a human being while increasing compliance, reducing side effects and improving efficacy of the active therapeutic ingredient(s) within a large therapeutic range. The method comprises the use of modified-release dosage formulations of sulfone compounds including 4,4'-diaminodiphenylsulfone, its didextrose sulfonate derivative(s), their analogs, metabolites, any enantiomers, any diasteriomers, or mixtures thereof and/or therapeutically acceptable salts thereof. Dapsone is an active substance that is known in the treatment of various infectious diseases and inflammatory conditions. There is a wealth of data and experimental studies regarding the activity of dapsone and related sulfones. In particular, there is a large amount of data regarding the bioavailability and pharmacokinetics of the drug. It is also known in the prior art that dapsone has therapeutic activity against leprosy,
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dermatitis herpetiformis, actinomycotic mycetoma, asthma, malaria, rheumatoid arthritis, Kaposis sarcoma, pneumocystis carinii (pneumonia), subcorneal pustular dermatosis and cystic acne, in patients in need of such therapy. However, since the acute or chronic toxicity of dapsone is unacceptable at the doses necessary to treat most diseases, it is not possible to use this compound for these indications in the presently available formulation(s). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Intravaginal mucosal or transmucosal delivery of antimigraine and antinausea drugs Inventor(s): Pauletti, Giovanni M.; (Loveland, OH), Ritschel, Wolfgang A.; (Cincinnati, OH), Soderstrom, Richard; (Seattle, WA) Correspondence: Hana Verny; Peters, Verny, Jones & Schmitt, Llp; Suite 6; 385 Sherman Avenue; Palo Alto; CA; 94306; US Patent Application Number: 20040043071 Date filed: June 20, 2003 Abstract: A method, composition and device for intravaginal mucosal or transmucosal delivery of antimigraine and/or antinausea drugs to a female subject for treatment of migraine and other diseases accompanied by or associated with nausea and vomiting. A mucoadhesive composition comprising antimigraine or antinausea drugs, mucoadhesive agent, penetration enhancer or sorption promoter and a hydrophilic or lipophilic carries. An intravaginal device for delivery of antimigraine or antinausea drugs. Excerpt(s): This application is based on and claims priority of the Provisional Application Ser. No. 60/390,748 filed on Jun. 21, 2002. The present invention concerns a method, composition and device for intravaginal mucosal or transmucosal delivery of antimigraine and/or antinausea drugs to a female subject for treatment of migraine and other diseases accompanied by or associated with nausea and vomiting. In particular, the invention concerns a method, composition, and device for mucosal delivery of antimigraine and/or antinausea drugs to the vagina for topical vaginal treatment or for transmucosal delivery of these drugs into the systemic blood circulation for systemic therapy using a mucoadhesive composition comprising these drugs. The composition is administered directly or incorporated into an intravaginal device. The mucoadhesive composition of the invention or intravaginal device incorporated with said composition delivers the antimigraine and/or antinausea drug into the vagina, provides a continuous contact with the vaginal mucosa, releases the therapeutic agent from the formulation in timely fashion and at controllable quantities, and delivers the drugs transmucosally across the vaginal epithelial barrier into the systemic circulation. The mucoadhesive composition adheres to the vaginal mucosa and promotes topical adhesion of the drug released from said composition to the vaginal mucosa and further promotes delivery of the drug transmucosally through the vaginal mucosa and wall to the systemic circulation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Methods of screening for agonists and agonists of the interaction between the AXOR8 and AXOR52 receptors and ligands thereof Inventor(s): Ames, Robert S. JR.; (Haverford, PA), Foley, James J.; (Radnor, PA), McNulty, Dean E.; (Philadelphia, PA), Sarau, Henry M.; (Harleysville, PA), Slemmon, J. Randall; (Glenview, IL), Vawter, Lisa; (Coopersburg, PA) Correspondence: Smithkline Beecham Corporation; Corporate Intellectual Property-us, Uw2220; P. O. Box 1539; King OF Prussia; PA; 19406-0939; US Patent Application Number: 20030059856 Date filed: April 25, 2002 Abstract: Disclosed are methods for discovering agonists and antagonists of the interaction between monkey AXOR8, human AXOR8, and human AXOR52 receptors with their natural ligands: human BV8-a, mouse BV8-a, frog BV8, human BV8-b, human PRO1186, human PRO1186 variant, and mamba intestinal toxin (herein "MIT"). Such agonists or antagonists can be used in the treatment of several human diseases and disorders, including, but not limited to: bacterial, fungal, protozoan and viral infections, particularly infections caused by HIV-1 or HIV-2; pain; cancers; diabetes, obesity; anorexia; bulimia; asthma; Parkinson's disease; acute heart failure; hypotension; hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; stroke; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic and neurological disorders, including anxiety, schizophrenia, manic depression, depression, delirium, dementia, and severe mental retardation; and dyskinesias, such as Huntington's disease or Gilles dela Tourett's syndrome. Excerpt(s): This application claims benefit to the earlier provisional U.S. Application No. 60/286,234, filed on Apr. 25, 2001, the contents of which are incorporated herein by reference in their entirety. This invention relates to methods for discovering agonists and antagonists of the interaction between the monkey AXOR8, human AXOR8, and human AXOR52 receptors and their natural ligands. The invention also relates to the use of the identified agonists, antagonists and/or inhibitors, which are potentially useful in the treatment of human diseases/disorders, including, but not limited to: infections such as bacterial, fungal, protozoan and viral infections, particularly infections such as bacterial, fungal, protozoan and viral infections, particularly infections caused by HIV-1 or HIV-2; pain; cancers; diabetes, obesity; anorexia; bulimia; asthma; Parkinson's disease; acute heart failure; hypotension; hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; stroke; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic and neurological disorders, including anxiety, schizophrenia, manic depression, depression, delirium, dementia, and severe mental retardation; and dyskinesias, such as Huntington's disease or Gilles dela Tourett's syndrome. It is well established that many medically significant biological processes are mediated by proteins participating in signal transduction pathways that involve G-proteins and/or second messengers, e.g., cAMP (Lefkowitz, Nature, 1991, 351:353-354). Herein these proteins are referred to as proteins participating in pathways with G-proteins or PPG proteins. Some examples of these proteins include the G-protein coupled (GPC) receptors, such as those for adrenergic agents and dopamine (Kobilka, B. K., et al., Proc. Natl Acad Sci., USA, 1987, 84:46-50; Kobilka, B. K., et al., Science, 1987, 238:650-656; Bunzow, J. R., et al, Nature, 1988, 336:783-787), G-proteins themselves, effector proteins, e.g., phospholipase C, adenyl cyclase, and phosphodiesterase, and actuator proteins, e.g., protein kinase A and protein kinase C (Simon, M. I., et al., Science, 1991, 252:802-8).
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Novel arginine/ascorbic acid mixed powder as an oral supplement Inventor(s): Kimoto, Eiji; (Jonan-ku, JP), Morishige, Fukumi; (Sanbu-gun, JP) Correspondence: Oliff & Berridge, Plc; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20020091156 Date filed: November 13, 2001 Abstract: A mixture obtained by mixing ascorbic acid powder with arginine powder in a weight ratio (ascorbic acid/arginine) of 1/5 to 20, especially 1/5 to 1/4; and a supplement such as a nutrient preparation and a health-care food containing the mixture. Mixing of arginine powder and ascorbic acid powder in the weight ratios eliminates stringent taste specific to arginine and alleviates stringent feeling in the stomach (heartburn, nausea or vomiting) after oral intake thereof. The mixture prevents also peroxidative injuries of cells caused by an administration of a great amount of arginine alone. Further, mixing of arginine powder with ascorbic acid powder prevents browning of the mixture after long-term storage. Excerpt(s): The present invention relates to a method for eliminating the stringent taste and alleviating stringent feeling in the stomach of L-arginine (hereinafter referred to as arginine) by mixing L-ascorbic acid (hereinafter referred to as ascorbic acid) and for alleviating the toxicity of arginine-derived NO radical by arginine-ascorbic acidcombined treatment. From late 1970's to 1980's, a research group of Illinois University reevaluated that dietary arginine is indispensable for optimal health of adult and especially aged humans. (see E. Kimoto, "Nutritional Chemistry of L-Arginine", Kaisei Publishing Co. Ltd., Tokyo, 1999 (Literature 2), page 93). In 1987, it was reported that NO radical participating in a wide variety of physiological functions such as blood pressure control and prevention of infections is derived from arginine as a source. This led to increased attention paid to arginine in the field of amino acid nutrition science (see Literature 2, page 57). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Novel crystal forms of ondansetron, processes for their preparation, pharmaceutical compositions containing the novel forms and methods for treating nausea using them Inventor(s): Aronhime, Judith; (Rehovot, IL), Meszaros Sos, Erzsebet; (Debrecen, HU), Molnar, Sandor; (Debrecen, HU), Salyi, Szabolcs; (Debrecen, HU), Szabo, Csaba; (Debrecen, HU), Tamas, Tivadar; (Debrecen, HU) Correspondence: Kenyon & Kenyon; One Broadway; New York; NY; 10004; US Patent Application Number: 20040019093 Date filed: April 29, 2003 Abstract: Ondansetron crystalline Forms A and B are useful in the treatment of nausea and vomiting. Form B has a uniquely high melting point of about 244.degree. C. and both forms are stable against thermally induced polymorphic transition from 30.degree. C. up to their melting points. Excerpt(s): This application claims the benefit under 35 U.S.C.sctn.1.119(e) of Provisional Application Serial No. 60/376,395, filed Apr. 30, 2002, and is incorporated herein by
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reference. The present invention relates to (.+-.) 1,2,3,9-tetrahydro-9-methyl- -3-[2methyl-1h-imidazol-1-yl)methyl]-4h-carbazol-4-one (ondansetron). More particularly, it relates to a newly discovered high melting crystalline form of ondansetron, to a second newly discovered crystalline form, to processes for producing the new forms, to pharmaceutical compositions containing them and methods of treating nausea and vomiting using them. and formula C.sub.18H.sub.19N.sub.3O is a selective 5-HT.sub.3 receptor antagonist. It is a nitrogen-containing compound capable of existence in free base and salt forms. The free base is known by the generic name ondansetron. Ondansetron is useful for reducing nausea in patients undergoing chemotherapy. Grunberg, S. M.; Hesketh, P.J. "Control of Chemotherapy-Induced Emesis" N. Engl. J. Med. 1993, 329, 1790-96. It is approved by the United States Food and Drug Administration for prophylactic treatment of nausea and vomiting associated with some cancer chemotherapy, radiotherapy and postoperative nausea and/or vomiting. Ondansetron is commercially available in orally disintegrating tablets under the trade name Zofran.RTM. ODT. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Oral pediatric trimethobenzamide formulations and methods Inventor(s): Bruns, Robert G.; (Johnson City, TN), Cirotta, Dean R.; (Webster, NY), Gregory, Jefferson J.; (Bristol, TN), Pamplin, Charles L. III; (Chapel Hill, NC), Rogers, Thomas K. III; (Bristol, TN) Correspondence: Edwards & Angell, Llp; P.O. Box 9169; Boston; MA; 02209; US Patent Application Number: 20040034102 Date filed: February 6, 2003 Abstract: Oral pediatric trimethobenzamide compositions and methods for treating and controlling nausea and/or vomiting are disclosed in warm blooded animals, especially humans including children. The oral pediatric trimethobenzamide compositions and methods of the present invention are believed to be at least as effective as a 200 mg intramuscular (I.M.) trimethobenzamide HCl injectable formulation when administered at a dose of about 100 mg. In addition, an oral pediatric composition containing about 120 mg of trimethobenzamide HCl is believed to be uniquely approximately bioequivalent to a 200 mg intramuscular (I.M.) trimethobenzamide HCl injectable formulation when administered at a dose of about 100 mg. Excerpt(s): This application for U.S. patent is filed as a provisional application under U.S.C., Title 35,.sctn.111(b). The present invention is concerned with oral pediatric trimethobenzamide compositions and methods useful for treating and controlling nausea and/or vomiting or emesis in warm-blooded animals, especially children. The process of nausea and vomiting is regulated by the chemoreceptor trigger zone ("CTZ") which is located in the vomiting center. The vomiting center is located in the medulla. The chemoreceptor trigger zone is the primary trigger for emesis. Because the chemoreceptor trigger zone must first stimulate the vomiting center to induce emesis, the chemoreceptor trigger zone, by itself, cannot induce vomiting. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Patient activated mouth moisturizer Inventor(s): Conway, Patrick J.; (Annapolis, MD) Correspondence: Fisher, Christen & Sabol; 1725 K Street, N.W.; Suite 1108; Washington; DC; 20006; US Patent Application Number: 20030116158 Date filed: January 29, 2003 Abstract: A patient recovering from major surgery often suffers from cracked lips and parched palate. The patient usually frequently contacts the nursing staff and requests that they provide the patient with cool water and/or cracked ice. The amount of water and/or cracked ice which the patient can have has to be very limited in order to prevent debilitating vomiting by the patient. The patient's discomfort and suffering is greatly reduced by the mouth moisturizer which via an atomizer supplies a controlled amount of water mist to the lips and palate of the patient. Also, the nurses have more time to devote to their other duties. Excerpt(s): This application has benefit of U.S. Provisional Application Serial No. 60/224,509, filed on Aug. 14, 2000. The invention relates to patient activated mouth moisturizer systems and methods of using such systems. so-called major surgery, often involves difficulties, discomfort and problems for a patient. From the patient's point of view, one of the most difficult experiences connected to major surgery is the occurrence of cracked lips and parched palate that goes on for several days after surgery. Normally the patient is allowed only very limited amounts of water or cracked ice in order to prevent vomiting or so-called "dry heaving" by the patient. Vomiting can cause serious stress on the body and other problems to the patient. The patient very often suffers substantially from being given only the small amounts of water or cracked ice. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Pharmaceutical compositions for headache, migraine, nausea and emesis Inventor(s): Barkan, Raphael; (Zion, IL), Mirimsky, Alexander; (Rehovot, IL) Correspondence: Winston & Strawn; Patent Department; 1400 L Street, N.W.; Washington; DC; 20005-3502; US Patent Application Number: 20040006044 Date filed: March 5, 2003 Abstract: S-alkylsiothiouronium derivatives such as S-ethylisothiouronium diethylphosphate are used for the treatment of headaches, in particular, migraines, as well as for the prevention or treatment of nausea and vomiting. The compositions of the invention are also effective in preventing or alleviating emesis associated with migraines or other medical conditions such as chemotherapy or radiotherapy, as well as other symptoms of migraines including phonophobia and photophobia. Excerpt(s): The present invention relates to the use of S-alkylisothiouronium derivatives, including, but not limited to, S-ethylisothiouronium diethylphosphate, for the prevention or treatment of headache, including but not limited to migraine, and for the prevention or treatment of emesis, and more particularly, to the alleviation of migraine symptoms, including but not limited to headache, nausea and vomiting. Headache is a term used to describe a varied set of symptoms, ranging in intensity from mild discomfort to the very severe syndrome known by the name of migraine. While the
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most severe and debilitating form of headache is migraine headache there are several other types of headaches that warrant consideration in terms of prevalence, including but not limited to premenstrual syndrome (PMS) associated headaches and the condition associated with morning after alcohol consumption, commonly referred to as hangover. Symptoms such as headache, fever, chills, nausea, muscle and nerve pain, lethargy, and others are often manifested during the syndrome known as hangover. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Polypeptide sequences of human EDG-1c Inventor(s): Bergsma, Derk J.; (Berwyn, PA), Chambers, Jonathan K.; (Cambridge, GB), Chan, Winnie; (West Chester, PA), Jensen, Pamela Joy; (Wayne, PA), Johnson, Randall K.; (Ardmore, PA), Khandoudi, Nassirah; (Saint Gregoire, FR), Livi, George P.; (Havertown, PA), Robert, Phillipe; (Saint Gregoire, FR), Stadel, Jeffrey M.; (Wayne, PA), Wilson, Shelagh; (Hertford, GB) Correspondence: Glaxosmithkline; Corporate Intellectual Property - Uw2220; P.O. Box 1539; King OF Prussia; PA; 19406-0939; US Patent Application Number: 20030082743 Date filed: January 12, 2001 Abstract: Human EDG-1c polypeptidees and polynucleotides and methods for producing such polypeptides by recombinant techniques are disclosed. Human EDG-1c is identified as a selective receptor for sphingosine-1-phosphate ("S-1-P") and for dihydro S-1-P. Also disclosed are methods for discovering agonists and antagonists of the interaction between S-1-P and di-hydro S-1-P and their cellular receptor, human EDG1c, which may have utility in the treatment of several human diseases and disorders, including, but not limited to the treatment of infections such as bacterial, fungal, protozoan and viral infections, particularly infections such as bacterial, fungal, protozoan and viral infections, particularly infections caused by HIV-1 or HIV-2; pain; cancers; diabetes, obesity; anorexia; bulimia; asthma; Parkinson's disease; acute heart failure; hypotension; hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; stroke; congestive heart failure; left ventricular hypertrophy; arrythmias; restenosis after coronary artery angioplasty; vascular sclerosis; deleterious fibrosis; atherosclerosis; inflammation; angiogenesis; wound healing; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic and neurological disorders, including anxiety, schizophrenia, manic depression, depression, delirium, dementia, and severe mental retardation; degenerative diseases, such as neurodegenerative diseases and ischemic stroke; and dyskinesias, such as Huntington's disease or Gilles dela Tourett's syndrome. Excerpt(s): This application claims benefit to the earlier provisional U.S. application Ser. Nos. 60/077,369, filed on Mar. 9, 1998, and 60/087,102, filed on May 28, 1998, the contents of which are incorporated herein by reference in their entirety. This invention relates to newly identified polypeptides and polynucleotides encoded by them and to the use of such polynucleotides and polypeptides, and to their production. More particularly, the polynucleotides and polypeptides of the present invention relate to the G-protein coupled receptors, hereinafter referred to as human EDG-1c receptor. This invention also relates to methods for discovering agonists and antagonists of the interaction between sphingosine 1-phosphate (hereinafter referred to as "S-1-P") and dihydro sphingosine 1-phosphate (also known as sphingoanine 1-phosphate and hereinafter referred to as "di-hydro S-1-P") and their cellular receptor, human EDG-1c
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receptor. The invention also relates to the use of human EDG-1c polynucleotides and polypeptides in therapy and in identifying compounds which may be agonists, antagonists and/or inhibitors which are potentially useful in therapy, and to production of such polypeptides and polynucleotides. The drug discovery process is currently undergoing a fundamental revolution as it embraces `functional genomics`, that is, high throughput genome- or gene-based biology. This approach is rapidly superseding earlier approaches based on `positional cloning`. A phenotype, that is a biological function or genetic disease, would be identified and this would then be tracked back to the responsible gene, based on its genetic map position. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
PROKINETIC AGENTS FOR TREATING GASTRIC HYPOMOTILITY AND RELATED DISORDERS Inventor(s): ANDREWS, PAUL L. R.; (LONDON, GB), WATSON, JOHN W.; (LEDYARD, CT), WOODS, ANTHONY J.; (LONDON, GB) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030176421 Date filed: December 30, 1999 Abstract: Stasis is treated or prevented in all or any part or parts of the stomach of a patient, especially a human patient, in need of such treatment, where said stasis results from hypomotility in the stomach, particularly gastric hypomotility with delayed emptying of the liquid and/or solid contents of the stomach. Gastric or gastrointestinal disorders are also treated which are characterized by one or more symptoms selected from pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion and gastroesophageal reflux. Such treatment or prevention is achieved by administering to the patient a therapeutically effective amount of an inhibitor of phosphodiesterase-4 (PDE4), including isozyme subtypes thereof, sufficient to treat or prevent such hypomotility or gastric or gastrointestinal disorder in said patient. The PDE4 inhibitor comprises a compound of Formula (IA) or (IB): 1where in a preferred embodiment, R is cyclopentyl or cyclohexyl; R.sup.1 is (C.sub.1-C.sub.2) alkyl; one of R.sup.2.sub.a and R.sup.2.sub.b is hydrogen and the other is a substituent of partial Formula (1.0.0) above, where the dashed line represents a single bond, m is 0, R.sup.113 and R.sup.114 are in a cis relationship to each other, R.sup.113 is cyano, R.sup.115 is hydrogen, and R.sup.114 is carboxy, --CH.sub.2OH, or --CH.sub.2C(.dbd.O)NH.sub.2.Pharmaceutical compositions are also described which are useful for carrying out the above-mentioned methods of treatment and prevention, and which are also useful in the treatment of a gastric or gastrointestinal disorder in a patient which comprises with respect to said patient, (i) a sign or concomitant of diabetic neuropathy, anorexia nervosa, achlorhydria, gastrointestinal surgery, post-surgical recovery in the period of emergence from general anesthesia; or the administration of morphine and morphine-like opioids; (ii) a secondary aspect of a primary disease or disorder in said patient which is organic, wherein said disease or disorder involves particularly a gastroenteric or gastroesophageal organ or tissue, or an organ or tissue of the central nervous system of said patient; or (iii) an adverse side effect of a different therapeutic agent administered to said patient in the course of treating another unrelated disease or disorder in said patient.
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Excerpt(s): The method of treatment of the present invention involves a therapeutic agent having a prokinetic effect on, i.e., that promotes activity with regard to gastric motility. This type of drug is useful in treating gastric hypomotility with delayed gastric emptying of liquid and/or solid contents of the antrum (stomach), which is a component of a number of gastric or gastrointestinal disorders. The symptoms of such gastric or gastrointestinal disorders can be quite serious and include pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion, and gastroesophageal reflux. In particular, the present invention relates to therapeutic agents which by various mechanisms are able to elevate cAMP in populations of neurons in the myenteric plexus, leading to release of excitatory transmitters, e.g., acetylcholine, and subsequent stimulation with resulting contraction of the smooth muscle of the antrum. The therapeutic compounds useful as active ingredients in the pharmaceutical compositions and methods of treatment of the present invention are closely related, in terms of their chemical structure and biological activity, to inhibitors of the phosphodiesterase-IV (PDE4) isoenzyme. However, to date the art has incorrectly taught that PDE4 inhibitors antagonize gastrointestinal contractile responses, suggesting their use as antikinetic agents for treating hypermotility disorders; rather than as prokinetic agents for treating gastric hypomotility, as surprisingly discovered in accordance with the present invention. The gastrointestinal system must preserve a proper balance between absorption and secretion of water and electrolytes in order to keep nutrients, wastes, electrolytes and water in a life-sustaining flux. Equally important to successful performance of this ongoing process is the maintenance along the gastrointestinal tract of the appropriate anterograde motility. Gastrointestinal motility is also known to be a key component of vomiting. This aspect of its role is important in light of the fact that some antiemetic agents have enhanced gastric emptying as a significant aspect of their actions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Prosthesis having a sleeve valve Inventor(s): Dua, Kulwinder S.; (Brookfield, WI), Karpiel, John A.; (Winston-Salem, NC), Moore, Scott T.; (Rural Hill, NC) Correspondence: Cook Group Patent Office; P.O. Box 2269; Bloomington; IN; 47402 Patent Application Number: 20020032487 Date filed: June 7, 2001 Abstract: Disclosed is a pressure sensitive prosthesis (10) that includes a tubular member (11) having a passageway (12) extending therethrough and a sleeve (13) attached about one end of the tubular member. The sleeve functions as a one-way valve to permit fluid flowing through the sleeve lumen (15) in a first direction (17) and under a first pressure, while collapsing in response to fluid flowing in a second direction 18 where the pressure that exceeds that of the first direction or pressure. One aspect of the invention includes an esophageal anti-reflux expandable prosthesis wherein the sleeve is adapted to invert back through the tubular stent frame to permit belching or vomiting (fluid or materials under a third, significantly higher pressure). Another aspect of the invention includes a tubular drainage stent (60), such as a biliary or urethral stent in which the sleeve opens to permit passage of fluids, then collapses to prevent retrograde flow. Excerpt(s): This application claims priority of provisional application Serial No. 60/211,753, filed Jun. 14, 2000, and is a continuation-in-part of co-pending U.S. patent
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application Ser. No. 09/386,173, filed Aug. 31, 1999, which claims priority to provisional application Ser. No. 60/098,542, filed Aug. 31, 1998. This invention relates generally to medical devices and, in particular, to an indwelling valved prosthesis. Anti-reflux esophageal prosthesis or stents are typically placed in the lower esophagus and through the lower esophageal sphincter to maintain the patency thereof due to the presence of a cancerous tumor commonly found in the vicinity thereof. The cancerous tumor growth typically impinges the flow of food and fluids through the esophagus. Lower esophageal cancer in the United States presently occurs at the rate of approximately 12,000 patients per year. The incidence in the United States is approximately 5.1 per 100,000 people, which is rising particularly in white male patients. Esophageal prosthesis or stents are typically utilized in these cancerous patients. However, these devices are not FDA approved for benign tumors which also cause blockage or partial stenosis of the esophagus. Esophageal prosthesis or stents are utilized in Europe and other countries for benign tumor conditions, but not in the United States at this time. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Regulation of human adenylate cyclase, type iv Inventor(s): Flockner, Johannes; (Osaka-shi, JP), Liu, Ningshu; (Nara-shi, JP) Correspondence: Banner & Witcoff; 1001 G Street N W; Suite 1100; Washington; DC; 20001; US Patent Application Number: 20040029247 Date filed: July 3, 2003 Abstract: An adenylate cyclase type IV protein, cDNA, and reagents which regulate human adenylate cyclase type IV can play a role in preventing, ameliorating, or correcting dysfunctions or diseases including, but not limited to, diseases that are caused by aberrant activity of this enzyme and diseases whose symptoms can be ameliorated by stimulating or inhibiting the activity of type IV adenylyl cyclase. Such diseases include, for example, hypertension; urinary retention; osteoporosis; angina pectoris; myocardial infarction; restenosis; atherosclerosis; diseases characterized by excessive smooth muscle cells or reduced smooth muscle cell proliferation; aneurysms; wound healing; stroke; ischemia; ulcers; asthma; allergies; benign prostatic hypertrophy; migraine; vomiting; psychotic; and neurological disorders, including anxiety, schizophrenia, manic depression, depression, delirium, dementia, and severe mental retardation, degenerative diseases, such as neurodegenerative diseases and dyskinesias, among others. Excerpt(s): The present invention relates to human adenylate cyclase type IV (hAC4), nucleotide sequence encoding the same, and the regulation of hAC4. The common mechanism for cells to process external stimuli incorporates a receptor at the cell surface to be activated by the stimulus. The activation of the receptor propagates signal to the cell interior and recruits several additional proteins in the process. Typical example of the receptor is a member of G-protein-coupled membrane receptors. The receptors affect the activity of a variety of effectors including adenylyl cyclases, phospholipases, and protein kinases. Each of these effectors includes isoforms with different regulatory properties allowing complex signal integration, and then the signal integration presents the opportunities for the cell to engineer highly specific responses to an external stimulus. The adenylyl cyclase family contains a group of enzymes that synthesize cAMP, a key second messenger involved in signaling pathways governing many cellular processes (e.g. cell growth, development, metabolism and differentiation). To
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date, nine ACs, were identified principally from rodents. The structure of adenylyl cyclases is well studied and shows a common topology with five domains in sequence: a cytoplasmic N-terminal region; a membrane-anchoring hydrophobic domain (M1) consisting of six transmembrane helices; a large cytoplasmic domain (C1); a second transmembrane helical cluster (M2); and a second cytoplasmic domain (C2), homologous to the First, at tile C-terminus. The predicted topology of AC1-AC9 resembles that of the ATP-binding cassette (ABC) membrane transporter such as the Pglycoprotein, although there is no evidence that any mammalian AC functions as a channel or pump to date. All nine AC isoforms contain at least one site predicted to undergo N-linked glycosylation in M2. Following the demonstration by Tang and Gilman of a recombinant soluble AC entirely lacking M1 and M2, a large body of biochemical and structural evidence has made it clear that the interaction of the homologous C1 and C2 domains lies at the heart of the cyclase catalytic mechanism. It is likely that all isoforms share a common catalytic mechanism that requires dimerization of identical or homologous domains. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Regulation of human extracellular calcium- sensing g protein-coupled receptor Inventor(s): Xiao, Yonghong; (Cambridge, MA) Correspondence: Banner & Witcoff; 1001 G Street N W; Suite 1100; Washington; DC; 20001; US Patent Application Number: 20040030100 Date filed: May 13, 2003 Abstract: Reagents which regulate human extracellular calcium sensing G proteincoupled receptor and reagents which bind to human extracellular calcium-sensing GPCR gene products can play a role in preventing, ameliorating, or correcting dysfunctions or diseases including, but not limited to, obesity and diseases related to obesity, cancer, diabetes, osteoporosis, anxiety, depression, hypertension, migraine, compulsive disorders, schizophrenia, autism, neurodegenerative disorders, such as Alzheimer's disease, Parkinsonism, and Huntington's chorea, and cancer chemotherapyinduced vomiting. Excerpt(s): The invention relates to the area of G protein-coupled receptors. More particularly, it relates to the area of human extracellular calcium-sensing G proteincoupled receptor and its regulation. Many medically significant biological processes are mediated by signal transduction pathways that involve G-proteins (Lefkowitz, Nature 351, 353-354, 1991). The family of G protein-coupled receptors (GPCR) includes receptors for hormones, neurotransmitters, growth factors, and viruses. Specific examples of GPCRs include receptors for such diverse agents as calcitonin, adrenergic hormones, endothelin, cAMP, adenosine, acetylcholine, serotonin, dopamine, histamine, thrombin, kinin, follicle stimulating hormone, opsins, endothelial differentiation gene-1, rhodopsins, odorants, cytomegalovirus, G proteins themselves, effector proteins such as phospholipase C, adenyl cyclase, and phosphodiesterase, and actuator proteins such as protein kinase A and protein kinase C. The GPCR protein superfamily now contains over 250 types of paralogues, receptors that represent variants generated by gene duplications (or other processes), as opposed to orthologues, the same receptor from different species. The superfamily can be broken down into five families: Family I, receptors typified by rhodopsin and the.beta.2-adrenergic receptor and currently represented by over 200 unique members (reviewed by Dohlman et al., Ann. Rev.
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Biochem. 60, 653-88, 1991, and references therein); Family II, the recently characterized parathyroid hormone/calcitonin/secretin receptor family (Juppner et al., Science 254, 1024-26, 1991; Lin et al., Science 254, 1022-24, 1991); Family III, the metabotropic glutamate receptor family in mammals (Nakanishi, Science 258, 597-603, 1992); Family IV, the cAMP receptor family, important in the chemotaxis and development of D. discoideum (Klein et al., Science 241, 1467-72, 1988; and Family V, the fingal mating pheromone receptors such as STE2 (reviewed by Kurjan, Ann. Rev. Biochem. 61, 10971129, 1992). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Remedy for hepatopathy Inventor(s): Chin, Masahiro; (Miyagi, JP), Doi, Hideyuki; (Miyagi, JP), Koga, Hiroshi; (Tokyo, JP), Komatsu, Hiromichi; (Shizuoka, JP), Satomi, Susumu; (Miyagi, JP) Correspondence: Browdy And Neimark, P.L.L.C.; 624 Ninth Street, NW; Suite 300; Washington; DC; 20001-5303; US Patent Application Number: 20040022827 Date filed: July 30, 2003 Abstract: Compositions that contain valine as an active ingredient but which are entirely free of other amino acids or substantially free of amino other acids as an active ingredient are used as drugs or foods for treating or ameliorating hepatic diseases, whereupon less side effects are caused than in the conventional regimens of pharmacotherapy and yet the compositions ameliorate, palliate or gain recovery from symptoms and abnormalities that are caused by such hepatic diseases, for example, fever, lassitude, loss of appetite, vomiting stomachache, ascites and pleural effusion, or complications of hepatic disease (not including hepatic encephalopathy). Excerpt(s): The present application is a continuation of U.S. Ser. No. 09/509,680, filed Mar. 30, 2000, which is the national stage under 35 U.S.C.371 of PCT/JP98/04495, filed Sep. 30, 1998. This invention relates to compositions for treating hepatic diseases or improving the hepatic function that are characterized by containing valine as an active ingredient and being substantially free of other amino acids as an active ingredient. More specifically, the invention relates to pharmaceutical or food compositions that contain valine as an active ingredient capable of treating or ameliorating hepatic diseases such as acute hepatitis, hepatic insufficiency, chronic hepatitis and cirrhosis but which are substantially free of other amino acids as an active ingredient. Various amino acid preparations are conventionally used against hepatic diseases such as hepatic insufficiency and cirrhosis. For example, amino acid preparations such as Aminoleban (registered trademark), Morihepamin (registered trademark), Aminoleban (registered trademark) EN, Hepan (registered trademark) ED and Livact (registered trademark) granule are used for such purposes as ameliorating hepatic encephalopathy and hypoalbuminemia that accompany hepatic diseases such as cirrhosis and hepatic insufficiency. In fact, however, these amino acid preparations are used not for direct treatment or amelioration of the mentioned hepatic diseases but rather in anticipation of an improvement in impaired nutrition due to hepatic diseases, namely, for such purposes as improving nitrogen metabolism by correcting the imbalance in plasma amino acids and lowering the blood ammonia level. In addition, these preparations are mixtures of amino acids and single amino acids are little known to be capable of ameliorating the mentioned hepatic diseases. Referring to the official gazette of Examined Japanese Patent Publication No. 29446/1982, it is taught that an injection of L-
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valine, when administered alone, is useful in the treatment of hepatic encephalopathy; however, hepatic encephalopathy is one of the complications of worsened hepatic disease and toxic substances such as ammonia that accumulate in blood impair the central nervous system to cause various neurotic symptoms; hence, hepatic encephalopathy is different from "hepatic disease" in the sense of term used in the present invention. What is more, the official gazette, supra, makes no suggestion that Lvaline is capable of direct treatment or amelioration of hepatic diseases per se. As a matter of fact, hepatic encephalopathy is currently treated with blood ammonia lowering agents such as lactulose and there have been reported no cases of using therapeutics for hepatic diseases in the treatment of hepatic encephalopathy, of which fact shows that the present invention is by no means easy to derive from the official gazette, supra. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Therapeutic agents useful for treating pain Inventor(s): Gharagozloo, Parviz; (Pennington, NJ), Islam, Khondaker; (Langhorne, PA), Kyle, Donald J.; (Newtown, PA), Sun, Qun; (Princeton, NJ), Tafesse, Laykea; (Robinsville, NJ), Whitehead, John William Frank; (Newtown, PA), Yang, Ji; (Princeton Junction, NJ), Zhou, Xiaoming; (Plainsboro, NJ) Correspondence: Jones Day; 222 East 41st Street; New York; NY; 10017; US Patent Application Number: 20040053914 Date filed: May 2, 2003 Abstract: A compound of formula 1(wherein A, R.sub.1, R.sub.2, R.sub.6, m and n are disclosed herein) or a pharmaceutically acceptable salt thereof (a "Piperazine Compound"); pharmaceutical compositions comprising a Piperazine Compound; and methods for treating pain, urinary incontinence (UI), an addictive disorder, Parkinson's disease, parkinsonism, anxiety, epilepsy, stroke, a seizure, a pruritic condition, psychosis, a cognitive disorder, a memory deficit, restricted brain function, Huntington's chorea, amyotrophic lateral sclerosis (ALS), dementia, retinopathy, a muscle spasm, a migraine, vomiting, dyskinesia and depression in an animal comprising administering to an animal in need thereof an effective amount of a Piperazine Compound are disclosed. Excerpt(s): This application claims the benefit of U.S. provisional application No. 60/376,803, filed May 2, 2002, and U.S. provisional application No. ______ (Pennie & Edmonds LLP docket no. 6750-210-888), filed Apr. 3, 2003, the disclosure of each provisional application being incorporated by reference herein in its entirety. The present invention relates to Piperazine Compounds, compositions comprising a Piperazine Compound and methods for treating or preventing a condition such as pain, urinary incontinence (UI), an addictive disorder, Parkinson's disease, parkinsonism, anxiety, epilepsy, stroke, a seizure, a pruritic condition, psychosis, a cognitive disorder, a memory deficit, restricted brain function, Huntington's chorea, amyotrophic lateral sclerosis (ALS), dementia, retinopathy, a muscle spasm, a migraine, vomiting, dyskinesia or depression comprising administering to the animal in an animal in need thereof an effective amount of a Piperazine Compound. Pain is the most common symptom for which patients seek medical advice and treatment. Pain can be acute or chronic. While acute pain is usually self-limited, chronic pain persists for 3 months or longer and can lead to significant changes in a patient's personality, lifestyle, functional
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ability and overall quality of life (K. M. Foley, Pain, in Cecil Textbook of Medicine 100107 (J. C. Bennett and F. Plum eds., 20th ed. 1996)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Treatment method Inventor(s): Dedrick, Russell L.; (Kensington, CA), Garovoy, Marvin R.; (San Anselmo, CA), Kramer, Susan M.; (San Francisco, CA), Starko, Karen M.; (Hillsborough, CA) Correspondence: Genentech, INC.; 1 Dna Way; South San Francisco; CA; 94080; US Patent Application Number: 20030223988 Date filed: June 20, 2003 Abstract: A method is provided for reducing the occurrence of fever, headache, nausea and/or vomiting associated with administration of a therapeutic compound to a mammal in need thereof, comprising administering to the mammal a first conditioning dose of a non-target cell depleting compound which binds to a cell surface receptor on a target mammalian cell; and administering a second therapeutic dose of the compound, wherein the second dose is higher than the first dose. Excerpt(s): This application is a continuation of Ser. No. 09/819,921, filed on Mar. 28, 2001, which is a divisional of Ser. No. 09/527,957, filed on Mar. 17, 2000 (now abandoned) which claims the benefit under USC.sctn.119(e)(1) to provisional patent applications Serial No. 60/125,228 and Serial No. 60/125,351, both filed on Mar. 19, 1999, the disclosures of which are incorporated by reference herein in their entirety. The invention relates to methods of treating mammals, for example humans, to reduce the occurrence of undesired administration reactions, to treat an LFA-1 mediated disease, to condition a mammal to tolerate high doses of a therapeutic compound and to down modulate a cell surface receptor. Administration of many therapeutic agents rapidly induces adverse side effects, or events, including but not limited to fever, headache, nausea, vomiting, breathing difficulties and changes in blood pressure. These adverse events limit the amount of a drug or therapeutic compound that can be given, which in turn limits the therapeutic effectiveness that could be achieved with higher doses of the drug. There is a continuing need to develop techniques which limit the toxicity of higher drug doses so that therapeutic efficacy can be improved. This need exists for both polypeptide and non-polypeptide compounds. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Two-component anti-emetic composition Inventor(s): Jannetta, Anthony; (Haverford, PA) Correspondence: Patent Adminstrator; Katten Muchin Zavis; Suite 1600; 525 West Monroe Street; Chicago; IL; 60661; US Patent Application Number: 20020055495 Date filed: September 5, 2001 Abstract: The invention relates to an anti-emetic composition containing dexamethasone (DEX) and metoclopramide (MTC). In a particular embodiment, a composition containing DEX:MTC in a relative weight ratio of about 1 to less than 1.25 is found to be effective in providing relief from the discomfort caused by symptoms of both vomiting
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and nausea in all patients receiving the composition. Alternatively, an effective suppository composition may contain DEX:MTC in a relative weight ratio of about 1:112.5. Other effective compositions and methods of their use are also disclosed. Excerpt(s): This application claims the benefit of an earlier-filed provisional application No. 60/229,547 filed Sep. 5, 2000, the entire disclosure of which is incorporated herein by reference. The present invention relates to both a therapeutic composition comprising a synergistic combination of antiemetic drugs and to a method for treating emesis, including nausea. Nausea and vomiting can follow the administration of many drugs, particularly anticancer or chemotherapeutic agents. The symptoms also often accompany infectious and non-infectious gastrointestinal disorders. 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 vomiting, 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 “vomiting” (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 vomiting. You can also use this procedure to view pending patent applications concerning vomiting. 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 6. BOOKS ON VOMITING Overview This chapter provides bibliographic book references relating to vomiting. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on vomiting 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 “vomiting” (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 vomiting: •
PDR for Herbal Medicines. 1st ed Source: Montvale, NJ: Medical Economics Company. 1998. 1244 p. Contact: Available from Medical Economics Publishing Inc. P.O. Box 10689, Des Moines, IA 50336. (800) 922-0937. Fax (515) 284-6714. Website: www.medecbookstore.com. PRICE: $59.99. ISBN: 1563632926. Summary: Most of today's herbal remedies exhibit varying degrees of therapeutic value. Some, such as ginkgo, valerian, and saw palmetto, seem genuinely useful, while others, such as ephedra, tansy, and nightshade, can actually be dangerous. As the use of unfamiliar botanicals spreads, the need to steer patients toward the few truly useful preparations and warn them away from ineffective, dangerous alternatives is becoming an increasingly significant priority. This volume, from the publishers of Physicians Desk Reference, brings together the findings of the German Regulatory Authority's herbal watchdog agency (commonly caused Commission E). This agency conducted an
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intensive assessment of the peer-reviewed literature on some 300 common botanicals, weighing the quality of the clinical evidence and identifying the uses for which the herb can reasonably be considered effective. This reference book contains profiles of over 600 medicinal herbs. Each entry contains up to 9 standard sections: name(s), description, actions and pharmacology, indications and usage, contraindications, precautions and adverse reactions, overdosage, dosage, and literature. The entries have also been indexed by scientific and common name, indications, therapeutic category, and side effects. To assist in identification, the reference book includes a section of full-color plates of the plants included. The book concludes with a glossary of the specialized botanical nomenclature and other unfamiliar terminology, a list of poison control centers, and a list of drug information centers. Some of the herbs are listed for use for abdominal cramps or distress, acid indigestion, appetite stimulation, rectal bleeding, various bowel disorders, stomach cancer, cholelithiasis (gallstones), colic, colitis, constipation, dehydration, diarrhea, digestive disorders, dysentery, enteritis, anal fissure, flatulence (intestinal gas), gastritis, gastroenteritis, gastrointestinal disorders, gout, helminthiasis, hemorrhage, hemorrhoids, hepatitis, hypercholesterolemia, jaundice, liver and gall bladder complaints, liver disorders, malaria, nausea, abdominal pain, and vomiting. •
Children and Teens in Weight Crisis: Summary Edition Source: Hettinger, ND: Healthy Weight Journal, 35 p. Contact: Healthy Living Institute, 402 S. 14th St., Hettinger, ND 58639. (701) 567-2645. Summary: Ms. Berg discusses the main issues surrounding childhood and adolescent obesity, including self-image difficulties, societal pressures, sedentary lifestyles, and harmful dieting practices. She also focuses on eating disorders, size prejudice, and the risks of obesity at a young age. Especially vulnerable to weight issues are the athletes, particularly female gymnasts, ballet dancers, weight lifters, boxers, bodybuilders, wrestlers, and figure skaters. The extreme emphasis placed on leanness and light weight in these sports often leads to eating disorders, including self-induced vomiting, laxative abuse, and food deprivation. On the other hand, obese children are often ridiculed by peers, forced to attend ineffective "diet camps," and made to feel at fault for their excess weight. To counter these trends, Ms. Berg advocates a change in attitude, beginning with health professionals and extending to parents and coaches. Teaching self-esteem, allowing choices, and helping children feel comfortable with their bodies is healthier than attempts to fit all children into a slimmer mold. By insisting on weight loss, parents may put in motion a lifelong cycle of weight loss and gain that is much less healthy than a steady weight. It is all part of a "control paradigm," in which adults dictate how much a child should weigh. Rather, says Ms. Berg, adults should accept the child as he or she is, never making love conditional on weight, clothing size, eating habits, or looks. By setting an example of healthy eating, exercise, and self-esteem, adults can show children that inner talents are as important as outward appearances.
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Diabetes Problem Solver Source: Alexandria, VA: American Diabetes Association. 1999. 511 p. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 for members; plus shipping and handling. ISBN: 1570400091.
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Summary: This book is a reference guide that helps people who have diabetes identify and prevent the most common diabetes-related problems they encounter on a daily basis. The book is divided into two major sections. The first section consists of a series of flowcharts to help readers decide what they need to do about a particular condition or symptom. Flowcharts focus on arm and hand pain, back pain, blurry vision, chest pain, confusion, convulsions or seizures, difficulty breathing, dizziness, dry skin, eating disorders, emotional problems, emotional changes in women, feeling tired, fever, foot problems, headache, hyperglycemia, hypoglycemia, injection site problems, and intestinal problems. Other flowcharts deal with leg and foot pain, loss of consciousness, muscular weakness, nausea, numbness and tingling, pain or discomfort in women, palpitations, problems with the mouth, problems with blood glucose in women, sexual problems in men and women, skin discoloration, skin lesions, skin rashes and itchy skin, sleeping problems, stomach pain, sweating, swelling, thickening of the skin, urinary problems, vision problems, and vomiting. The second section provides more detailed information about many of the problems people who have diabetes face. Solutions are provided for monitoring and testing problems; hypoglycemia and hyperglycemia problems; insulin delivery and oral medication problems; circulation, neuropathy, kidney, vision, gastrointestinal, infection, foot, and skin problems; men's, women's, and children's problems; eating, exercise, and weight problems; lifestyle problems; coping problems; discrimination and insurance problems; and other medical problems. Each section provides the reader with information on the symptoms of the condition, who is at risk and what risk the particular condition poses for the reader, what the reader's immediate course of action should be, treatment in a medical setting, and how to prevent the condition from developing. The reader may use the book in two ways. If the reader knows he or she has a particular condition or wants more information, he or she can go straight to the second section and look up the condition. The reader may use the book as a guide to possible conditions that may be causing symptoms by referring to the flowcharts in the first section. The book also includes a glossary, resources, and an index. 6 figures. 5 tables. •
Guide to your child's nutrition: Making peace at the table and building healthy eating habits for life Source: Elk Grove Village, IL: American Academy of Pediatrics. 1999. 234 pp. Contact: Available from American Academy of Pediatrics, 141 Northwest Point Boulevard, P.O. Box 927, Elk Grove Village, IL 60009-0927. Telephone: (847) 228-5005 or (800) 433-9016 / fax: (847) 228-5097 / e-mail:
[email protected] / Web site: http://www.aap.org. Retail $23.00; APA member price $19.95. Summary: This book is designed to help parents with their child's nutrition at various stages of the child's life, and reflects the consensus of members of the American Academy of Pediatrics. Topics include what is best for the newborn; expanding the baby's diet; nutrition for toddlers, the school years, and adolescents; nutrition basics; spitting up, gagging, vomiting, diarrhea, and constipation; assessing whether a child is too fat, thin, small, or tall; eating disorders; handling outside influences; cutting a child's risk of health problems; food safety and additives, alternative diets and supplements, and allergies. Appendices give checklists of what caregivers need to know, foodmedication interactions, standard growth charts, body mass index charts, food substitutions, and additional resources.
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Managing the Side Effects of Chemotherapy and Radiation Therapy: A Guide for Patients and Their Families. 3rd ed Source: San Francisco, CA: UCSF Nursing Press. 1996. 198 p. Contact: Available from UCSF Nursing Press. 521 Parnassus Avenue, Room N-535C, San Francisco, CA 94143-0608. (415) 476-4992 or (415) 476-2626. Fax (415) 476-6042. PRICE: $20.00 plus $6.00 shipping and handling. ISBN: 0943671120. Summary: This book is designed to help patients and their families learn to cope with the many side effects of cancer chemotherapy and radiation therapy. The chemotherapy section lists every frequently used cancer drug and common side effects of each. This information is first presented in chart format, then discussed in some detail. Suggestions for managing each side effect are included. The section on side effects includes a description of the problem, its likely duration, recommended self-care measures, and when to consult with a health care provider. The remainder of the book discusses the common side effects of radiation therapy, with the same type of information and in the same format. Side effects particularly relevant to the digestive system include abdominal pain, constipation, diarrhea, liver damage, sore mouth or difficulty swallowing, nausea and vomiting, and stomach irritation and ulcers. A subject index concludes the book.
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Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones Source: New York, NY: Oxford University Press. 1992. 227 p. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This book offers advice on how to take care of and avoid a whole complex of disturbances categorized as indigestion. The author begins with an overview of the anatomy and physiology of digestion, including a chapter on terminology and definitions. After an additional chapter on diagnostic testing, the author turns to specific problems, including acid related problems (heartburn, esophagitis, and hiatal hernia), peptic ulcers, nonulcer dyspepsia, chest pain, gallbladder problems and gallstones, pancreatic diseases, jaundice, malabsorption and maldigestion, food intolerance and food allergies, the impact of aging on the upper digestive tract (including the role of medications and drug interactions), and the brain gut connection. The appendices of the book offer coverage of related problems, including belching, nausea and vomiting, dry mouth and bitter taste, difficulty in tasting, lump in the throat, butterflies, difficulties in swallowing, delayed stomach emptying, the effects of diabetes on the upper digestive system, and the controversy over yeast. The author hopes to foster a cooperative dialogue between patients and their physicians as they work together to diagnose and manage upper digestive tract problems. A subject index concludes the book. 8 figures. 6 tables.
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Medical Advisor Home Edition: The Complete Guide to Alternative and Conventional Treatments Source: Alexandria, VA: Time-Life Books. 1997. 960 p. Contact: Available from Time-Life Books. 400 Keystone Industrial Park, Dunsmore, PA 18512. PRICE: $20.00. ISBN: 0783552505.
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Summary: This book offers information about 300 health problems, ranging from relatively benign conditions to the most serious diseases. There are symptoms charts which name several related problems and help readers decide which ailment entry to look up. Ailment entries provide a more complete list of symptoms, plus guidelines to discern whether the condition is potentially serious or requires a doctor's attention. Each entry describes the ailment and how it affects the body. Next, the entry outlines the underlying causes of the ailment and the tests and procedures a doctor may use to confirm the diagnosis. The treatment segment presents conventional and alternative recommendations for curing the problem or alleviating the symptoms. Most ailment entries conclude with advice on preventive measures that can be used to maintain health. Alternative treatments discussed include bodywork, acupuncture and acupressure, herbal therapies, homeopathy, lifestyle changes, and nutrition and diet. The book begins with a section on emergency medicine. Also included is a visual diagnostic guide, an atlas to the body, a medicine chest section (describing herbs, homeopathic remedies, and over the counter drugs), a glossary, a subject index, a bibliography, and a list of health associations and organizations. Topics related to digestive diseases include abdominal pain, AIDS, allergies, anal bleeding, anal fissure, anorexia nervosa, bad breath, bowel movement abnormalities, bulimia, celiac disease, cholesterol problems, colitis, colorectal cancer, constipation, Crohn's disease, diarrhea, diverticulitis, flu, food poisoning, gallstones, gas and gas pains, gastritis, gastroenteritis, heartburn, hiatal hernia, hiccups, incontinence, indigestion, irritable bowel syndrome, lactose intolerance, lupus, obesity, pancreatic cancer, pancreatic problems, stomach cancer, stomach ulcers, swallowing difficulty, trichomoniasis, vomiting, and worms. The book is illustrated with line drawings and full-color photographs. •
Irritable Bowel Syndrome and the Mind-Body Brain-Gut Connection Source: Columbus, OH: Parkview Publishing. 1997. 302 p. Contact: Available from Parkview Publishing. P.O. Box 1103, Columbus, OH 43216. (888) 599-6464 or (614) 258-4848. Fax (614) 258-7272. PRICE: $19.95. ISBN: 0965703894. Summary: This book offers readers a guide to understanding and treating their functional gastrointestinal (GI) disorders, focusing on irritable bowel syndrome (IBS). The author emphasizes the role that individuals can play in managing their own symptoms and future. The book is framed around eight steps to positive change; eight chapters cover the GI tract and the mind-body connection; the common functional GI disorders; healing with diagnosis and education; understanding one's own symptoms and GI tract; identifying gut 'triggers'; emphasizing self-care and wellness; taking action if symptoms persist; and managing the functional GI disorder. Specific topics include the interplay between stress, psychology and symptoms; colitis and inflammatory bowel disease (IBD); the International Foundation for Functional Gastrointestinal Disorders (IFFGD); self-tests for personal and psychological problems; the role of a history of abuse; cognitive behavioral factors; food and symptom diaries; food allergy versus food intolerance and sensitivity; inflammation and infection; the menstrual cycle; seasonal changes; nutrition; weight; exercise; the impact of alcohol, nicotine, and tobacco; the use of an elimination diet; stress, emotional, and psychological issues; chronic pain management; and managing the symptoms of chest pain, heartburn, dysphagia, dyspepsia, nausea, vomiting, aerophagia (burping and belching), abdominal bloating, rectal gas and flatulence, abdominal pain, diarrhea, constipation, bowel incontinence, and anal and rectal pain. The book includes black and white photographs, charts, and figures; a subject index concludes the volume.
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Diabetes Travel Guide Source: Alexandria, VA: American Diabetes Association. 2000. 172 p. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 1580400418. Summary: This book organizes the process of traveling for people who have diabetes. Chapter one focuses on preparing for a trip. Topics include researching one's destination; seeing one's health care provider prior to departure, carrying a letter from one's doctor; locating medical facilities at one's destination; taking one's medications along; and obtaining health insurance, passports, and visas. Chapter two explains how to pack clothing, diabetes supplies, snacks, and items for an emergency and offers tips for preventing foot infections and other complications from happening. Chapter three provides detailed guidelines for packing and using insulin, syringes, a blood glucose meter, test strips, ketone strips, and a glucagon kit. Other topics include adjusting insulin and an insulin pump for various time zone changes. Chapter four provides tips for packing and taking oral medications, handling time zone changes, dealing with meals and physical activity, and creating a diabetes survival kit. Chapter five provides guidelines for traveling by auto, airplane, or boat. Chapter six addresses the issue of eating well and exercising while away from home. Topics include dealing with time zone changes, deciding where and when to eat, following a meal plan, eating fast foods, and adjusting insulin or diabetes pill doses according to physical activity level. Chapter seven uses a question and answer format to provide tips for coping with illness while traveling. Topics include receiving immunizations prior to traveling if necessary; checking blood glucose and ketones during an illness; dealing with vomiting, diarrhea, colds, jet lag, and urinary tract or vaginal infections; avoiding constipation; preventing insulin pump site infections; and preparing for health care prior to traveling. Chapter eight explains how to plan for situations that may occur during overseas travel, outdoor trips, and scuba diving. 22 appendices. 6 tables.
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Eating Hints for Cancer Patients: Before, During and After Treatment Source: Bethesda, MD: National Cancer Institute (NCI), National Institutes of Health (NIH). 1999. 60 p. Contact: Available from National Cancer Institute (NCI). Publications Ordering Service, P.O. Box 24128, Baltimore, MD 21227. Voice (800) 422-6237. TTY (800) 332-8615. Fax (301) 330-7968. PRICE: Single copy free; bulk rates available. NIH Publication Number 99-2079. Summary: This booklet contains a variety of ideas about food needs and eating problems that patients undergoing cancer therapy may encounter. The authors emphasize the need for eating well during cancer treatment and outline the nutrition problems that may arise with different cancer treatments. Strategies for coping with side effects are provided for loss of appetite, sore mouth or throat, changed sense of taste or smell, dry mouth, nausea, vomiting, diarrhea, constipation, weight gain, tooth decay, and lactose intolerance. The next section provides suggestions for increasing protein and calorie intake, including the use of healthy snacks. Another section discusses diets for patients with special needs, including the clear liquid diet, full liquid diet, soft diet, fiber restricted diet, low lactose diet, and commercial products to improve nutrition. The booklet includes a glossary of related terms and the contact information for two resource organizations: the Cancer Information Service (800-422-6237) and the American Cancer
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Society (800-227-2345). The booklet then provides 40 pages of recipes designed to help patients achieve better nutrition during cancer treatment. A recipe index is provided. Colorful drawings illustrate the booklet. 8 tables. •
Keep Yourself Healthy at Home: A Guide for Adults with Diabetes Source: South Deerfield, MA: Channing L. Bete Co., Inc. 2000. 60 p. Contact: Available from Channing L. Bete, Co., Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. Fax (800) 499-6464. PRICE: $3.50 each; plus shipping and handling; quantity discounts available. Order number 97915. Summary: This illustrated handbook provides adults who have diabetes with information on health care. Section one provides general information about health care, the prevention of health problems, and the use of diabetes and general medications. Section two discusses specific problems and their treatment, focusing on allergies, appendicitis, asthma; back pain; bites and stings; bronchitis; bruises, cuts, and scrapes; burns and sunburns; chest pain; colds, flu, and cough; constipation; diarrhea; dizziness and fainting; fever; foot and leg problems; headaches; heartburn; mouth problems; nausea and vomiting; sexual concerns; sexually transmitted diseases; skin problems; sprains and strains; urinary tract infections; and vaginitis. Section three focuses on conditions of special concern for people who have diabetes, including heart disease and stroke and eye, kidney, and nerve diseases. Section four explains how to deal with hypoglycemia and hyperglycemia and provides space for writing down emergency numbers and other emergency information.
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Clinical Practice of Gastroenterology. Volume One Source: Philadelphia, PA: Current Medicine. 1999. 783 p. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: This lengthy textbook brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. This first volume includes 86 chapters in four sections: esophagus, stomach and duodenum, small bowel, and colon. Specific topics include normal esophageal physiology, gastroesophageal reflux disease (GERD), motor disorders of the esophagus, esophageal foreign bodies, esophagitis, esophageal trauma, esophageal surgery, gastric and duodenal histology and histopathology, gastroduodenal motility and motility disorders, abdominal pain, nausea and vomiting, dyspepsia (heartburn), Helicobacter pylori, gastric and duodenal ulcer, gastric cancer, gastric infection, gastric surgery, small intestine anatomy and physiology, symptoms and signs of small bowel disease, maldigestion and malabsorption, intestinal obstruction and pseudoobstruction, immunologic disorders, small intestinal malignancies (cancer), short bowel syndrome, Whipple's disease, infectious diarrhea, parasitic diseases of the small intestine, foodborne diseases of the small intestine, gastroenteritis, Crohn's disease, anatomy and physiology of the colon, irritable bowel syndrome (IBS), secretory diarrhea, constipation and fecal impaction, fecal incontinence, gas and flatulence, gastrointestinal bleeding, colitis (including ulcerative colitis), diverticulitis and diverticular hemorrhage, appendicitis, benign tumors of the colon and polyposis syndrome, malignant tumors of the colon, and anorectal disorders. The chapters include figures, algorithms, charts, graphs, radiographs, endoscopic pictures, intraoperative photographs, photomicrographs,
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tables, and extensive references. The volume concludes with a detailed subject index and a section of color plates. •
Pediatric Gastrointestinal Disease. 2nd ed Source: Philadelphia, PA: W.B. Saunders Company. 1999. 823 p. Contact: Available from W.B. Saunders Company. Book Order Fulfillment Department, 11830 Westline Industrial Drive, Saint Louis, MO 63146-9988. (800) 545-2522 or (314) 4537010. Fax (800) 568-5136 or (314) 453-7095. E-mail:
[email protected]. Website: customerservice.wbsaunders.com. PRICE: $155.00 plus shipping and handling. ISBN: 0721674615. Summary: This medical textbook covers all facets of clinical pediatric gastrointestinal disease. The text emphasizes a clinical focus and incorporates anatomy and physiology considerations into each chapter rather than a separate section. The book is organized into distinct sections, starting with the common clinical problems and followed by organ specific diseases. General chapters on clinical problems cover chronic abdominal pain of childhood and adolescence, vomiting, diarrhea, constipation and encopresis (fecal soiling), failure to thrive, gastrointestinal hemorrhage, eating disorders and obesity, jaundice, ascites, caustic ingestion and foreign bodies, abdominal masses in pediatric patients, and abdominal surgical emergencies. Sections on diseases of the esophagus, stomach, and the small and large bowel (intestine) are followed by chapters reviewing the clinical facets of pediatric liver disease. Specific chapters include gastrointestinal reflux, achalasia and other motor disorders, congenital anomalies, gastric motility disorders, bezoars (a mass of food, hair or other components found in the stomach or intestine), maldigestion and malabsorption, celiac disease, short bowel syndrome, enteric parasites, Crohn's disease, ulcerative colitis, polyps, appendicitis, hernia, Hirschsprung's disease, neoplasms (cancerous and noncancerous), hepatitis, gallbladder diseases, and liver transplantation. The last two sections review diseases of the pancreas and basic nutrition in children, including pancreatitis, cystic fibrosis, nutritional assessment, parenteral (outside the digestive system, for example, intravenous nutrition) and enteral nutrition, and the management of diarrhea. Each chapter offers black and white photographs and figures and concludes with extensive references. A detailed subject index concludes the text.
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Nutrition: Your Ammunition for AIDS Contact: University of California San Diego, Medical Center, Department of Clinical Nutrition, 225 Dickinson St H-802, San Diego, CA, 92103-1990, (619) 543-3783. Summary: This monograph addresses nutritional needs, especially for persons with HIV/AIDS. It states that the best nutritional status is maintained with a well-balanced diet and an ample amount of calories to prevent weight loss. It explains that symptoms of AIDS, such as fevers, nausea, vomiting, diarrhea, candidiasis (thrush), infection, and herpetic and Kaposi's sarcoma lesions have a direct effect on specific nutritional needs and lists ways to reduce such symptoms. Eating a variety of food from the basic food groups in frequent but small amounts is also recommended. It encourages taking vitamins, minerals, protein, and calorie supplements. Difficulties with chewing, swallowing, nausea, vomiting, diarrhea, are also addressed. It offers suggestions for eliminating loss of appetite, feeling full too soon, and being too tired to cook food. It also includes intake guidelines for males, females, and vegetarians with HIV/AIDS, highcalorie recipes, and foods that can be stored for days when a person with HIV/AIDS may be too tired to cook.
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Pass the Calories, Please! Contact: American Dietetic Association, 216 W Jackson Blvd Ste 800, Chicago, IL, 606066995, (800) 877-1600, http://www.eatright.org. Summary: This monograph is designed as a practical guide for people who need suggestions on ways to increase calories in their diets. Practical tips are given on how to handle conditions that prevent one from eating well, such as nausea, vomiting, diarrhea, sore or dry mouth, or a general loss of appetite. The recipes included are rich in the nutrients that may be needed at such times, including vitamins, protein, and fiber. The book also discusses eating out, commercial supplements, and food safety.
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What to Do When Your Child Gets Sick Source: Whittier, CA: Institute for Healthcare Advancement. 1999. 181 p. Contact: Available from Institute for Healthcare Advancement. 15111 East Whittier Blvd., Suite 460, Whittier, CA 90603. (800) 434-4633. Fax (562) 907-1963. Website: www.iha4health.org. PRICE: $14.95 plus shipping and handling; bulk copies available. ISBN: 0828114404. Summary: This reference book uses simple everyday language and illustrations to provide information on common childhood illnesses and health problems. Written in nontechnical language designed to be accessible to adults at any reading level, the book features 11 topical chapters: safety tips, caring for the sick child, the newborn baby, the child's eyes, the child's ears and nose, the child's mouth and throat, the child's breathing, the child's stomach, bed wetting, the child's skin, and what to do when the child gets hurt. Topics related to digestive diseases include infection, jaundice, swallowing foreign objects, blood in the bowel movements, colic, constipation, diarrhea, food allergies, hernia, spitting up, stomach pain, vomiting, and poisoning. The book features extensive illustrations, with topics simplified to key points on each page. The book's content is simplified through the use of short, active sentences and single syllable words where appropriate. For most of the topics, the book follows a similar style covering a definition (what is it?), symptoms (what do I see?), how to care for the child (what can I do at home?), how to know when to call the doctor or nurse, and further information (what else should I know about this condition?). The book concludes with a word list (a glossary of terms), a subject index, and a list of acknowledgments. The book is available in either Spanish or English.
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Digestive Diseases and Disorders Sourcebook Source: Detroit, MI: Omnigraphics. 2000. 300 p. Contact: Available from Omnigraphics, Inc. 615 Griswold, Detroit, MI 48226. (800) 2341340. Fax (800) 875-1340. PRICE: $48.00 plus shipping and handling. ISBN: 0780803272. Summary: This sourcebook provides basic information for the layperson about common disorders of the upper and lower digestive tract. The sourcebook also includes information about medications and recommendations for maintaining a healthy digestive tract. The book's 40 chapters are arranged in three major parts. The first section, Maintaining a Healthy Digestive Tract, offers basic information about the digestive system and digestive diseases, information about tests and treatments, and recommendations for maintaining a healthy digestive system. The second section, Digestive Diseases and Functional Disorders, describes nearly 40 different diseases and disorders affecting the digestive system. These include appendicitis, bleeding in the digestive tract, celiac disease, colostomy, constipation, constipation in children, Crohn's
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disease, cyclic vomiting syndrome, diarrhea, diverticulosis and diverticulitis, gallstones, gas in the digestive tract, heartburn (gastroesophageal reflux disease), hemorrhoids, hernias, Hirschsprung's disease, ileostomy, indigestion (dyspepsia), intestinal pseudoobstruction, irritable bowel syndrome (IBS), IBS in children, lactose intolerance, Menetrier's disease, rapid gastric emptying, short bowel syndrome, ulcerative colitis, ulcers, Whipple's disease, and Zollinger Ellison syndrome. The final section offers a glossary of terms, a subject index and a directory of digestive diseases organizations (which includes website and email addresses as available). Material in the book was collected from a wide range of government agencies, nonprofit organizations, and periodicals. •
20 Common Problems in Gastroenterology Source: New York, NY: McGraw-Hill, Inc. 2002. 317 p. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Website: www.bookstore.mcgraw-hill.com. PRICE: $45.00;plus shipping and handling. ISBN: 0070220557. Summary: This text is one from a series that provides concise, practical information for health care professionals. This book focuses on the most common gastroenterological problems encountered in a primary practice setting and represents a selection of 20 clinical issues that every practitioner of primary care and general gastroenterology will encounter on a regular basis. The chapters are organized to support rapid access to the information necessary to evaluate and treat most patients with these problems. The text features three sections: general gastroenterology, gastrointestinal (GI) bleeding, and hepatic (liver) and biliary problems. Twenty chapters cover heartburn, nausea and vomiting, dysphagia (swallowing difficulties), weight loss, dyspepsia, chronic abdominal pain (functional GI disorders), acute abdominal pain, acute upper GI bleeding, acute lower GI bleeding, occult (hidden) bleeding and iron deficiency anemia, flatulence (gasiness), acute diarrhea in adults, constipation, colorectal cancer screening, anal pain, viral hepatitis, right upper quadrant pain (gallbladder disease and its complications), liver masses, abnormal liver function tests, and biliary obstruction. Each chapter includes a chapter outline for quick reference, the text itself, a diagnostic and treatment algorithm, and selected references. The text concludes with a subject index. Color photographs are provided in a special section; black and white photographs, figures, and charts illustrate the volume.
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Functional Disorders of the Gut Source: London, England: Churchill Livingstone. 1998. 370 p. Contact: Available from Harcourt Brace and Company. Foots Cray High Street, Sidcup, Kent, DA14 5 HP, United Kingdom. 02083085700. Fax 02083085702. E-mail:
[email protected]. Website: www.harcourt-international.com. PRICE: $65.00 plus shipping and handling. ISBN: 0443054207. Summary: This textbook provides practical, clinical advice on the management of patients with symptoms of abnormal gastrointestinal (GI) function. Experts in the field offer information about the conflicting management options in order to support patient care. The first section of the book deals with topics, including neurobiology, that are relevant to several or perhaps all functional disorders of the gut. Topics in this section include functional anatomy and physiology, enteric neuropathobiology, clinical pharmacology (drug therapy), epidemiology (incidence and prevalence), psychopathology of functional disorders of the gut, chronic abdominal pain, and
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hypersensitivity and food intolerance. The remainder of the book offers two parallel tracks through the successive regions of the digestive tract. The first summarizes the present views on physiology and pathophysiology, while the second addresses the problems of clinical management. Topics in this section include the esophagus, including disorders of swallowing and chest pain; nausea, vomiting and other food related symptoms of stomach problems; the clinical physiology of the small bowel; the colon and anorectum, including constipation, urgency, and pain syndromes; the clinical management of irritable bowel syndrome (IBS); and the symptoms and management of biliary tract problems. The text concludes with a postscript chapter summarizing both the changes and the consistencies in the field of functional bowel disorders. Each chapter concludes with numerous references, and a subject index concludes the volume. Drawings, charts, and reproductions are in black and white. •
Drug Therapy for Gastrointestinal and Liver Diseases Source: Florence, KY: Martin Dunitz. 2001. 352 p. Contact:.AV.-Available from Martin Dunitz. Fulfillment Center, Taylor and Francis, 7625 Empire Drive, Florence, KY 41042. (800) 634-7064. E-mail: cserve@routledge_ny.com. Website: www.dunitz.co.uk. PRICE: $75.00 plus shipping and handling. ISBN: 1853177334. Summary: This textbook reviews the drug therapy for gastrointestinal and liver diseases. Fifteen chapters cover drug therapy of gastroesophageal reflux disease (GERD), peptic ulcer disease, emesis (vomiting), gastrointestinal bleeding, inflammatory bowel disease, gastrointestinal and liver infections, motility disorders, functional abdominal disorders, gastrointestinal cancer, pancreatitis and pancreatic insufficiency, viral hepatitis, non-viral liver disease, drug therapy for portal hypertension, hepatic (liver) failure, and the adverse effects of drugs on the gastrointestinal tract. Each chapter provides a brief summary of the pathophysiology of the disease, the rationale for drug intervention, and appropriate treatment regimens as indicated by current knowledge. Also includes is a drug list that summarizes mode of action, and other aspects of clinical pharmacology where appropriate, drug doses, common adverse affects, and drug interactions. A subject index concludes the volume.
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 “vomiting” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “vomiting” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “vomiting” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
101 Ways to Say Vomit by Christine Becker (Author); ISBN: 0679883703; http://www.amazon.com/exec/obidos/ASIN/0679883703/icongroupinterna
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Cancer Treatment & Marijuana Therapy: Marijuana's Use in the Reduction of Nausea and Vomiting and for Appetite Stimulation in Cancer Patients. Testimony from Historic Federal Hearings on m (Marijuana, Medicine & the Law Series) by R. C.
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Randall (Editor); ISBN: 0936485051; http://www.amazon.com/exec/obidos/ASIN/0936485051/icongroupinterna •
Nausea and Vomiting; ISBN: 3540154361; http://www.amazon.com/exec/obidos/ASIN/3540154361/icongroupinterna
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Nausea and Vomiting in Pregnancy -- An Integrated Approach to Management by Denise Tiran, Julian Woolfson; ISBN: 0443073929; http://www.amazon.com/exec/obidos/ASIN/0443073929/icongroupinterna
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Nausea and Vomiting of Pregnancy: State of the Art 2000 (Vol. 1) by MD, FACCT, FRCPC Gideon Koren (Editor), MD, MSc, DCH Raafat Bishai (Editor); ISBN: 0968659802; http://www.amazon.com/exec/obidos/ASIN/0968659802/icongroupinterna
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Nausea and Vomiting: Mechanisms and Treatment (Advances in Applied Neurological Sciences, Vol 3) by C.J. Davis, et al; ISBN: 0387154361; http://www.amazon.com/exec/obidos/ASIN/0387154361/icongroupinterna
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Nausea and Vomiting: Overview, Challenges, Practical Treatments and New Perspectives by W. Leroy Heinrichs, et al; ISBN: 1861560796; http://www.amazon.com/exec/obidos/ASIN/1861560796/icongroupinterna
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Nausea and Vomiting: Recent Research and Clinical Advances by John Kucharczyk, et al; ISBN: 0849367816; http://www.amazon.com/exec/obidos/ASIN/0849367816/icongroupinterna
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The Handbook of Nausea and Vomiting by Marvin H. Sleisenger (Editor); ISBN: 1850705283; http://www.amazon.com/exec/obidos/ASIN/1850705283/icongroupinterna
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The Official Patient's Sourcebook on Cyclic Vomiting Syndrome: A Revised and Updated Directory for the Internet Age by Icon Health Publications; ISBN: 0597833877; http://www.amazon.com/exec/obidos/ASIN/0597833877/icongroupinterna
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Treatment of cancer chemotherapy-induced nausea and vomiting; ISBN: 0893521531; http://www.amazon.com/exec/obidos/ASIN/0893521531/icongroupinterna
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Understanding and Management of Nausea and Vomiting by Jan Hawthorn; ISBN: 0632038195; http://www.amazon.com/exec/obidos/ASIN/0632038195/icongroupinterna
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Vomiting and Medicine: Subject Reference and Research Guidebook by Roxanne Z. Marcus; ISBN: 0881645907; http://www.amazon.com/exec/obidos/ASIN/0881645907/icongroupinterna
Chapters on Vomiting In order to find chapters that specifically relate to vomiting, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and vomiting 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 “vomiting” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on vomiting:
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Approach to the Patient with Nausea and Vomiting Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 760-780. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: Nausea and vomiting are nonspecific symptomatic responses to a variety of conditions. This chapter on the approach to patients with nausea and vomiting is from a lengthy, two-volume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. Topics include the socioeconomic impact, pathophysiology, differential diagnosis, history and physical examination, laboratory studies and diagnostic testing, and principles of management. The author notes that the care of the patient with nausea and vomiting involves assessment of the etiology and the severity of the condition, with prompt initiation of therapy to prevent complications. 3 figures. 4 tables. 282 references.
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Drugs Used for Vertigo and Vomiting Source: in Bennett, D.R., ed. Drug Evaluations Annual 1994. Chicago, IL: American Medical Association, Division of Toxicology. 1994. p. 439-464. Contact: Available from American Medical Association. Division of Drugs and Toxicology, 515 North State Street, Chicago, IL 64610. (312) 464-500. ISBN: 0899706029. PRICE: $78.00 for AMA members, $98.00 for nonmembers. Summary: This chapter discusses drugs that are effective in combating vertigo or nausea and vomiting. The vertigo section includes a description of vertigo; its causes; subjective vertigo; drug-induced vertigo; and Meniere's disease. The section also includes a discussion of drug selection for antivertigo drugs. Drugs discussed include scopolamine; antihistaminic drugs; antianxiety agents and antidepressants; diazepam (Valium); droperidol (Innovar); and fentanyl citrate (Sublimaze). The chapter concludes with the chemical formation, and a discussion of uses, adverse reactions and precautions, and dosage and preparations for each of the pharmaceuticals discussed. 1 table. 101 references.
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Gastroparesis, Nausea, and Vomiting Source: in Lewis, J.H., ed. Pharmacologic Approach to Gastrointestinal Disorders. Baltimore, MD: Williams and Wilkins. 1994. p. 131-162. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-0672 or (410) 528-4000. Fax (410) 528-4414. PRICE: $85 (as of 1995). ISBN: 0683049704. Summary: This chapter, from a book on the pharmacologic approach to gastrointestinal disorders, explains gastroparesis, nausea, and vomiting. The author reviews the normal regulation of gastric motility and the mechanism of emesis production and covers diseases that may benefit from treatment including peptic ulcer disease, diabetes, collagen diseases, anorexia nervosa, postoperative ileus, tachygastria, short bowel syndrome, and pernicious anemia. The author also describes medications available for the treatment of vomiting and gastric stasis, including anticholinergic and cholinomimetic agents, histamine receptor antagonists, neuroleptic drugs, adrenergic
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blocking drugs, substituted benzamides acting at multiple receptor sites, dopamine antagonists, 5-HT3-receptor antagonists, specific 5-HT4-receptor agonists, opioid agonists and antagonists, and motilin analogs. 2 figures. 3 tables. 244 references. (AAM).
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to vomiting 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:10 •
Directory of Plain Language Health Information Source: Ottawa, Ontario: Canadian Public Health Association. 1999. 104 p. Contact: Available from Canadian Public Health Association. 400-1565 Carling Avenue, Ottawa, Ontario, K1Z 8R1. (613) 725-3769. Fax (613) 725-9826. E-mail:
[email protected]. PRICE: $19.95 plus shipping and handling. Also available at www.pls.cpha.ca for free. ISBN: 189432403X. Summary: Patient education materials are often written at a level that is higher than the reading level of the people who need the materials. This directory lists 'plain language' patient education materials. An extensive introductory chapter in the directory describes how patient education materials are evaluated and offers specific information about the best strategies to create plain language materials. Each piece of health information in the directory is rated according to its design assessment, in order to help readers make informed decisions about choosing materials. Part I is a list of health subjects presented in alphabetical order, in the style of a typical index. The page number after a listing notes where to find that piece of health information in Part II. Part II is a list of organizations and their contact information. Below the contact information is a list of the plain language health titles produced by the organization. Each title is grouped under a grade level heading, is numbered, and has a design rating. Part III is an alphabetical list of all the organizations in Part II. Materials related to digestive system diseases include allergies, constipation and soiling in children, cholesterol, hepatitis, constipation, diabetes and diet therapy, exercise for weight control, food choices, nutrition, heart health, immunization, low fat cooking, nausea, vomiting, diarrhea, smoking, and weight loss. Appendices to the directory include a guide to the S.M.O.G. readability formula, clear design tips, and plain language tips. The Directory is also available at www.pls.cpha.ca on the Internet.
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You will need to limit your search to “Directory” and “vomiting” 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 “vomiting” (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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CHAPTER 7. MULTIMEDIA ON VOMITING Overview In this chapter, we show you how to keep current on multimedia sources of information on vomiting. 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 vomiting is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “vomiting” 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 “vomiting” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on vomiting: •
Cyclic Vomiting Syndrome with David R. Fleisher, M.D Source: Elm Grove, WI: Cyclic Vomiting Syndrome Association. 1993. Contact: Available from Cyclic Vomiting Syndrome Association. 13180 Caroline Court, Elm Grove, WI 53122. (414) 784-6842. Fax (414) 821-5494. E-mail:
[email protected]. PRICE: $15.00 including shipping and handling. Summary: This videotape, narrated by Dr. David Fleisher of the University of Missouri School of Medicine, provides an overview of cyclic vomiting syndrome (CVS). Dr. Fleisher describes CVS and presents information appropriate for patients, families, and professionals. Also included is a 3-minute television news story about the Jolles family of Columbia, Maryland, who share their experience with CVS. There are also excerpts from the first patient/family/professional conference on CVS, held in April 1993 at the Medical College of Wisconsin. (AA-M).
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CHAPTER 8. PERIODICALS AND NEWS ON VOMITING Overview In this chapter, we suggest a number of news sources and present various periodicals that cover vomiting.
News Services and Press Releases One of the simplest ways of tracking press releases on vomiting 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 “vomiting” (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 vomiting. 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 “vomiting” (or synonyms). The following was recently listed in this archive for vomiting: •
Treatment can relieve nausea and vomiting of pregnancy Source: Reuters Medical News Date: April 13, 2004
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Electrical stimulation of median nerve relieves nausea, vomiting of pregnancy Source: Reuters Industry Breifing Date: June 30, 2003
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FDA advisers: vomit-inducer should be prescription Source: Reuters Health eLine Date: June 13, 2003
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FDA advisers say vomit-inducer should not be sold OTC Source: Reuters Industry Breifing Date: June 12, 2003
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U.S. re-examines vomit-inducer for poisoning Source: Reuters Health eLine Date: June 10, 2003
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FDA panel partially backs Merck anti-vomiting drug Source: Reuters Industry Breifing Date: March 06, 2003
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FDA reviewer backs Merck anti-vomiting drug Source: Reuters Industry Breifing Date: March 05, 2003 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 “vomiting” (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
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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “vomiting” (or synonyms). If you know the name of a company that is relevant to vomiting, 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 “vomiting” (or synonyms).
Newsletters on Vomiting Find newsletters on vomiting using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “vomiting.” 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.” Type “vomiting” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •
Kidney Disease Source: Sarcoidosis Networking. 8(3): 2. May-June 2000. Contact: Available from Sarcoid Network Association. Sarcoidosis Networking, 13925 80th Street East, Puyallup, WA 98372-3614. Email:
[email protected]. Summary: Sarcoidosis is a chronic, progressive systemic granulomatous (causing lesions) disease of unknown cause (etiology), involving almost any organ or tissue, including the skin, lungs, lymph nodes, liver, spleen, eyes, and small bones of the hands or feet. This brief article, from a newsletter for patients with sarcoidosis, reviews kidney disease, its types, diagnosis, and management. The article begins with a summary of the anatomy and function of the kidneys, which filter the blood (removing waste and excess body fluids), and maintain the balance of some essential nutrients helping to regulate blood pressure, red blood cells, and elements such as potassium and calcium. Without functioning kidneys, one cannot live without dialysis, the mechanical filtration of the blood. Kidneys fail for a variety of reasons, including trauma to the kidney, toxins, heart failure, obstruction (kidney stones), overuse of some medications, and diseases that invade the kidney, such as sarcoidosis. Diabetes and high blood pressure are the most common causes for loss of kidney function. Warning signs of kidney disease are high blood pressure (hypertension), blood or protein in the urine, creatinine level greater than 1.2 in women or 1.4 in men, more frequent urination (especially at night), difficult or painful urination, and puffy eyes or swelling of the hands or feet (especially in children). Loss of kidney function can produce symptoms including fatigue, weakness, nausea, vomiting, diarrhea or constipation, headaches, loss of appetite, increased edema (fluid retention), and fever or chills. Kidney failure is characterized as acute kidney failure, chronic kidney insufficiency, and chronic kidney failure. The need to put a person on dialysis depends upon the levels of creatinine and urea nitrogen in the blood and the evaluation of body parameters such as fluid status, and symptoms of toxicity.
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The author encourages readers to practice preventive measures which include drinking 8 to 10 glasses of water per day, preventing or treating diabetes and high blood pressure, avoiding tobacco, eating a well balanced diet, practicing good hygiene, treating wounds and infections, limiting exposure to heavy metals and toxic chemicals, and avoiding unnecessary over the counter drug use. •
Special Edition: 1992 NAPPS/Creighton Symposium Source: Medford, MA: North American Pediatric Pseudo-obstruction Society. 1992. 12 p. Contact: Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail:
[email protected]. Summary: This special edition of the American Pseudo-obstruction and Hirschsprung's Disease Society's (formerly the North American Pediatric Pseudo-obstruction Society) newsletter reports on the symposium 'Gastrointestinal Motility Disorders in Children and the Role of Intestinal Transplantation,' held in April 1992 in Omaha, NE. During the 2-day conference, there were 23 guest lecturers and 4 panel discussions. Topics in these sessions include parent-child interaction, psychosocial issues of hospitalization and home care, the parents' role as members of their child's health care team, misdiagnosis of motility disorders, small bowel transplants, ethical and legal issues, upper gastrointestinal motility disorders, the regulation of gastric emptying and lower esophageal sphincter function, current concepts in dual pH monitoring, cyclic nausea and vomiting and Munchausen Syndrome by Proxy, small intestinal motility in neonates and preterm infants, classification and histopathology of pseudo-obstruction syndromes, pharmacotherapy, the history of transplantation, clinical management issues, and intestinal motility following transplantation. The newsletter includes photographs of the speakers and comments from the evaluation forms completed by attendees.
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “vomiting” (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 vomiting: •
Is Cyclic Vomiting Different from Chronic Vomiting? Source: Code V. p. 5. Spring 1994. Contact: Available from Cyclic Vomiting Syndrome Association. 13180 Caroline Court, Elm Grove, WI 53122. (414) 784-6842. Fax (414) 821-5494. E-mail:
[email protected]. PRICE: Single copy free. Summary: In this brief letter, a physician reviews the differences between cyclic vomiting and chronic vomiting. The author reports on his observations that, of children who were vomiting repeatedly for more than three months duration, one-third had the cyclic pattern and two-thirds had the chronic pattern. He goes on to describe the
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differences, including the criteria used to separate the cyclic from chronic groups; addresses the problem of dehydration; and notes the different etiologies of the two types of vomiting. Children with cyclic vomiting were more likely to have disorders outside the gastrointestinal tract, such as abdominal migraine, sinus infection, or metabolic disorders. Children with chronic vomiting were more likely to have diseases within the gastrointestinal tract, including esophagitis, gastritis (Helicobacter infection), duodenitis (acid-induced), Giardia, and irritable bowel syndrome (IBS). •
Cyclic Vomiting in Children: A Migraine Equivalent Source: Cyclic Vomiting Syndrome Association (CVSA). 1(1): 3. Winter-Spring 1993. Contact: Available from Cyclic Vomiting Syndrome Association. 13180 Caroline Court, Elm Grove, WI 53122. (414) 784-6842. Fax (414) 821-5494. E-mail:
[email protected]. PRICE: Single copy free. Summary: This brief newsletter article reports on the experience of a group of physicians treating children with cyclic vomiting syndrome. The authors reviewed, through medical charts and via telephone, all children ages 2 to 18 who presented to their GI clinic with chronic vomiting between 1985-1991 (n=109). Cyclic vomiters (CYC)(n=34) were identified by clinical criteria and compared to chronic vomiters (CHR) group (n=75). The authors review symptoms, family histories, diagnostic studies, and therapeutic responses in these patients. The authors conclude that the historical features support the diagnosis of abdominal migraine in half of the cyclic vomiters whereas those of peptic and infectious causes predominate in chronic vomiters.
Academic Periodicals covering Vomiting Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to vomiting. In addition to these sources, you can search for articles covering vomiting 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 9. 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 vomiting. 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 nonprofit 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 vomiting. 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 vomiting: Allopurinol •
Systemic - U.S. Brands: Aloprim; Zyloprim http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202021.html
Almotriptan •
Systemic - U.S. Brands: Axert http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500301.html
Altretamine •
Systemic - U.S. Brands: Hexalen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202634.html
Aminoglutethimide •
Systemic - U.S. Brands: Cytadren http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202026.html
Anastrozole •
Systemic - U.S. Brands: Arimidex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203659.html
Antiandrogens, Nonsteroidal •
Systemic - U.S. Brands: Casodex; Eulexin; Nilandron http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203418.html
Anticholinergics/Antispasmodics •
Systemic - U.S. Brands: Anaspaz; A-Spas S/L; Banthine; Bentyl; Cantil; Cystospaz; Cystospaz-M; Donnamar; ED-SPAZ; Gastrosed; Homapin; Levbid; Levsin; Levsin/SL; Levsinex Timecaps; Pro-Banthine; Quarzan; Robinul; Robinul Forte; Symax SL http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202049.html
Antidepressants, Tricyclic •
Systemic - U.S. Brands: Anafranil; Asendin; Aventyl; Elavil; Endep; Norfranil; Norpramin; Pamelor; Sinequan; Surmontil; Tipramine; Tofranil; Tofranil-PM; Vivactil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202055.html
Antidiabetic Agents, Sulfonylurea •
Systemic - U.S. Brands: Amaryl; DiaBeta; Diabinese; Dymelor; Glucotrol; Glucotrol XL; Glynase PresTab; Micronase; Orinase; Tolinase http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202742.html
Antidyskinetics •
Systemic - U.S. Brands: Akineton; Artane; Artane Sequels; Cogentin; Kemadrin; Parsidol; Trihexane; Trihexy http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202057.html
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Antihistamines •
Systemic - U.S. Brands: Alavert; Allegra; Aller-Chlor; AllerMax Caplets; Allermed; Atarax; Banophen; Banophen Caplets; Benadryl; Benadryl Allergy; Bromphen; Calm X; Chlo-Amine; Chlorate; Chlor-Trimeton; Chlor-Trimeton Allergy; Chlor-Trimeton Repetabs; Clarinex; Claritin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202060.html
Antihistamines, Phenothiazine-derivative •
Systemic - U.S. Brands: Anergan 25; Anergan 50; Antinaus 50; Pentazine; Phenazine 25; Phenazine 50; Phencen-50; Phenergan; Phenergan Fortis; Phenergan Plain; Phenerzine; Phenoject-50; Pro-50; Promacot; Pro-Med 50; Promet; Prorex-25; Prorex-50; Prothazine; Prothazine Plain http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202063.html
Anti-inflammatory Drugs, Nonsteroidal •
Systemic - U.S. Brands: Actron; Advil; Advil Caplets; Advil, Children's; Aleve; Anaprox; Anaprox DS; Ansaid; Bayer Select Ibuprofen Pain Relief Formula Caplets; Cataflam; Clinoril; Cotylbutazone; Cramp End; Daypro; Dolgesic; Dolobid; EC-Naprosyn; Excedrin IB http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202743.html
Aprepitant •
Systemic - U.S. Brands: Emend http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500463.html
Asparaginase •
Systemic - U.S. Brands: Elspar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202072.html
Atovaquone and Proguanil •
Systemic - U.S. Brands: Malarone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500229.html
Azathioprine •
Systemic - U.S. Brands: Imuran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202077.html
Benzodiazepines •
Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
Benzonatate •
Systemic - U.S. Brands: Tessalon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202085.html
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Bethanechol •
Systemic - U.S. Brands: Duvoid; Urabeth; Urecholine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202090.html
Bleomycin •
Systemic - U.S. Brands: Blenoxane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202093.html
Busulfan •
Systemic - U.S. Brands: Busulfex; Myleran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202101.html
Carbamazepine •
Systemic - U.S. Brands: Atretol; Carbatrol; Epitol; Tegretol; Tegretol-XR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202111.html
Carbonic Anhydrase Inhibitors •
Systemic - U.S. Brands: Ak-Zol; Daranide; Dazamide; Diamox; Diamox Sequels; MZM; Neptazane; Storzolamide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202114.html
Carboplatin •
Systemic - U.S. Brands: Paraplatin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202115.html
Carmustine •
Systemic - U.S. Brands: BiCNU http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202117.html
Charcoal, Activated •
Oral - U.S. Brands: Actidose with Sorbitol; Actidose-Aqua; CharcoAid; CharcoAid 2000; CharcoAid G; Insta-Char in an Aqueous Base; Insta-Char in an Aqueous Base with Cherry Flavor; Insta-Char Pediatric in an Aqueous Base with Cherry Flavor; Insta-Char Pediatric with Cherry http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202120.html
Chlorambucil •
Systemic - U.S. Brands: Leukeran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202124.html
Cisplatin •
Systemic - U.S. Brands: Platinol; Platinol-AQ http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202143.html
Cladribine •
Systemic - U.S. Brands: Leustatin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202699.html
Researching Medications
Clomiphene •
Systemic - U.S. Brands: Clomid; Milophene; Serophene http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202151.html
Clonidine •
Systemic - U.S. Brands: Catapres; Catapres-TTS-1; Catapres-TTS-2; CatapresTTS-3 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202152.html
Copper Supplements •
Systemic - U.S. Brands: Cupri-Pak http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202164.html
Cysteamine •
Systemic - U.S. Brands: Cystagon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202772.html
Cytarabine, Liposomal •
Intrathecal - U.S. Brands: DepoCyt http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500008.html
Daunorubicin, Liposomal •
Systemic - U.S. Brands: DaunoXome http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203539.html
Didanosine •
Systemic - U.S. Brands: Videx http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202616.html
Docetaxel •
Systemic - U.S. Brands: Taxotere http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202920.html
Dolasetron •
Systemic - U.S. Brands: Anzemet http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203375.html
Doxorubicin, Liposomal •
Systemic - U.S. Brands: Doxil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203540.html
Droperidol •
Systemic - U.S. Brands: Inapsine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203411.html
Eletriptan •
Systemic - U.S. Brands: Relpax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500459.html
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Enteral Nutrition Formulas •
Systemic - U.S. Brands: 206 Shake; Accupep HPF; Advera; Alitraq; Amin-Aid; Attain; Carnation Instant Breakfast; Carnation Instant Breakfast No Sugar Added; Casec; CitriSource; Citrotein; Compleat Modified; Compleat Regular; Comply; Criticare HN; Crucial; Deliver 2.0 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202673.html
Epirubicin •
Systemic - U.S. Brands: Ellence http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500038.html
Fludarabine •
Systemic - U.S. Brands: Fludara http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202630.html
Frovatriptan •
Systemic - U.S. Brands: Frova http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500343.html
Gemcitabine •
Systemic - U.S. Brands: Gemzar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203038.html
Granisetron •
Systemic - U.S. Brands: Kytril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202724.html
Idarubicin •
Systemic - U.S. Brands: Idamycin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202611.html
Insulin •
Systemic - U.S. Brands: Humulin 50/50; Humulin 70/30; Humulin 70/30 Pen; Humulin L; Humulin N; Humulin N Pen; Humulin R; Humulin R, Regular U500 (Concentrated); Humulin U; Lente; Lente Iletin II; Novolin 70/30; Novolin 70/30 PenFill; Novolin 70/30 Prefilled; Novolin L http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203298.html
Irinotecan •
Systemic - U.S. Brands: Camptosar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203051.html
Metformin •
Systemic - U.S. Brands: Glucophage; Glucophage XR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202756.html
Naratriptan •
Systemic - U.S. Brands: Amerge http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203513.html
Researching Medications
Oxaliplatin •
Systemic - U.S. Brands: Eloxatin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500411.html
Paclitaxel •
Systemic - U.S. Brands: Taxol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202682.html
Pegaspargase •
Systemic - U.S. Brands: Oncaspar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203543.html
Penicillins and Beta-Lactamase Inhibitors •
Systemic - U.S. Brands: Augmentin; Timentin; Unasyn; Zosyn http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202705.html
Pentostatin •
Systemic - U.S. Brands: Nipent http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202650.html
Streptozocin •
Systemic - U.S. Brands: Zanosar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202532.html
Sulfadoxine and Pyrimethamine •
Systemic - U.S. Brands: Fansidar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202534.html
Sulfinpyrazone •
Systemic - U.S. Brands: Anturane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202538.html
Sumatriptan •
Systemic - U.S. Brands: Imitrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202665.html
Tamoxifen •
Systemic - U.S. Brands: Nolvadex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202545.html
Temozolomide •
Systemic - U.S. Brands: Temodar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500076.html
Teniposide •
Systemic - U.S. Brands: Vumon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203661.html
197
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Testolactone •
Systemic - U.S. Brands: Teslac http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202549.html
Thiabendazole •
Systemic - U.S. Brands: Mintezol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202558.html
Thiethylperazine •
Systemic - U.S. Brands: Torecan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202561.html
Topotecan •
Systemic - U.S. Brands: Hycamtin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203049.html
Trimethobenzamide •
Systemic - U.S. Brands: Benzacot; Stemetic; Tebamide; Tigan; Tribenzagan; Trimazide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202578.html
Trimetrexate •
Systemic - U.S. Brands: Neutrexin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202693.html
Vinblastine •
Systemic - U.S. Brands: Velban http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202593.html
Vincristine •
Systemic - U.S. Brands: Oncovin; Vincasar PFS; Vincrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202594.html
Vinorelbine •
Systemic - U.S. Brands: Navelbine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203542.html
Zalcitabine •
Systemic - U.S. Brands: HIVID http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202652.html
Zolmitriptan •
Systemic - U.S. Brands: Zomig http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203426.html
Researching Medications
199
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.
201
APPENDICES
203
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
11
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
205
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
12
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “vomiting” (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 39800 495 1018 316 3379 45008
HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “vomiting” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
14
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
15
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
Physician Resources
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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
19 Adapted 20
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
209
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 vomiting 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 vomiting. 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 vomiting. 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 “vomiting”:
210
•
Vomiting
Guides on vomiting Nausea and Vomiting http://www.nlm.nih.gov/medlineplus/nauseaandvomiting.html
•
Other guides Cancer Chemotherapy http://www.nlm.nih.gov/medlineplus/cancerchemotherapy.html Food Contamination and Poisoning http://www.nlm.nih.gov/medlineplus/foodcontaminationandpoisoning.html Gastroenteritis http://www.nlm.nih.gov/medlineplus/gastroenteritis.html Infant and Toddler Health http://www.nlm.nih.gov/medlineplus/infantandtoddlerhealth.html
Within the health topic page dedicated to vomiting, the following was listed: •
General/Overviews About Nausea and Vomiting Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/1800/1810.asp?index=8106
•
Diagnosis/Symptoms Nausea and Vomiting Source: American Academy of Family Physicians http://familydoctor.org/529.xml Nausea and Vomiting in Infants and Children Source: American Academy of Family Physicians http://familydoctor.org/530.xml
•
Nutrition Nutrition Tips for Managing Nausea and Vomiting Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01133
•
Specific Conditions/Aspects Morning Sickness Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ146VY77C&s ub_cat=57 Nausea and Vomiting (PDQ) Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/supportivecare/nausea/patient/
Patient Resources
•
211
Children Guide to Your Child's Symptoms: Vomiting Source: American Academy of Pediatrics http://www.aap.org/pubserv/vomiting.htm Vomiting Source: Nemours Foundation http://kidshealth.org/parent/firstaid_safe/emergencies/vomit.html Vomiting and Diarrhea: Helping Your Child through Sickness Source: American Academy of Family Physicians http://familydoctor.org/196.xml What is Puke? Source: Nemours Foundation http://kidshealth.org/kid/ill_injure/sick/puke.html
•
Latest News Ginger Eases Morning Sickness Source: 04/12/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_17103 .html
•
Organizations Cyclic Vomiting Syndrome Association http://www.cvsaonline.org National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on vomiting. 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: •
Do You Know a Child Who Vomits for Prolonged Periods? Is the Child Well Between Episodes?: Cyclic Vomiting Syndrome Association Source: Elm Grove, WI: Cyclic Vomiting Syndrome Association. 1996. 4 p.
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Contact: Available from Cyclic Vomiting Syndrome Association. 13180 Caroline Court, Elm Grove, WI 53122. (414) 784-6842. Fax (414) 821-5494. E-mail:
[email protected]. PRICE: Single copy free. Summary: This brochure describes cyclic vomiting syndrome (CVS), a rare unexplained disorder characterized by recurrent, prolonged attacks of severe vomiting, nausea, and prostration with no apparent cause. The brochure addresses the occurrence, symptoms, triggers, diagnosis, and treatment of CVS. The brochure also includes a list of related terms; quotes and experiences related from the patient's perspective; the family's perspective; information from health care providers; and a description of the CVS Association. The information stresses that the collaborative model for the doctor-patientfamily relationship is critical to the management of CVS. A membership form for joining CVSA is also included. •
Self-Care for Vomiting and Diarrhea Source: San Bruno, CA: Krames Communications. 1995. 2 p. Contact: Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $17.95 per pack of 50 brochures (as of 1996). Summary: This brochure provides basic suggestions for readers coping with vomiting and diarrhea. The brochure first describes the causative agents of stomach upset and then provides recommendations for relieving digestive discomfort. Suggestions include drinking liquids, starting with light meals, using stomach-soothing medications, and avoiding stomach-upsetting medications. The brochure includes two checklists: the symptoms of dehydration (excess fluid loss) and when to call a health care provider. The brochure is illustrated with colorful drawings.
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Cyclic Vomiting Syndrome (CVS): An Under-Explained, Under-Diagnosed, Difficultto-Treat Disorder that Mostly Affects Children But, Wreaks Havoc on Entire Families Source: Canal Winchester, OH: Cyclic Vomiting Syndrome Association, USA/Canada. 1999. [1 p]. Contact: Available from Cyclic Vomiting Syndrome Association, USA/Canada. 3585 Cedar Hill Road, NW, Canal Winchester, OH 43110. (614) 837-2586. Fax (614) 837-2586. E-mail:
[email protected]. Website: www.cvsaonline.org. PRICE: Single copy free. Summary: This fact sheet describes cyclic vomiting syndrome. Cyclic vomiting refers to discrete and severe episodes of vomiting, nausea, and lethargy (severe tiredness). Episodes are discrete in that the sufferer is free of nausea and vomiting between episodes. Episodes can occur on a routine schedule, be triggered by physical or psychological stress, or appear to come at random. Cyclic vomiting has many known causes, including intestinal blockage, brain disorders, kidney disease, and several different metabolic disorders. Many of these causes are treatable, so a careful diagnostic work up is important. However, in the vast majority of cases, none of the above causes can be found, and these individuals are given the diagnosis of cyclic vomiting syndrome (CVS). The author stresses that patients with CVS need care that is expert, accessible, prompt, and effective. The fact sheet emphasizes the CVS can have a severe impact on family life, particular when the person with CVS is a child (as in the majority of cases).
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Diagnostic Guide: Cyclic Vomiting Syndrome (CVS) Source: Canal Winchester, OH: Cyclic Vomiting Syndrome Association, USA/Canada. 1999. [1 p]. Contact: Available from Cyclic Vomiting Syndrome Association, USA/Canada. 3585 Cedar Hill Road, NW, Canal Winchester, OH 43110. (614) 837-2586. Fax (614) 837-2586. E-mail:
[email protected]. Website: www.cvsaonline.org. PRICE: Single copy free. Summary: This fact sheet offers a diagnostic guide for cyclic vomiting syndrome. Cyclic vomiting refers to discrete and severe episodes of vomiting, nausea, and lethargy (severe tiredness). Episodes are discrete in that the sufferer is free of nausea and vomiting between episodes. Episodes can occur on a routine schedule, be triggered by physical or psychological stress, or appear to come at random. The fact sheet lists the research definition, the current diagnostic criteria, diagnostic studies that can be used to exclude specific diagnoses that mimic CVS, and which tests should be obtained between acute episodes as well as those tests that should be performed during an acute episode. The essential diagnostic criteria for CVS include: recurrent severe episodes of nausea and vomiting, minimum of 3 distinct episodes; more than 4 emeses per hour at the peak; episodes last from hours to days, 24 to 48 hours on average; less than 2 episodes per week; varying intervals of normal health between episodes. Diagnoses that can cause a cyclic vomiting pattern include abdominal migraine, chronic sinus infections, brain tumors, structural abnormalities of the intestinal tract, kidney blockage, metabolic and endocrine disorders, and psychological disturbances.
•
Cyclic Vomiting Syndrome: A Fact Sheet Source: Elm Grove, WI: Cyclic Vomiting Syndrome Association. 1994. 1 p. Contact: Available from Cyclic Vomiting Syndrome Association. 13180 Caroline Court, Elm Grove, WI 53122. (414) 784-6842. Fax (414) 821-5494. E-mail:
[email protected]. PRICE: Single copy free. Summary: This fact sheet presents information about cyclic vomiting syndrome (CVS), a rare, unexplained disorder of children characterized by recurrent episodes of severe vomiting, nausea, and prostration with no apparent cause. Topics include the symptoms of CVS and their onset; epidemiology; the relationship between CVS and migraines; problems of dehydration and electrolyte imbalance; trigger events; diagnosis; treatment options; and the importance of the family professional relationship. 4 references.
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Guide to Management of Cyclic Vomiting Episodes (Totally Empirical) Source: Canal Winchester, OH: Cyclic Vomiting Syndrome Association, USA/Canada. 2001. [1 p]. Contact: Available from Cyclic Vomiting Syndrome Association, USA/Canada. 3585 Cedar Hill Road, NW, Canal Winchester, OH 43110. (614) 837-2586. Fax (614) 837-2586. E-mail:
[email protected]. Website: www.cvsaonline.org. PRICE: Single copy free. Summary: This fact sheet provides a guide to the empirical management of cyclic vomiting syndrome episodes. Cyclic vomiting refers to discrete and severe episodes of vomiting, nausea, and lethargy (severe tiredness). Episodes are discrete in that the sufferer is free of nausea and vomiting between episodes. Episodes can occur on a routine schedule, be triggered by physical or psychological stress, or appear to come at random. The fact sheet explains what to do to treat a patient with CVS, from immediate
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assessment to differential diagnosis to preventing dehydration. The author discusses drug therapy, diagnostic tests that may be appropriate, how to cope with abdominal pain associated with the episode, and the importance of sleep as the only state that affords comfort to the patient with intractable nausea and vomiting. The author concludes that prompt responsiveness and attention to the patient's physical and emotional comfort are hallmarks of finesse in the management of CVS episodes. One chart outlines the dosing for odansetron (Zofran) and maintenance of IV fluids for common body weights. 1 table. •
Controlling Nausea and Vomiting Source: San Bruno, CA: Krames Communications. 1998. 2 p. Contact: Available from Krames Communications. 1100 Grundy Lane, San Bruno, CA 94066-3030. (800) 333-3032. Fax (415) 244-4512. PRICE: $12.50 for pad of 50 sheets. Summary: This fact sheet provides suggestions on controlling nausea and vomiting in patients who are undergoing chemotherapy and radiation therapy. These side effects occur because the treatment affects normal cells as well as cancer cells. The cells lining the stomach and the part of the brain that controls vomiting may be affected. The fact sheet notes that nausea may be prevented or controlled with medications and lists such suggestions as taking medications as prescribed; eating small meals slowly throughout the day, preferably with a companion; eating foods at room temperature or colder to avoid strong smells; eating dry foods such as toast, crackers, or pretzels; and avoiding food for 1 to 2 hours before treatment. Other strategies are listed to help ease nausea and vomiting and to distract oneself from these side effects. Indications for when to contact the health care provider are also given. The fact sheet is illustrated with full-color line drawings and includes blank space for notes or special instructions. The fact sheet is one of a series of patient education materials on the complications of cancer treatment.
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Nausea and Vomiting Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, for people with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses HIV-related nausea and vomiting. Nausea and vomiting are nonspecific symptoms resulting from side effects of medications, pregnancy, substance abuse, chemical imbalances, pain of the internal abdominal organs, motility problems of the digestive tract, conditions affecting balance, and psychological issues. Nausea and vomiting can lead to serious medical complications. Individuals with HIV who are vomiting or are nauseous should see a physician if they do not feel better within 12 to 24 hours, blood or partly digested blood appears, a fever persists, abdominal pain is experienced, sever headaches occur, the abdomen is swollen and bloated, or necessary medications are interfered with. The medical evaluation includes a review of how long and how often patients have been vomiting, what they have eaten in the past day, and a description of any associated symptoms. The best way to manage and treat nausea and vomiting is to identify and treat the condition that is causing them.
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Cyclic Vomiting in Mitochondrial Disease Source: Canal Winchester, OH: Cyclic Vomiting Syndrome Association, USA/Canada. 2000. [3 p].
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Contact: Available from Cyclic Vomiting Syndrome Association, USA/Canada. 3585 Cedar Hill Road, NW, Canal Winchester, OH 43110. (614) 837-2586. Fax (614) 837-2586. E-mail:
[email protected]. Website: www.cvsaonline.org. PRICE: Single copy free. Summary: This newsletter article discusses cyclic vomiting in mitochondrial disease. Cyclic vomiting refers to discrete and severe episodes of vomiting, nausea, and lethargy (severe tiredness). Episodes are discrete in that the sufferer is free of nausea and vomiting between episodes. Episodes can occur on a routine schedule, be triggered by physical or psychological stress, or appear to come at random. Cyclic vomiting has many known causes, including intestinal blockage, brain disorders, kidney disease, and several different metabolic disorders. Many of these causes are treatable, so a careful diagnostic work up is important. However, in the vast majority of cases, none of the above causes can be found, and these individuals are given the diagnosis of cyclic vomiting syndrome (CVS). At present, migraine headaches, abdominal migraine, and CVS are considered to be related, and possibly are different manifestations of the same disorder. The author reports on work with patients who have mitochondrial disease and CVS, focusing on diagnostic tests, patient selection, and treatment options. The author provides web site addresses for readers seeking additional information (www.cvsaonline.org or www.umdf.org). •
Antidepressants for Cyclic Vomiting Syndrome Source: Canal Winchester, OH: Cyclic Vomiting Syndrome Association, USA/Canada. 2002. [3 p]. Contact: Available from Cyclic Vomiting Syndrome Association, USA/Canada. 3585 Cedar Hill Road, NW, Canal Winchester, OH 43110. (614) 837-2586. Fax (614) 837-2586. E-mail:
[email protected]. Website: www.cvsaonline.org. PRICE: Single copy free. Summary: This newsletter article discusses the use of antidepressants in the treatment of cyclic vomiting in mitochondrial disease. Cyclic vomiting refers to discrete and severe episodes of vomiting, nausea, and lethargy (severe tiredness). Episodes are discrete in that the sufferer is free of nausea and vomiting between episodes. Episodes can occur on a routine schedule, be triggered by physical or psychological stress, or appear to come at random. Cyclic vomiting has many known causes, including intestinal blockage, brain disorders, kidney disease, and several different metabolic disorders. Many of these causes are treatable, so a careful diagnostic work up is important. However, in the vast majority of cases, none of the above causes can be found, and these individuals are given the diagnosis of cyclic vomiting syndrome (CVS). Antidepressants are particularly useful in controlling functional symptoms in conditions including irritable bowel syndrome, functional dyspepsia, and fibromyalgia. Benefits on the physical symptoms can be independent of the drugs' psychiatric effects. The tricyclic antidepressants (TCAs), such as amitriptyline, nortriptyline, or desipramine, appear particularly useful, even in low daily dosages that would be considered subtherapeutic from the psychiatric standpoint. No single TCA has surfaced as superior to the other for CVS, although amitriptyline is most often utilized. The author offers guidelines for administration and dosage, patient selection, and coping with side effects of these drugs. 1 figure. 9 references.
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Vomiting and Diarrhea: Helping Your Child Through Sickness Source: Kansas City, MO: American Academy of Family Physicians. 1993. 4 p.
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Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $22.00 for 100 copies for members, $33.00 for 100 copies for nonmembers. Summary: This patient education brochure helps parents understand vomiting and diarrhea and how they can help their child through sickness. Vomiting (throwing up) and diarrhea (frequent, watery bowel movements) can be caused by viruses, bacteria, parasites, foods that are hard to digest, and other things. Vomiting and diarrhea can be harmful to children because they can cause dehydration. Fluids can be replaced by oral rehydration solutions (ORS). The brochure explains the different types of ORS, including powders and premixed liquids, and home remedies. The brochure also outlines how much ORS to give to a child with diarrhea or with vomiting. The brochure also recommends feeding a child during illness. Even though eating may cause the amount of diarrhea to increase, the child will be able to get some nutrients from the food. This may prevent too much weight loss and may enable the child to get better more quickly. The brochure notes that medications to stop diarrhea are not usually needed. A final section outlines diarrhea prevention strategies, focusing on handwashing and hygienic considerations. One sidebar lists the signs of dehydration in children and babies. 2 tables. (AA-M). •
Dietary Suggestions for Controlling Nausea and Vomiting Source: Rochester, MN: Mayo Clinic, Patient and Health Education Center. 1990. 2 p. Contact: Available From Mayo Clinic, Patient and Health Education Center. 200 First Street, SW, Rochester, MN 55905. (507) 284-2511. PRICE: $0.80 plus shipping and handling (for health care professionals). Order Number MC 657/R890. Summary: This patient education brochure offers dietary suggestions for managing nausea and vomiting. Topics include the importance of eating well-balanced, regularly scheduled meals; trying a variety of foods; the timing of fluid intake; and minimizing activities or surroundings that may make the nausea worse. The brochure includes blank spaces for the listing of health care providers and phone numbers.
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Vomiting and Diarrhea in Children Source: American Family Physician. 51(5): 1117-1118. April 1995. Summary: This patient information fact sheet about vomiting and diarrhea in children, from the American Family Physician journal, is designed for reproduction and distribution to parents. Written in a question and answer format, the fact sheet covers the risk of getting dehydrated; how to prevent dehydration; oral rehydration solution (ORS); home remedies for dehydration; how ORS should be given; how long to give ORS; breast feeding and formula feeding for the child with diarrhea; medications for diarrhea; and how to determine if a dehydrated child needs to be hospitalized. 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 “vomiting” (or synonyms). The following was recently posted:
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American Gastroenterological Association medical position statement: nausea and vomiting Source: American Gastroenterological Association - Medical Specialty Society; 2000 May 21 (reviewed 2001); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3060&nbr=2286&a mp;string=vomiting
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ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery Source: American Society of Health-System Pharmacists - Professional Association; 1999; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1875&nbr=1101&a mp;string=vomiting
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Recommendations for the evaluation and management of nausea and vomiting of early pregnancy ( Source: University of Texas at Austin School of Nursing, Family Nurse Practitioner Program - Academic Institution; 2002 May; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3228&nbr=2454&a mp;string=vomiting 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: •
Cyclic Vomiting Syndrome Summary: Describes the four phases of cyclic vomiting syndrome as well as its triggers, symptoms, treatment, diagnosis, complications, and relationship to migraines. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6495
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Marijuana Use in Supportive Care for Cancer Patients Summary: A fact sheet about marijuana use to treat chemotherapy-induced nausea, vomiting, anorexia and cachexia in cancer patients Source: Cancer Information Service, National Cancer Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7054
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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 vomiting. 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 Vomiting The following is a list of associations that provide information on and resources relating to vomiting: •
Cyclic Vomiting Syndrome Association (CVSA) Telephone: (614) 837-2586 Fax: (614) 837-2586 Email:
[email protected] Web Site: http://www.cvsaonline.org Background: The Cyclic Vomiting Syndrome Association (CVSA) is a voluntary not-forprofit self-help organization dedicated to giving affected individuals, families, and health care professionals the opportunity to offer and receive support and share knowledge about cyclic vomiting syndrome (CVS). The organization also promotes ongoing medical research into CVS; increases worldwide public and professional awareness of the syndrome; and serves as a resource center for information on CVS. Established in 1993 by parents of children with CVS and health care professionals, the Cyclic Vomiting Syndrome Association provides appropriate referrals, promotes patient advocacy, and enables affected families to network nationally and internationally to exchange information and provide mutual support. In addition, it
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offers a variety of educational materials to parents, health care professionals, and the general public.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to vomiting. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with vomiting. 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 vomiting. 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 “vomiting” (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 “vomiting”. 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 “vomiting” (or synonyms) into the “For these
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words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “vomiting” (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.22
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
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Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •
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/
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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
•
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
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
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 vomiting: •
Basic Guidelines for Vomiting Vomiting blood Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm
•
Signs & Symptoms for Vomiting Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Black stools Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003130.htm Bleeding from the nose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003106.htm Blood in the stool Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003130.htm
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Blood in the stools Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003130.htm Coughing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm Coughing up blood Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003073.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm GI bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003133.htm Nasal drainage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003051.htm Stomach acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm Vomit Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •
Diagnostics and Tests for Vomiting CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm EGD Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003888.htm Endoscopy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003338.htm Erosion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm Ulcer Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm
Online Glossaries 229
•
Background Topics for Vomiting Duodenum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002347.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.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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VOMITING DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 1-phosphate: A drug that halts cell suicide in human white blood cells. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Cramps: Abdominal pain due to spasmodic contractions of the bowel. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abducens: A striated, extrinsic muscle of the eyeball that originates from the annulus of Zinn. [NIH] Abducens Nerve: The 6th cranial nerve. The abducens nerve originates in the abducens nucleus of the pons and sends motor fibers to the lateral rectus muscles of the eye. Damage to the nerve or its nucleus disrupts horizontal eye movement control. [NIH] Abducens Nerve Diseases: Diseases of the sixth cranial (abducens) nerve or its nucleus in the pons. The nerve may be injured along its course in the pons, intracranially as it travels along the base of the brain, in the cavernous sinus, or at the level of superior orbital fissure or orbit. Dysfunction of the nerve causes lateral rectus muscle weakness, resulting in horizontal diplopia that is maximal when the affected eye is abducted and esotropia. Common conditions associated with nerve injury include intracranial hypertension; craniocerebral trauma; ischemia; and infratentorial neoplasms. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Acclimatization: Adaptation to a new environment or to a change in the old. [NIH] Acetic Acids: Acetic acid and its derivatives which may be formed by substitution reactions. Mono- and di-substituted, as well as halogenated compounds have been synthesized. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcholinesterase: An enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. In the CNS, this enzyme plays a role in the function of peripheral neuromuscular junctions. EC 3.1.1.7. [NIH] Achlorhydria: A lack of hydrochloric acid in gastric juice despite stimulation of gastric secretion. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an
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increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles. [NIH] Acustimulation: Mild electrical stimulation of acupuncture points to control symptoms such as nausea and vomiting. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Monophosphate: Adenylic acid. Adenine nucleotide containing one phosphate group esterified to the sugar moiety in the 2'-, 3'-, or 5'-position. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] 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] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU]
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Adrenergic Agents: Drugs that act on adrenergic receptors or affect the life cycle of adrenergic transmitters. Included here are adrenergic agonists and antagonists and agents that affect the synthesis, storage, uptake, metabolism, or release of adrenergic transmitters. [NIH]
Adverse Effect: An unwanted side effect of treatment. [NIH] Aerophagia: A condition that occurs when a person swallows too much air. Causes gas and frequent belching. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
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] Aggravation: An increasing in seriousness or severity; an act or circumstance that intensifies, or makes worse. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Agranulocytosis: A decrease in the number of granulocytes (basophils, eosinophils, and neutrophils). [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [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] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergens: Antigen-type substances (hypersensitivity, immediate). [NIH]
that
produce
immediate
hypersensitivity
Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH]
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Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [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] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] 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] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [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] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent
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that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anergy: Absence of immune response to particular substances. [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] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the capillaries, and characterized by development of giant wheals. [EU] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of
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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] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Anterograde: Moving or extending forward; called also antegrade. [EU] Anthracycline: A member of a family of anticancer drugs that are also antibiotics. [NIH] Anthrax: An acute bacterial infection caused by ingestion of bacillus organisms. Carnivores may become infected from ingestion of infected carcasses. It is transmitted to humans by contact with infected animals or contaminated animal products. The most common form in humans is cutaneous anthrax. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [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]
Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH]
Dictionary 237
Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Anticonvulsive: An agent that prevents or relieves convulsions. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipruritic: Relieving or preventing itching. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipsychotic Agents: Agents that control agitated psychotic behavior, alleviate acute
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psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antispasmodic: An agent that relieves spasm. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apathy: Lack of feeling or emotion; indifference. [EU] Apnea: A transient absence of spontaneous respiration. [NIH] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Aspiration: The act of inhaling. [NIH]
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Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [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] Astrocytoma: A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes. [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. 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] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [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] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Aura: A subjective sensation or motor phenomenon that precedes and marks the of a paroxysmal attack, such as an epileptic attack on set. [EU] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoclave: Apparatus using superheated steam under pressure. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autogenic: A type of succession when the developing vegetation itself is the cause for the
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succession. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [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] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components
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such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]
Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Benzamides: Benzoic acid amides. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bezoars: Concretions of swallowed hair, fruit or vegetable fibers, or similar substances found in the alimentary canal. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding agent: A substance that makes a loose mixture stick together. For example, binding agents can be used to make solid pills from loose powders. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Bioequivalent: Having the same strength and similar bioavailability in the same dosage
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form as another specimen of a given drug substance. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [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] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Bioluminescence: The emission of light by living organisms such as the firefly, certain mollusks, beetles, fish, bacteria, fungi and protozoa. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [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 Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] 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]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Breast reconstruction: Surgery to rebuild a breast's shape after a mastectomy. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchial Hyperreactivity: Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bullous: Pertaining to or characterized by bullae. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Butterflies: Slender-bodies diurnal insects having large, broad wings often strikingly colored and patterned. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH]
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Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Calcitonin: A peptide hormone that lowers calcium concentration in the blood. In humans, it is released by thyroid cells and acts to decrease the formation and absorptive activity of osteoclasts. Its role in regulating plasma calcium is much greater in children and in certain diseases than in normal adults. [NIH] Calcitonin Gene-Related Peptide: Calcitonin gene-related peptide. A 37-amino acid peptide derived from the calcitonin gene. It occurs as a result of alternative processing of mRNA from the calcitonin gene. The neuropeptide is widely distributed in neural tissue of the brain, gut, perivascular nerves, and other tissue. The peptide produces multiple biological effects and has both circulatory and neurotransmitter modes of action. In particular, it is a potent endogenous vasodilator. [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] Calcium Sulfate: It exists in an anhydrous form and in various states of hydration: the hemihydrate is plaster of Paris, the dihydrate is gypsum. It is used in building materials, as a desiccant, in dentistry as an impression material, cast, or die, and in medicine for immobilizing casts and as a tablet excipient. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Calicivirus: A genus in the family Caliciviridae containing many species including feline calicivirus , vesicular exanthema of swine virus, and San Miguel sea lion viruses. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]
Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU]
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Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carboxymethylcellulose: It is used as an emulsifier, thickener, suspending agent, etc., in cosmetics and pharmaceuticals; in research as a culture medium; in chromatography as a stabilizer for reagents; and therapeutically as a bulk laxative with antacid properties. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [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] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [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] Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are
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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 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 proliferation: An increase in the number of cells as a result of cell growth and cell 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] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [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 Aqueduct: Narrow channel in the mesencephalon that connects the third and fourth ventricles. [NIH] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] 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] 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]
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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] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chimeras: Organism that contains a mixture of genetically different cells. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Cholera: An acute diarrheal disease endemic in India and Southeast Asia whose causative agent is vibrio cholerae. This condition can lead to severe dehydration in a matter of hours unless quickly treated. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] 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 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]
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Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Choroid Plexus: A villous structure of tangled masses of blood vessels contained within the third, lateral, and fourth ventricles of the brain. It regulates part of the production and composition of cerebrospinal fluid. [NIH] Choroid Plexus Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes, or glandular ducts. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] 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] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] 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] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [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] Clot Retraction: Retraction of a clot resulting from contraction of platelet pseudopods attached to fibrin strands that is dependent on the contractile protein thrombosthenin. Used as a measure of platelet function. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH]
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Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] 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] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation
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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] Complement Activation: The sequential activation of serum components C1 through C9, initiated by an erythrocyte-antibody complex or by microbial polysaccharides and properdin, and producing an inflammatory response. [NIH] 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] Complete response: The disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] 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] Conflict of Interest: A situation in which an individual might benefit personally from official or professional actions. It includes a conflict between a person's private interests and official responsibilities in a position of trust. The term is not restricted to government
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officials. The concept refers both to actual conflict of interest and the appearance or perception of conflict. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Conscious Sedation: An alternative to general anesthesia in patients for whom general anesthesia is refused or considered inadvisable. It involves the administering of an antianxiety drug (minor tranquilizer) and an analgesic or local anesthetic. This renders the patient free of anxiety and pain while allowing the patient to remain in verbal contact with the physician or dentist. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] 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] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraceptive Agents: Chemical substances that prevent or reduce the probability of conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [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]
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Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]
Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] 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] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be
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classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Craniotomy: An operation in which an opening is made in the skull. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Credentialing: The recognition of professional or technical competence through registration, certification, licensure, admission to association membership, the award of a diploma or degree, etc. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclic Vomiting Syndrome: Sudden, repeated attacks of severe vomiting (especially in children), nausea, and physical exhaustion with no apparent cause. Can last from a few hours to 10 days. The episodes begin and end suddenly. Loss of fluids in the body and changes in chemicals in the body can require immediate medical attention. Also called abdominal migraine. [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] Cyproheptadine: A serotonin antagonist and a histamine H1 blocker used as antipruritic, appetite stimulant, antiallergic, and for the post-gastrectomy dumping syndrome, etc. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [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] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [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.
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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]
Day Care: Institutional health care of patients during the day. The patients return home at night. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] 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] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermal: Pertaining to or coming from the skin. [NIH]
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Dermatitis: Any inflammation of the skin. [NIH] Dermatitis Herpetiformis: Rare, chronic, papulo-vesicular disease characterized by an intensely pruritic eruption consisting of various combinations of symmetrical, erythematous, papular, vesicular, or bullous lesions. The disease is strongly associated with the presence of HLA-B8 and HLA-DR3 antigens. A variety of different autoantibodies has been detected in small numbers in patients with dermatitis herpetiformis. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dexmedetomidine: A selective inhibitor of receptors, adrenergic alpha-2 that has analgesic and sedative properties. Medetomidine is the other racemic form. [NIH] Dextrorotatory: Turning towards the right hand. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Diaphoresis: Perspiration, especially profuse perspiration. Called also sudoresis. [EU] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH]
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Dilatation: The act of dilating. [NIH] Dilatation and Curettage: Dilatation of the cervix uteri followed by a scraping of the endometrium with a curette. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimerization: The process by which two molecules of the same chemical composition form a condensation product or polymer. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diphenhydramine: A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. It has some undesired antimuscarinic and sedative effects. [NIH] Diploid: Having two sets of chromosomes. [NIH] Diplopia: A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include refractive errors; strabismus; oculomotor nerve diseases; trochlear nerve diseases; abducens nerve diseases; and diseases of the brain stem and occipital lobe. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]
Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dispenser: Glass, metal or plastic shell fitted with valve from which a pressurized formulation is dispensed; an instrument for atomizing. [NIH] Dissection: Cutting up of an organism for study. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU]
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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] Distention: The state of being distended or enlarged; the act of distending. [EU] Diurnal: Occurring during the day. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulosis: A condition marked by small sacs or pouches (diverticula) in the walls of an organ such as the stomach or colon. These sacs can become inflamed and cause a condition called diverticulitis, which may be a risk factor for certain types of cancer. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Diving: An activity in which the organism plunges into water. It includes scuba and bell diving. Diving as natural behavior of animals goes here, as well as diving in decompression experiments with humans or animals. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Antagonists: Drugs that bind to but do not activate dopamine receptors, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (antipsychotic agents) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as antiemetics, in the treatment of Tourette syndrome, and for hiccup. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows
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which of several possible therapies the person is receiving. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Industry: That segment of commercial enterprise devoted to the design, development, and manufacture of chemical products for use in the diagnosis and treatment of disease, disability, or other dysfunction, or to improve function. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dumping Syndrome: Gastrointestinal nonfunctioning pylorus. [NIH]
symptoms
resulting
from
an
absent
or
Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]
Duodenitis: An irritation of the first part of the small intestine (duodenum). [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU]
Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysphoria: Disquiet; restlessness; malaise. [EU] Dystonia: Disordered tonicity of muscle. [EU] Dystonia Musculorum Deformans: A neurological disorder characterized by alterations in muscle tone. [NIH] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous
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and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electroconvulsive Therapy: Electrically induced convulsions primarily used in the treatment of severe affective disorders and schizophrenia. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [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] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried
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until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Emergency Medicine: A branch of medicine concerned with an individual's resuscitation, transportation and care from the point of injury or beginning of illness through the hospital or other emergency treatment facility. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]
Emetic: An agent that causes vomiting. [EU] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Encopresis: Incontinence of feces not due to organic defect or illness. [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] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] 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] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]
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Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Enteric bacteria: Single-celled microorganisms that lack chlorophyll. Some bacteria are capable of causing human, animal, or plant diseases; others are essential in pollution control because they break down organic matter in the air and in the water. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Enterotoxins: Substances that are toxic to the intestinal tract causing vomiting, diarrhea, etc.; most common enterotoxins are produced by bacteria. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophilic Gastroenteritis: Infection and swelling of the lining of the stomach, small intestine, or large intestine. The infection is caused by white blood cells (eosinophils). [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] 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] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epiglottis: Thin leaf-shaped cartilage, covered with mucous membrane, at the root of the tongue, which folds back over the entrance to the larynx, covering it, during the act of
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swallowing. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] 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] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [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] Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Etodolac: A nonsteroidal anti-inflammatory agent with potent analgesic and antiarthritic properties. It has been shown to be effective in the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and in the alleviation of postoperative pain. [NIH]
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Euphoria: An exaggerated feeling of physical and emotional well-being not consonant with apparent stimuli or events; usually of psychologic origin, but also seen in organic brain disease and toxic states. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Excrete: To get rid of waste from the body. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotoxin: Toxic substance excreted by living bacterial cells. [NIH] 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] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH]
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Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Eye Injuries: Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries. [NIH] 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] Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Family Therapy: A form of group psychotherapy. It involves treatment of more than one member of the family simultaneously in the same session. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [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] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH]
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Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] 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] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Fluorescein Angiography: Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Follicles: Shafts through which hair grows. [NIH] Food Deprivation: The withholding of food in a structured experimental situation. [NIH] Food Hypersensitivity: Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens ingested in food. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fourth Ventricle: An irregularly shaped cavity in the rhombencephalon, between the medulla oblongata, the pons, and the isthmus in front, and the cerebellum behind. It is continuous with the central canal of the cord below and with the cerebral aqueduct above, and through its lateral and median apertures it communicates with the subarachnoid space. [NIH]
Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [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] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental
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conditions, as moulds or yeasts. [EU] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]
Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower
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esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal Hemorrhage: Bleeding in the gastrointestinal tract. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [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] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [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 Duplication: It encodes the major envelope protein and includes all the specifications for HBsAg. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]
Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gigantism: The condition of abnormal overgrowth or excessive size of the whole body or
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any of its parts. [NIH] Ginger: Deciduous plant rich in volatile oil (oils, volatile). It is used as a flavoring agent and has many other uses both internally and topically. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] 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 tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glucuronides: Glycosides of glucuronic acid formed by the reaction of uridine diphosphate glucuronic acid with certain endogenous and exogenous substances. Their formation is important for the detoxification of drugs, steroid excretion and bilirubin metabolism to a more water-soluble compound that can be eliminated in the urine and bile. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycols: A generic grouping for dihydric alcohols with the hydroxy groups (-OH) located on different carbon atoms. They are viscous liquids with high boiling points for their molecular weights. [NIH]
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Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Granisetron: A serotonin receptor (5HT-3 selective) antagonist that has been used as an antiemetic for cancer chemotherapy patients. [NIH] Granule: A small pill made from sucrose. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [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] Gynaecological: Pertaining to gynaecology. [EU] Haematemesis: The vomiting of blood. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Handwashing: The act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal
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condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helminthiasis: Infestation with parasitic worms of the helminth class. [NIH] Hematemesis: Vomiting of blood. [NIH] Hemicrania: An ache or a pain in one side of the head, as in migraine. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
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Hepatic: Refers to the liver. [NIH] Hepatic Encephalopathy: A condition that may cause loss of consciousness and coma. It is usually the result of advanced liver disease. Also called hepatic coma. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [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] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]
Herpetiformis: Duhring's disease a recurring, inflammatory disease of the skin of unknown etiology characterized by erythematous, papular, pustular, or vesicular lesions which tend to group and are accompanied by itching and burning. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Heterotropia: One in which the angle of squint remains relatively unaltered on conjugate movement of the eyes. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeopathic remedies: Small doses of medicines, herbs, or both that are believed to stimulate the immune system. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU]
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Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human growth hormone: A protein hormone, secreted by the anterior lobe of the pituitary, which promotes growth of the whole body by stimulating protein synthesis. The human gene has already been cloned and successfully expressed in bacteria. [NIH] Humeral: 1. Of, relating to, or situated in the region of the humerus: brachial. 2. Of or belonging to the shoulder. 3. Of, relating to, or being any of several body parts that are analogous in structure, function, or location to the humerus or shoulder. [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydration: Combining with water. [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxides: Inorganic compounds that contain the OH- group. [NIH] Hydroxyl Radical: The univalent radical OH that is present in hydroxides, alcohols, phenols, glycols. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperaemia: An excess of blood in a part; engorgement. [EU] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH]
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Hyperemesis: Excessive vomiting. [EU] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperphagia: Ingestion of a greater than optimal quantity of food. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypersensitivity, Immediate: Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigenantibody reaction and causes smooth muscle contraction and increased vascular permeability. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypodermic: Applied or administered beneath the skin. [EU] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterectomy: Excision of the uterus. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU]
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Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Illusion: A false interpretation of a genuine percept. [NIH] Iloprost: An eicosanoid, derived from the cyclooxygenase pathway of arachidonic acid metabolism. It is a stable and synthetic analog of epoprostenol, but with a longer half-life than the parent compound. Its actions are similar to prostacyclin. Iloprost produces vasodilation and inhibits platelet aggregation. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] 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] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH]
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In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infectious Diarrhea: Diarrhea caused by infection from bacteria, viruses, or parasites. [NIH] 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] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Information Centers: Facilities for collecting and organizing information. They may be specialized by subject field, type of source material, persons served, location, or type of services. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called
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intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] 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] Inorganic: Pertaining to substances not of organic origin. [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] Inotropic: Affecting the force or energy of muscular contractions. [EU] 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] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insufflation: The act of blowing a powder, vapor, or gas into any body cavity for experimental, diagnostic, or therapeutic purposes. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] 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]
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Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal contents toward the anus. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [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 Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intrathecal chemotherapy: Anticancer drugs that are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Invertebrates: Animals that have no spinal column. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a
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positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isonicotinic: A drug used in the treatment of tuberculosis. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Jet lag: Symptoms produced in human beings by fast travel through large meridian difference. [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] Ketoprofen: An ibuprofen-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis. [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.
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Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [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] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laceration: 1. The act of tearing. 2. A torn, ragged, mangled wound. [EU] Lactation: The period of the secretion of milk. [EU] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Lactulose: A mild laxative. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Lamivudine: A reverse transcriptase inhibitor and zalcitabine analog in which a sulfur atom replaces the 3' carbon of the pentose ring. It is used to treat HIV disease. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Lassitude: Weakness; exhaustion. [EU]
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Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]
Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [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] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be
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associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [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] Luminescence: The property of giving off light without emitting a corresponding degree of heat. It includes the luminescence of inorganic matter or the bioluminescence of human matter, invertebrates and other living organisms. For the luminescence of bacteria, bacterial luminescence is available. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] 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] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphokine: A soluble protein produced by some types of white blood cell that stimulates other white blood cells to kill foreign invaders. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is
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endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] 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]
Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Marijuana Abuse: The excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning. [NIH] Mastectomy: Surgery to remove the breast (or as much of the breast tissue as possible). [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of
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the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [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] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental 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 Processes: Conceptual functions or thinking in all its forms. [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]
Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metabotropic: A glutamate receptor which triggers an increase in production of 2 intracellular messengers: diacylglycerol and inositol 1, 4, 5-triphosphate. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in
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the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [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] Milk Hypersensitivity: Allergic reaction to milk (usually cow's milk) or milk products. In infants the hypersensitivity is manifested by colic, vomiting, diarrhea, rhinitis, wheezing, etc. Milk hypersensitivity should be differentiated from lactose intolerance, an intolerance to milk as a result of congenital deficiency of lactase. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] 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] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA,
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can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motilin: A 22-amino acid polypeptide (molecular weight 2700) isolated from the duodenum. At low pH it inhibits gastric motor activity, whereas at high pH it has a stimulating effect. [NIH]
Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] 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] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spasticity: Strongly marked hypertonicity of muscles. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myalgia: Pain in a muscle or muscles. [EU]
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Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myenteric: On stimulation of an intestinal segment, the segment above contracts and that below relaxes. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nadir: The lowest point; point of greatest adversity or despair. [EU] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [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] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] 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] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [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]
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Neonatal Abstinence Syndrome: Fetal and neonatal addiction and withdrawal as a result of the mother's dependence on drugs during pregnancy. Withdrawal or abstinence symptoms develop shortly after birth. Symptoms exhibited are loud, high-pitched crying, sweating, yawning and gastrointestinal disturbances. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] 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] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [EU] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuraminidase: An enzyme that catalyzes the hydrolysis of alpha-2,3, alpha-2,6-, and alpha-2,8-glycosidic linkages (at a decreasing rate, respectively) of terminal sialic residues in oligosaccharides, glycoproteins, glycolipids, colominic acid, and synthetic substrate. (From Enzyme Nomenclature, 1992) EC 3.2.1.18. [NIH] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurogenic Inflammation: Inflammation caused by an injurious stimulus of peripheral neurons and resulting in release of neuropeptides which affect vascular permeability and help initiate proinflammatory and immune reactions at the site of injury. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH]
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Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] 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] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neuropharmacology: The branch of pharmacology dealing especially with the action of drugs upon various parts of the nervous system. [NIH] Neuroprotective Agents: Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event, but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]
Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [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]
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Nociceptors: Peripheral receptors for pain. Nociceptors include receptors which are sensitive to painful mechanical stimuli, extreme heat or cold, and chemical stimuli. All nociceptors are free nerve endings. [NIH] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Staff: Personnel who provide nursing service to patients in an organized facility, institution, or agency. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Occipital Lobe: Posterior part of the cerebral hemisphere. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Oculomotor Nerve: The 3d cranial nerve. The oculomotor nerve sends motor fibers to the levator muscles of the eyelid and to the superior rectus, inferior rectus, and inferior oblique muscles of the eye. It also sends parasympathetic efferents (via the ciliary ganglion) to the muscles controlling pupillary constriction and accommodation. The motor fibers originate in the oculomotor nuclei of the midbrain. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU]
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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] Olfaction: Function of the olfactory apparatus to perceive and discriminate between the molecules that reach it, in gas form from an external environment, directly or indirectly via the nose. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncology: The study of cancer. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Orofacial: Of or relating to the mouth and face. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone.
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An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] 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] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]
Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH]
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Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Papaverine: An alkaloid found in opium but not closely related to the other opium alkaloids in its structure or pharmacological actions. It is a direct-acting smooth muscle relaxant used in the treatment of impotence and as a vasodilator, especially for cerebral vasodilation. The mechanism of its pharmacological actions is not clear, but it apparently can inhibit phosphodiesterases and it may have direct actions on calcium channels. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parasitic Diseases: Infections or infestations with parasitic organisms. They are often contracted through contact with an intermediate vector, but may occur as the result of direct exposure. [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 hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [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]
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Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial response: A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment. [NIH] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pediatric Gastroenterologist: A doctor who treats children with digestive diseases. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU]
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Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [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] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU]
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Perivascular: Situated around a vessel. [EU] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Perspiration: Sweating; the functional secretion of sweat. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [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] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] 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] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Pheromone: A substance secreted externally by certain animal species, especially insects, to affect the behavior or development of other members of the species. [NIH] Phosphates: Inorganic salts of phosphoric acid. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [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] Phosphoric Acids: Inorganic derivatives of phosphoric acid (H3PO4). Inorganic salts are known as phosphates and organic esters are phosphoric acid esters. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and
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teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Photophobia: Abnormal sensitivity to light. This may occur as a manifestation of eye diseases; migraine; subarachnoid hemorrhage; meningitis; and other disorders. Photophobia may also occur in association with depression and other mental disorders. [NIH] Photoreceptor: Receptor capable of being activated by light stimuli, as a rod or cone cell of the eye. [NIH] Photosensitization: The development of abnormally heightened reactivity of the skin to sunlight. [EU] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [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] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Piloerection: Involuntary erection or bristling of hairs. [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] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plant Diseases: Diseases of plants. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmids: Any extrachromosomal hereditary determinant. Plasmids are self-replicating circular molecules of DNA that are found in a variety of bacterial, archaeal, fungal, algal, and plant species. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH]
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Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Pneumonitis: A disease caused by inhaling a wide variety of substances such as dusts and molds. Also called "farmer's disease". [NIH] Poison Control Centers: Facilities which provide information concerning poisons and treatment of poisoning in emergencies. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched
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or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]
Polyethylene Glycols: Alpha-Hydro-omega-hydroxypoly(oxy-1,2-ethanediyls). Additional polymers of ethylene oxide and water and their ethers. They vary in consistency from liquid to solid, depending on the molecular weight, indicated by a number following the name. Used as surfactants in industry, including foods, cosmetics and pharmaceutics; in biomedicine, as dispersing agents, solvents, ointment and suppository bases, vehicles, tablet excipients. Some specific groups are lauromagrogols, nonoxynols, octoxynols and poloxamers. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] 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] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] 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] Pontine: A brain region involved in the detection and processing of taste. [NIH] Portal Hypertension: High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [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] Postoperative: After surgery. [NIH] Postoperative Nausea and Vomiting: Emesis and queasiness occurring after anesthesia. [NIH]
Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH]
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Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [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] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Prejudice: A preconceived judgment made without adequate evidence and not easily alterable by presentation of contrary evidence. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Proctocolitis: Inflammation of the rectum and colon. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] 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
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severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Propanolol: Beta blocker. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propofol: A widely used anesthetic. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propulsive: Tending or having power to propel; driving onward or forward; impelling to action or motion. [EU] Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. [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] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostaglandins D: Physiologically active prostaglandins found in many tissues and organs. They show pressor activity, are mediators of inflammation, and have potential antithrombotic effects. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH]
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Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]
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] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoal: Having to do with the simplest organisms in the animal kingdom. Protozoa are single-cell organisms, such as ameba, and are different from bacteria, which are not members of the animal kingdom. Some protozoa can be seen without a microscope. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to
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obtain relief. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] 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]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts.
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[NIH]
Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyloric Sphincter: The muscle between the stomach and the small intestine. [NIH] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH]
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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] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Adrenergic: Cell-surface proteins that bind epinephrine and/or norepinephrine with high affinity and trigger intracellular changes. The two major classes of adrenergic receptors, alpha and beta, were originally discriminated based on their cellular actions but now are distinguished by their relative affinity for characteristic synthetic ligands. Adrenergic receptors may also be classified according to the subtypes of G-proteins with which they bind; this scheme does not respect the alpha-beta distinction. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recovery Room: Hospital unit providing continuous monitoring of the patient following anesthesia. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [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
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cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] 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] Refractive Errors: Deviations from the average or standard indices of refraction of the eye through its dioptric or refractive apparatus. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [EU] Rehydration Solutions: Fluids restored to the body in order to maintain normal waterelectrolyte balance. [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] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Residual Volume: The volume of air remaining in the lungs at the end of a maximal expiration. Common abbreviation is RV. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into
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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] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retching: Dry vomiting. [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] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrobulbar: Behind the pons. [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Retroperitoneal Space: An area occupying the most posterior aspect of the abdominal cavity. It is bounded laterally by the borders of the quadratus lumborum muscles and extends from the diaphragm to the brim of the true pelvis, where it continues as the pelvic extraperitoneal space. [NIH] Retropneumoperitoneum: Pathological or accidental introduction of air into the retroperitoneal space. [NIH] Retrospective: Looking back at events that have already taken place. [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]
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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] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Rhombencephalon: That part of the brain stem constituting the medulla oblongata (myelencephalon) and pons (metencephalon). [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] 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] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rotavirus: A genus of Reoviridae, causing acute gastroenteritis in birds and mammals, including humans. Transmission is horizontal and by environmental contamination. [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] Salicylic: A tuberculosis drug. [NIH] Saline: A solution of salt and water. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sanitation: The development and establishment of environmental conditions favorable to the health of the public. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH]
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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] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scopolamine: An alkaloid from Solanaceae, especially Datura metel L. and Scopola carniolica. Scopolamine and its quaternary derivatives act as antimuscarinics like atropine, but may have more central nervous system effects. Among the many uses are as an anesthetic premedication, in urinary incontinence, in motion sickness, as an antispasmodic, and as a mydriatic and cycloplegic. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secretin: A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice. [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] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sedatives, Barbiturate: Those derivatives of barbituric or thiobarbituric acid that are used as hypnotics or sedatives. The structural class of all such derivatives, regardless of use, is barbiturates. [NIH] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] 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] 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] Seminiferous tubule: Tube used to transport sperm made in the testes. [NIH] 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
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negatives. [NIH] 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] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [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] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shedding: Release of infectious particles (e. g., bacteria, viruses) into the environment, for example by sneezing, by fecal excretion, or from an open lesion. [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]
Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by
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a physician, or subjective when perceived by the patient. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Snails: Marine, freshwater, or terrestrial mollusks of the class Gastropoda. Most have an enclosing spiral shell, and several genera harbor parasites pathogenic to man. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [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] 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] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU]
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Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somnolence: Sleepiness; also unnatural drowsiness. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrometer: An apparatus for determining spectra; measures quantities such as wavelengths and relative amplitudes of components. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] 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 Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH]
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Splint: A rigid appliance used for the immobilization of a part or for the correction of deformity. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] 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] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Staphylococcal Food Poisoning: contaminated food. [NIH]
Poisoning
by
staphylococcal
toxins
present
in
Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [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] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid:
A
group
name
for
lipids
that
contain
a
hydrogenated
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cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomach Ulcer: An open sore in the lining of the stomach. Also called gastric ulcer. [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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [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] Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] 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] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH]
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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]
Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfonic Acids: Inorganic or organic oxy acids of sulfur which contain the RSO2(OH) radical. [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] Superantigens: Microbial antigens that have in common an extremely potent activating effect on T-cells that bear a specific variable region. Superantigens cross-link the variable region with class II MHC proteins regardless of the peptide binding in the T-cell receptor's pocket. The result is a transient expansion and subsequent death and anergy of the T-cells with the appropriate variable regions. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [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] Suppository: A medicated mass adapted for introduction into the rectal, vaginal, or urethral orifice of the body, suppository bases are solid at room temperature but melt or dissolve at body temperature. Commonly used bases are cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, polyethylene glycols of various molecular weights, and fatty acid esters of polyethylene glycol. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supratentorial: Located in the upper part of the brain. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathectomy: The removal or interruption of some part of the sympathetic nervous system for therapeutic or research purposes. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral 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] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH]
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Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [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] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [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] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tenesmus: Straining, especially ineffectual and painful straining at stool or in urination. [EU] Tennis Elbow: A condition characterized by pain in or near the lateral humeral epicondyle or in the forearm extensor muscle mass as a result of unusual strain. It occurs in tennis players as well as housewives, artisans, and violinists. [NIH] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Tetani: Causal agent of tetanus. [NIH] Tetanic: Having the characteristics of, or relating to tetanus. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound
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or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [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] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] 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] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH]
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Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Cartilage: The largest cartilage of the larynx consisting of two laminae fusing anteriorly at an acute angle in the midline of the neck. The point of fusion forms a subcutaneous projection known as the Adam's apple. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyrotoxicosis: The clinical syndrome that reflects the response of the peripheral tissues to an excess of thyroid hormone. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]
Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Toxoid: The material resulting from the treatment of toxin in such a way that the toxic properties are inactivated whilst the antigenic potency remains intact. [NIH]
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Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcutaneous: Transdermal. [EU] 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] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] 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
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motor to the muscles of mastication. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trochlear Nerve: The 4th cranial nerve. The trochlear nerve carries the motor innervation of the superior oblique muscles of the eye. [NIH] Trochlear Nerve Diseases: Diseases of the fourth cranial (trochlear) nerve or its nucleus in the midbrain. The nerve crosses as it exits the midbrain dorsally and may be injured along its course through the intracranial space, cavernous sinus, superior orbital fissure, or orbit. Clinical manifestations include weakness of the superior oblique muscle which causes vertical diplopia that is maximal when the affected eye is adducted and directed inferiorly. Head tilt may be seen as a compensatory mechanism for diplopia and rotation of the visual axis. Common etiologies include craniocerebral trauma and infratentorial neoplasms. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tubocurarine: A neuromuscular blocker and active ingredient in curare; plant based alkaloid of Menispermaceae. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Univalent: Pertaining to an unpaired chromosome during the zygotene stage of prophase to first metaphase in meiosis. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [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] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH]
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Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [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] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] 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] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [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 and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. [NIH]
Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH]
Dictionary 321
Vasodilator: An agent that widens blood vessels. [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] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venom: That produced by the poison glands of the mouth and injected by the fangs of poisonous snakes. [NIH] Venous: Of or pertaining to the veins. [EU] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [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] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vesicular Exanthema of Swine: A calicivirus infection of swine characterized by hydropic degeneration of the oral and cutaneous epithelia. [NIH] Vesicular Exanthema of Swine Virus: The type species of the genus Calicivirus, an RNA virus infecting pigs. The resulting infection is an acute febrile disease which is clinically indistinguishable from foot and mouth disease. Transmission is by contaminated food. [NIH] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vibrio: A genus of Vibrionaceae, made up of short, slightly curved, motile, gram-negative rods. Various species produce cholera and other gastrointestinal disorders as well as abortion in sheep and cattle. [NIH] Vibrio cholerae: The etiologic agent of cholera. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villous: Of a surface, covered with villi. [NIH]
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Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visual Cortex: Area of the occipital lobe concerned with vision. [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] Vitreoretinal: A rare familial condition characterized by a clear vitreous, except for preretinal filaments and veils which have been loosened from the retina, a dense hyaloid membrane which is perforated and detached, and masses of peripheral retinal pigmentation inters. [NIH] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [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] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] Vomitus: 1. Vomiting. 2. Matter vomited. [EU] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Wheezing: Breathing with a rasp or whistling sound; a sign of airway constriction or obstruction. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection
Dictionary 323
and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] 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] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yawning: An involuntary deep inspiration with the mouth open, often accompanied by the act of stretching. [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] Zalcitabine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chainterminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy. [NIH] Zidovudine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIVinduced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leukopenia. [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]
325
INDEX 1 1-phosphate, 160, 231 A Abdomen, 214 Abdominal Cramps, 170, 231 Abdominal Pain, 8, 24, 28, 170, 172, 173, 175, 176, 178, 214 Abducens, 231, 256 Abducens Nerve, 231, 256 Abducens Nerve Diseases, 231, 256 Aberrant, 163, 231 Abrasion, 139, 231 Acclimatization, 121, 231 Acetic Acids, 143, 231 Acetylcholine, 16, 162, 164, 231, 247, 288 Acetylcholinesterase, 152, 231 Achlorhydria, 161, 231 Acidity, 10, 231 Acidosis, 11, 19, 131, 231 Acne, 154, 155, 232 Acrylonitrile, 232, 307 Activities of Daily Living, 150, 232 Acuity, 29, 232 Acupuncture Points, 232 Acustimulation, 38, 70, 87, 88, 93, 232 Acute renal, 42, 232, 270 Acyl, 67, 232 Adaptation, 124, 231, 232 Adenine, 232, 303 Adenocarcinoma, 28, 232 Adenosine, 18, 164, 232, 296 Adenosine Monophosphate, 18, 232 Adenylate Cyclase, 135, 163, 232 Adjustment, 232 Adjuvant, 232, 267 Adolescence, 26, 176, 232 Adrenal Cortex, 232, 252, 299 Adrenal Medulla, 232, 245, 262, 289 Adrenergic, 11, 135, 156, 164, 181, 232, 233, 234, 236, 237, 257, 262, 304, 314 Adrenergic Agents, 135, 156, 233 Adverse Effect, 22, 121, 129, 132, 145, 148, 149, 179, 233, 238, 309 Aerophagia, 173, 233 Aerosol, 120, 233, 288 Afferent, 18, 20, 27, 126, 132, 136, 233 Affinity, 142, 148, 233, 239, 255, 280, 304, 310
Aggravation, 150, 233 Agonist, 11, 17, 149, 153, 233, 238, 257, 286, 288 Agoraphobia, 233, 274, 292 Agranulocytosis, 154, 233 Airway, 9, 233, 243, 310, 322 Akathisia, 127, 233, 237 Algorithms, 175, 233, 242 Alimentary, 141, 233, 241, 261, 292 Alkaline, 9, 231, 233, 234, 244, 316 Alkaloid, 233, 239, 285, 288, 292, 308, 319 Allergens, 16, 145, 233, 265 Allergic Rhinitis, 146, 233 Allylamine, 234 Alopecia, 234, 253 Alpha Particles, 234, 303 Alpha-1, 234 Alternative medicine, 83, 84, 116, 186, 234 Alveoli, 234, 321 Ameliorated, 121, 163, 234 Ameliorating, 132, 163, 164, 165, 234 Amenorrhea, 140, 234, 236 Amine, 193, 234, 271 Amino Acid Sequence, 138, 234, 236, 241, 267 Amitriptyline, 6, 215, 234 Ammonia, 141, 165, 234, 314, 319 Ampulla, 234, 261 Anaesthesia, 79, 85, 86, 91, 148, 154 Anaesthetic, 55, 154, 234 Anal, 135, 170, 173, 178, 235, 264 Anal Fissure, 135, 170, 173, 235 Analgesic, 92, 127, 142, 146, 148, 152, 153 Analog, 235, 265, 274, 279 Analogous, 235, 272, 297, 318 Analysis of Variance, 30, 235 Anaphylatoxins, 235, 250 Anaplasia, 235 Anatomical, 19, 235, 239, 242, 247, 256, 274, 308 Androgens, 232, 235, 252 Anemia, 98, 178, 181, 235, 282, 295, 323 Anergy, 235, 314 Anesthesia, 17, 85, 86, 89, 125, 161 Anesthetics, 111, 126, 235, 240, 262 Aneurysm, 235, 320 Angina, 18, 134, 135, 136, 138, 156, 160, 163, 235
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Angina Pectoris, 134, 135, 136, 138, 156, 160, 163, 235 Angioedema, 24, 95, 235 Angiogenesis, 160, 235 Angioplasty, 160, 235 Animal model, 7, 10, 13, 29, 236 Anions, 236, 278 Anomalies, 176, 236 Anorectal, 175, 236 Anorexia, 21, 28, 95, 120, 134, 135, 136, 140, 154, 156, 160, 161, 173, 181, 217 Anorexia Nervosa, 95, 140, 161, 173, 181, 236 Anterograde, 162, 236 Anthracycline, 236, 254 Anthrax, 25, 236 Antiallergic, 236, 252, 253 Anti-Anxiety Agents, 125, 126, 236, 299 Antibacterial, 15, 236, 311 Antibiotic, 143, 236, 254, 258, 293, 299, 311 Antibiotic Prophylaxis, 236, 299 Antibodies, 15, 236, 239, 262, 270, 274, 281, 296, 303 Antibody, 233, 236, 237, 249, 250, 270, 271, 273, 274, 275, 278, 283, 285, 303, 311, 323 Anticholinergic, 121, 181, 234, 236 Anticoagulant, 236, 301 Anticonvulsant, 125, 150, 237 Anticonvulsive, 146, 237 Antidepressant, 127, 152, 234, 237, 274, 321 Antiemetic, 13, 30, 34, 37, 56, 64, 71, 122, 128, 132, 137, 145, 162, 168, 237, 256, 269, 284 Antiepileptic, 22, 237 Antigen, 15, 233, 236, 237, 250, 262, 267, 271, 273, 274, 275, 283 Antigen-Antibody Complex, 237, 250 Antihistamine, 121, 237 Anti-inflammatory, 24, 127, 137, 142, 152, 193, 237, 252, 255, 262, 268, 274, 275, 278 Anti-Inflammatory Agents, 237, 252 Antimetabolite, 237, 265 Antimicrobial, 143, 237 Antineoplastic, 237, 252, 253, 258, 265 Antioxidant, 237, 238 Antipruritic, 237, 253 Antipsychotic, 146, 237, 257, 287 Antipsychotic Agents, 237, 257 Antipyretic, 238, 278 Antispasmodic, 238, 290, 308 Antitussive, 238, 256, 290
Antiviral, 25, 238, 276 Anuria, 238, 279 Anus, 235, 236, 238, 243, 249, 265, 277, 304 Anxiety, 14, 30, 132, 134, 135, 136, 146, 147, 153, 156, 160, 163, 164, 166 Anxiolytic, 238, 290 Apathy, 238, 287 Apnea, 126, 238 Apomorphine, 121, 238 Appendicitis, 95, 175, 176, 177, 238 Aqueous, 24, 145, 194, 238, 240, 253 Arachidonic Acid, 238, 274, 300 Arginine, 123, 157, 235, 238 Aromatic, 146, 238, 245, 295, 313 Arterial, 234, 238, 252, 273, 301, 315 Arteries, 136, 238, 242, 252, 278, 284, 286, 302 Arterioles, 238, 242, 286, 320 Artery, 35, 160, 235, 238, 245, 252, 260, 278, 282, 293, 302, 305 Articular, 238, 290 Ascites, 165, 176, 238 Ascorbic Acid, 123, 157, 238, 272 Aseptic, 130, 238, 312 Asphyxia, 238, 288 Aspiration, 9, 13, 45, 238 Assay, 13, 19, 25, 239 Asthenia, 148, 239 Astrocytes, 239 Astrocytoma, 55, 239 Asymptomatic, 19, 239, 291 Ataxia, 22, 239, 316 Atrial, 239, 252, 318 Atrioventricular, 239, 252 Atrium, 239, 252, 318, 321 Atrophy, 239, 287 Atropine, 72, 239, 241, 308 Atypical, 239, 289 Auditory, 239, 282, 320 Aura, 150, 239 Auricular, 38, 87, 239 Autacoids, 239, 275 Autoantibodies, 239, 255 Autoclave, 131, 239 Autodigestion, 239, 291 Autogenic, 123, 124, 239 Autoimmune disease, 240, 285 Autologous, 48, 240 Autonomic, 5, 13, 124, 231, 237, 240, 241, 268, 289, 294, 310, 314 Autonomic Nervous System, 240, 241, 294, 310, 314
327
Autosuggestion, 240, 273 Axonal, 240, 323 B Bacillus, 141, 236, 240 Back Pain, 84, 171, 175, 240 Bacterial Physiology, 232, 240 Bactericidal, 29, 240, 262 Bacteriophage, 240, 296, 318, 322 Bacterium, 12, 29, 240, 270 Barbiturates, 72, 149, 240, 308 Basal Ganglia, 136, 237, 239, 240, 247, 273 Basal Ganglia Diseases, 239, 240, 247, 273 Base, 10, 127, 130, 137, 152, 158, 161, 194, 231, 232, 240, 254, 267, 278, 279, 315, 319 Basement Membrane, 240, 263 Basophils, 233, 241, 269, 280 Belching, 162, 172, 173, 233, 241 Belladonna, 239, 241 Benign, 9, 16, 134, 135, 136, 138, 147, 156, 160, 163, 173, 175 Benign prostatic hyperplasia, 147, 241 Benign tumor, 163, 175, 241 Benzamides, 126, 182, 241 Beta-Endorphin, 153, 241 Bewilderment, 241, 251 Bezoars, 176, 241 Bilateral, 35, 36, 69, 241, 292 Bile, 241, 266, 268, 274, 278, 280, 308, 313 Bile Acids, 241, 266, 313 Bile Ducts, 241, 266 Bile Pigments, 241, 278 Biliary, 162, 178, 179, 241, 244, 291 Biliary Tract, 179, 241, 244, 291 Bilirubin, 241, 266, 268, 272 Binding agent, 128, 153, 241 Bioavailability, 22, 154, 241 Biochemical, 133, 164, 237, 241, 242, 269, 279, 290, 295, 309 Bioequivalent, 158, 241 Biological response modifier, 242, 276 Biological therapy, 242, 269 Biological Transport, 242, 255 Bioluminescence, 242, 281 Biosynthesis, 238, 242, 309 Biotechnology, 30, 31, 186, 205, 242 Bladder, 24, 95, 170, 241, 242, 250, 275, 285, 287, 300, 305, 319, 320 Bloating, 8, 173, 242, 267, 275, 278, 281, 289 Blood Cell Count, 242, 295 Blood Coagulation, 242, 244, 316 Blood Glucose, 8, 171, 174, 242, 270, 276
Blood Platelets, 242, 309 Blood pressure, 123, 157, 167, 187, 242, 247, 273, 285, 298, 302, 310 Blood-Brain Barrier, 134, 242 Body Fluids, 187, 242, 243, 258, 265, 289, 310 Body Mass Index, 46, 171, 242 Body Regions, 242, 249 Bone Marrow, 49, 242, 243, 274, 281, 310, 312, 323 Bone Marrow Transplantation, 49, 243 Bowel, 3, 8, 14, 55, 146, 147, 170, 173, 175, 176, 177, 178, 179, 181, 188, 216, 231, 235, 243, 255, 261, 275, 277, 280, 294, 309, 313, 319 Bowel Movement, 8, 173, 177, 216, 243, 255, 313 Brachial, 243, 272, 282 Brachial Plexus, 243, 282 Brachytherapy, 243, 277, 278, 303, 323 Brain Stem, 243, 246, 256, 307 Branch, 225, 243, 259, 260, 281, 282, 288, 293, 302, 311, 315, 316 Breakdown, 243, 255, 266, 290 Breast Feeding, 15, 216, 243 Breast reconstruction, 67, 243 Bronchi, 243, 262, 318 Bronchial, 9, 120, 146, 243, 271 Bronchial Hyperreactivity, 146, 243 Bronchitis, 95, 135, 175, 243 Buccal, 243, 281 Bulimia, 20, 46, 63, 74, 95, 134, 135, 136, 156, 160, 173, 243 Bullous, 243, 255 Burns, 55, 74, 175, 243 Burns, Electric, 243 Butterflies, 172, 243 Bypass, 147, 243 C Cachexia, 22, 28, 59, 217, 244 Calcitonin, 136, 138, 164, 244 Calcitonin Gene-Related Peptide, 138, 244 Calcium, 128, 135, 138, 164, 187, 244, 250, 292, 301, 309, 316 Calcium Sulfate, 135, 244 Calculi, 244, 269 Calicivirus, 25, 244, 321 Caloric intake, 14, 244 Candidiasis, 176, 244 Candidosis, 244 Cannabidiol, 146, 244 Cannabinoids, 31, 78, 244
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Cannabinol, 244 Capsules, 120, 128, 153, 244, 257, 267 Carbohydrate, 244, 252, 268, 269, 298 Carbon Dioxide, 131, 245, 254, 266, 296, 306 Carboxy, 161, 245 Carboxylic Acids, 126, 245 Carboxymethylcellulose, 127, 153, 245 Carcinogen, 24, 245 Carcinogenic, 245, 276, 300, 313 Carcinoma, 28, 245 Cardiac, 17, 18, 85, 138, 147 Cardiac arrest, 147, 245 Cardiac Output, 17, 245, 313 Cardiovascular, 17, 121, 124, 245, 309, 310 Cardiovascular System, 17, 245 Carnitine, 57, 81, 245 Carotid Body, 245, 247 Carpal Tunnel Syndrome, 84, 245 Catecholamine, 245, 257, 295 Catheterization, 236, 245 Cations, 245, 278 Caudal, 55, 245, 255, 273, 298 Causal, 10, 245, 270, 315 Caustic, 176, 245 Celiac Disease, 173, 176, 177, 245 Cell Cycle, 246, 248 Cell Differentiation, 246, 309 Cell Division, 240, 246, 269, 283, 296, 300 Cell proliferation, 134, 135, 163, 246, 309 Cell Survival, 246, 269 Cell Transplantation, 246 Cellobiose, 246 Cellulose, 127, 152, 246, 265, 296 Central Nervous System Infections, 246, 270 Cerebellar, 239, 246, 305, 318 Cerebellum, 246, 265, 298, 305 Cerebral, 19, 138 Cerebral Aqueduct, 246, 265, 316 Cerebral Cortex, 19, 239, 246, 263, 265, 303 Cerebrospinal, 55, 246, 248 Cerebrospinal fluid, 55, 246, 248 Cerebrum, 246, 315 Cervical, 243, 246, 282, 286 Cervix, 246, 247, 256, 305 Cesarean Section, 17, 50, 247 Character, 235, 247, 254, 268 Chemoreceptor, 121, 126, 158, 237, 247 Chemotactic Factors, 247, 250 Chemotaxis, 165, 247
Chemotherapeutic agent, 122, 132, 168, 247 Chest Pain, 171, 172, 173, 175, 179, 247 Chimeras, 16, 247 Chin, 68, 165, 247 Chlorophyll, 247, 261, 265 Cholecystectomy, 38, 39, 41, 43, 44, 50, 68, 85, 88, 247 Cholelithiasis, 170, 247 Cholera, 10, 247, 321 Cholesterol, 97, 173, 182, 241, 247, 266, 272, 313 Choline, 81, 231, 247 Cholinergic, 234, 237, 247, 288 Chorea, 121, 147, 164, 166, 237, 247 Choreatic Disorders, 247 Choroid, 74, 248, 306 Choroid Plexus, 74, 248 Choroid Plexus Papilloma, 74, 248 Chromatin, 248, 261, 288, 311 Chromosomal, 24, 248 Chronic Disease, 151, 152, 244, 248, 249 Circadian, 87, 248 Circulatory system, 131, 147, 248, 260, 277 Cirrhosis, 165, 248, 298 CIS, 142, 161, 248, 306 Cisplatin, 14, 34, 70, 81, 87, 137, 194, 248, 290 Citrus, 238, 248 Clamp, 16, 25, 248 Clinical trial, 7, 11, 14, 15, 28, 30, 70, 205, 248, 251, 257, 285, 293, 301, 304 Cloning, 137, 161, 242, 248 Clot Retraction, 248, 296 Coagulation, 24, 242, 248, 270, 316 Codeine, 248, 290 Coenzyme, 238, 249 Cofactor, 249, 301, 316 Cognition, 249, 287 Cognitive restructuring, 249, 313 Cohort Studies, 27, 249 Colic, 16, 170, 177, 249, 284 Colitis, 24, 170, 173, 175, 176, 178, 249, 278, 322 Collagen, 181, 241, 249, 267, 297, 300 Collagen disease, 181, 249 Collapse, 243, 249, 310 Colloidal, 249, 259 Colon, 175, 179, 249, 257, 258, 274, 275, 278, 279, 299, 319 Colorectal, 96, 173, 178, 249 Colorectal Cancer, 96, 173, 178, 249
329
Colostomy, 8, 177, 249 Combination Therapy, 11, 249 Complement, 24, 235, 249, 250, 267 Complement Activation, 24, 235, 250 Complementary and alternative medicine, 83, 84, 116, 250 Complementary medicine, 84, 250 Complete response, 6, 250 Compliance, 24, 145, 154, 250 Computational Biology, 205, 250 Conception, 250, 251, 264, 299, 312 Concomitant, 13, 132, 161, 250 Cone, 125, 140, 250, 296, 314 Conflict of Interest, 39, 250 Confusion, 59, 171, 251, 256, 273, 287, 319 Congestion, 237, 251, 262 Congestive heart failure, 160, 251 Conjunctiva, 251, 275, 318 Conjunctivitis, 15, 136, 251 Connective Tissue, 238, 243, 249, 251, 265, 266, 267, 281, 294, 306, 307 Conscious Sedation, 154, 251 Consciousness, 18, 171, 235, 236, 251, 254, 256, 271, 302, 306 Constipation, 132, 133, 142, 144, 145, 148, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 182, 187, 237, 251, 265, 278, 294 Constriction, 251, 278, 289, 322 Consultation, 6, 251 Consumption, 69, 160, 251, 255, 266, 289, 306 Contamination, 210, 251, 271, 307 Contraception, 129, 251 Contraceptive, 129, 251 Contraceptive Agents, 129, 251 Contraindications, ii, 170, 251 Control group, 8, 16, 28, 251 Controlled study, 72, 251 Convulsions, 147, 171, 237, 251, 259, 273, 288 Coordination, 246, 251, 285 Cor, 4, 13, 252 Coronary, 160, 235, 252, 284, 286 Coronary Arteriosclerosis, 252, 286 Coronary Circulation, 235, 252 Coronary Thrombosis, 252, 284, 286 Corpus, 252, 281, 299, 316 Corpus Luteum, 252, 281, 299 Cortex, 19, 103, 105, 252, 305 Cortical, 252, 263, 308, 316 Corticosteroid, 137, 252 Cortisol, 13, 252
Cortisone, 252, 255 Cranial, 150, 231, 246, 252, 268, 270, 277, 282, 287, 289, 290, 292, 294, 318, 319, 320 Craniocerebral Trauma, 231, 240, 252, 270, 316, 319 Craniotomy, 44, 67, 253 Creatinine, 187, 253, 279, 319 Credentialing, 84, 253 Curare, 16, 253, 285, 319 Curative, 253, 288, 316 Curette, 253, 256 Cutaneous, 236, 244, 253, 273, 278, 281, 321 Cyclic Vomiting Syndrome, 4, 5, 6, 178, 180, 183, 188, 189, 211, 212, 213, 214, 215, 217, 218 Cyclophosphamide, 30, 109, 253 Cyproheptadine, 6, 253 Cysteine, 109, 113, 253, 314 Cytokine, 28, 253 Cytomegalovirus, 49, 164, 253 Cytoplasm, 241, 253, 261, 269, 288 Cytotoxic, 253, 290, 303, 309 Cytotoxic chemotherapy, 253, 290 Cytotoxicity, 234, 248, 253 D Databases, Bibliographic, 205, 253 Daunorubicin, 195, 254, 258 Day Care, 72, 79, 254 Deamination, 254, 319 Decarboxylation, 254, 271 Decompression, 254, 257 Defense Mechanisms, 9, 254 Degenerative, 134, 135, 160, 163, 254, 271, 285, 290, 306 Dehydration, 4, 170, 189, 212, 213, 214, 216, 247, 254 Delirium, 127, 134, 135, 137, 156, 160, 163, 237, 254 Delusions, 254, 302 Dementia, 132, 134, 135, 137, 147, 156, 160, 163, 166, 237, 238, 254 Dendrites, 254, 288 Density, 24, 242, 254, 290, 298 Depolarization, 254, 309 Deprivation, 170, 254 Dermal, 145, 254 Dermatitis, 144, 145, 154, 155, 255, 258 Dermatitis Herpetiformis, 154, 155, 255 Dermatosis, 154, 155, 255 Desipramine, 215, 255 Deuterium, 255, 272
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Developing Countries, 10, 255 Dexamethasone, 13, 32, 38, 41, 50, 51, 59, 64, 66, 68, 72, 78, 87, 121, 131, 137, 167, 255 Dexmedetomidine, 66, 255 Dextrorotatory, 133, 255 Diagnostic procedure, 119, 186, 255 Dialysate, 130, 131, 255 Diaphoresis, 11, 255 Diaphragm, 122, 255, 271, 297, 306 Diarrhoea, 42, 255, 266 Diastolic, 255, 273 Diencephalon, 255, 273, 315, 316 Diffusion, 129, 242, 255 Digestion, 172, 233, 241, 243, 255, 258, 267, 275, 277, 280, 291, 293, 313 Digestive system, 127, 152, 172, 176, 177, 182, 255, 266 Digestive tract, 172, 177, 179, 214, 255, 310, 312 Dilatation, 41, 235, 236, 256, 320 Dilatation and Curettage, 41, 256 Dilatation, Pathologic, 256, 320 Dilation, 256, 320 Dimerization, 164, 256 Dimethyl, 146, 256 Diphenhydramine, 121, 256 Diploid, 256, 296 Diplopia, 52, 231, 256, 319 Direct, iii, 10, 13, 17, 29, 133, 140, 150, 151, 165, 176, 191, 256, 257, 292, 305 Discrete, 5, 212, 213, 215, 256 Discrimination, 171, 256 Disease Progression, 256, 322 Disinfectant, 256, 262 Dislocation, 36, 256, 312 Disorientation, 251, 254, 256 Dispenser, 144, 256 Dissection, 35, 256 Dissociation, 233, 256, 277 Distal, 8, 240, 257, 259, 266, 294, 301 Distention, 8, 126, 257 Diurnal, 13, 243, 257 Diverticula, 257 Diverticulitis, 173, 175, 178, 257 Diverticulosis, 178, 257 Diverticulum, 257 Diving, 174, 257 Dizziness, 22, 127, 142, 145, 148, 154, 171, 175, 257, 292, 321 Dopamine, 135, 156, 164, 182, 237, 238, 257, 284, 288, 295
Dopamine Antagonists, 182, 257 Dorsal, 29, 257, 298, 311 Dorsum, 257 Dosage Forms, 127, 152, 257 Dose-dependent, 257, 323 Double-blind, 14, 20, 32, 34, 43, 45, 50, 65, 67, 68, 70, 92, 148, 257 Double-blinded, 67, 257 Doxorubicin, 30, 195, 258 Drive, ii, vi, 3, 20, 77, 175, 176, 179, 258 Drug Industry, 128, 153, 258 Drug Interactions, 172, 179, 199, 258 Drug Tolerance, 258, 317 Duct, 234, 245, 258, 263, 274, 307, 312, 314 Dumping Syndrome, 253, 258 Duodenal Ulcer, 141, 175, 258 Duodenitis, 189, 258 Duodenum, 122, 147, 175, 229, 241, 258, 261, 266, 278, 285, 291, 294, 308, 313 Dura mater, 258, 283, 291 Dyes, 241, 258, 288 Dysentery, 170, 258 Dyskinesia, 121, 127, 147, 166, 237, 258 Dyspepsia, 21, 148, 172, 173, 175, 178, 215, 258, 275 Dysphagia, 9, 173, 178, 258 Dysphoria, 25, 127, 258 Dystonia, 121, 237, 258 Dystonia Musculorum Deformans, 121, 258 E Eating Disorders, 26, 96, 144, 145, 170, 171, 176, 258 Ectopic, 32, 258 Eczema, 16, 258 Edema, 25, 146, 187, 235, 259, 319 Effector, 12, 28, 135, 156, 164, 231, 249, 259, 295 Effector cell, 28, 259 Efferent, 29, 259 Efficacy, 7, 14, 21, 27, 32, 44, 45, 49, 57, 63, 66, 70, 83, 84, 87, 90, 93, 154, 167, 259, 318 Effusion, 165, 259 Ejaculation, 259, 308 Elastic, 139, 259, 268 Elastin, 249, 259 Elective, 44, 46, 259 Electrocoagulation, 248, 259 Electroconvulsive Therapy, 71, 94, 259 Electrode, 16, 259
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Electrolyte, 4, 71, 126, 130, 131, 213, 252, 254, 259, 265, 279, 284, 289, 298, 305, 310, 319 Electrons, 237, 240, 259, 277, 303 Electrophoresis, 19, 259 Electrophysiological, 16, 19, 259 Elementary Particles, 259, 288, 301 Emaciation, 140, 259 Embolus, 259, 275 Embryo, 246, 260, 275, 297, 299, 312 Embryo Transfer, 260, 299 Emergency Medicine, 35, 36, 56, 58, 72, 73, 173, 260 Emergency Treatment, 260 Emesis, 29, 121, 122, 126, 128, 131, 135, 137, 146, 158, 159, 168, 179, 181 Emetic, 54, 121, 122, 126, 137, 147, 167, 238, 260 Empiric, 3, 5, 260 Empirical, 213, 260 Encapsulated, 120, 128, 153, 260 Encephalopathy, 74, 165, 166, 260 Encopresis, 176, 260 Endarterectomy, 236, 260 Endemic, 247, 260, 282, 312 Endocarditis, 244, 260 Endocrine System, 260, 287 Endogenous, 5, 25, 126, 133, 149, 241, 244, 257, 258, 260, 263, 268, 288 Endometrium, 256, 260, 283 Endorphin, 153, 241, 260 Endoscope, 261 Endoscopic, 175, 261 Endothelial cell, 136, 242, 261, 316 Endotoxin, 261, 319 Enhancer, 155, 261 Enkephalin, 241, 261 Enteral Nutrition, 176, 196, 261 Enteric bacteria, 29, 261 Enteritis, 170, 261 Enterocolitis, 16, 261 Enterotoxins, 12, 261 Environmental Health, 204, 206, 261 Enzymatic, 18, 244, 250, 261, 271, 306, 322 Eosinophilic, 16, 46, 261 Eosinophilic Gastroenteritis, 16, 261 Eosinophils, 233, 261, 269, 280 Epidemic, 27, 261, 312 Epidermis, 261, 303 Epidermoid carcinoma, 261, 312 Epidural, 17, 59, 261 Epigastric, 261, 291
Epiglottis, 10, 261 Epinephrine, 232, 257, 262, 288, 289, 304, 319 Epithelial, 16, 155, 232, 242, 248, 262, 271 Epithelial Cells, 16, 262, 271 Epithelium, 240, 262, 266 Epitopes, 16, 262 Epoprostenol, 262, 274 Erectile, 121, 262 Erection, 262, 296 ERV, 206, 262, 263 Erythema, 262, 320 Erythrocytes, 235, 242, 262, 270, 304 Escalation, 11, 262 Esophageal, 24, 69, 162, 163, 175, 188, 262, 267 Esophagitis, 4, 46, 172, 175, 189, 262, 267 Esophagus, 4, 9, 10, 34, 37, 69, 163, 175, 176, 179, 255, 262, 266, 267, 270, 281, 294, 295, 305, 313 Esotropia, 231, 262, 313 Estrogen, 21, 262, 300 Ethanol, 128, 153, 262 Ether, 127, 153, 262 Etodolac, 127, 152, 262 Euphoria, 142, 263 Evacuation, 251, 263, 266, 280, 303 Evoke, 263, 313 Excipient, 244, 263 Excitability, 29, 263, 286, 287 Excitation, 11, 18, 247, 263, 288 Excitatory, 18, 148, 162, 263, 268, 288 Excitatory Amino Acids, 263, 288 Excrete, 238, 263, 279 Exhaustion, 97, 253, 263, 279, 282 Exocrine, 263, 291 Exogenous, 257, 259, 260, 263, 268 Exotoxin, 12, 263 Exotropia, 263, 313 Expiration, 263, 305, 306 Expiratory, 262, 263 Expiratory Reserve Volume, 262, 263 Extensor, 263, 315 External-beam radiation, 263, 278, 303, 323 Extracellular, 24, 164, 239, 251, 263, 310, 316 Extracellular Matrix, 25, 251, 263 Extracellular Space, 263 Extraction, 68, 247, 264 Extrapyramidal, 127, 233, 237, 257, 264 Extremity, 243, 264, 282, 292
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Exudate, 264, 290 Eye Injuries, 147, 264 F Facial, 150, 264, 282, 293, 310 Facial Pain, 150, 264 Failure to Thrive, 176, 264 Family Planning, 205, 264 Family Relations, 212, 264 Family Therapy, 6, 264 Fat, 171, 182, 238, 242, 252, 260, 264, 280, 285, 306, 310 Fatigue, 14, 23, 26, 59, 66, 96, 127, 152, 187, 228, 264, 270 Fatty acids, 245, 264, 300 Fecal Incontinence, 124, 175, 264, 275 Feces, 29, 251, 260, 264, 313 Fentanyl, 55, 153, 181, 264 Fertilization in Vitro, 264, 299 Fetus, 247, 264, 296, 312, 313, 320 Fibrin, 242, 248, 264, 294, 296, 316 Fibrinogen, 264, 297, 316 Fibrosis, 96, 160, 176, 234, 265, 307, 308 Filtration, 187, 265, 279 Fissure, 170, 173, 231, 265, 319 Fistula, 265, 266 Flatulence, 170, 173, 175, 178, 265 Flatus, 8, 264, 265, 266 Fluid Therapy, 265, 289 Fluorescein Angiography, 46, 265 Fluorouracil, 30, 111, 265 Fold, 152, 265 Follicles, 136, 265 Food Deprivation, 170, 265 Food Hypersensitivity, 15, 265 Foramen, 247, 265, 282, 294 Forearm, 242, 265, 282, 315 Fourth Ventricle, 55, 246, 248, 265, 316 Functional Disorders, 177, 178, 265 Fungi, 242, 265, 284, 316, 323 Fungus, 244, 265 G Gait, 6, 266 Gallbladder, 97, 172, 176, 178, 231, 241, 247, 255, 266 Gallstones, 97, 170, 172, 173, 178, 247, 266 Gamma Rays, 266, 303 Ganglia, 136, 147, 231, 240, 266, 287, 294, 314 Gap Junctions, 266, 315 Gas exchange, 266, 306, 321 Gastrectomy, 253, 266
Gastric, 5, 7, 9, 10, 13, 21, 27, 28, 29, 88, 122, 126, 141, 161, 162, 175, 176, 178, 181, 188 Gastric Acid, 9, 10, 266 Gastric Emptying, 7, 21, 27, 162, 178, 188, 266, 267 Gastric Juices, 266, 293 Gastric Mucosa, 141, 266 Gastrin, 266, 272 Gastritis, 29, 97, 141, 170, 173, 189, 266, 322 Gastroduodenal, 175, 266 Gastroenteritis, 10, 13, 16, 142, 143, 170, 173, 175, 210, 266, 307 Gastroenterology, 4, 5, 6, 21, 35, 40, 48, 52, 53, 60, 61, 62, 63, 72, 88, 175, 178, 181, 266 Gastroesophageal Reflux, 54, 161, 162, 175, 178, 179, 266, 267 Gastroesophageal Reflux Disease, 175, 178, 179, 267 Gastrointestinal Hemorrhage, 176, 267 Gastrointestinal tract, 10, 49, 121, 136, 162, 179, 189, 262, 265, 267, 279, 309, 312 Gastroparesis, 7, 21, 55, 181, 267 Gastrostomy, 261, 267 Gelatin, 120, 128, 153, 267, 268, 314, 316 Gemcitabine, 28, 196, 267 Gene, 12, 24, 67, 137, 138, 161, 164, 242, 244, 267, 272 Gene Duplication, 164, 267 Gene Expression, 12, 267 Genetic Code, 267, 289 Genetic Engineering, 242, 248, 267 Genetics, 61, 267, 293 Genital, 267, 320 Genitourinary, 150, 151, 267, 320 Genomics, 137, 161, 267 Genotype, 267, 295 Germ Cells, 267, 283, 290, 291, 311 Giant Cells, 267, 307 Gigantism, 138, 267 Ginger, 14, 33, 49, 65, 66, 70, 85, 89, 91, 92, 93, 103, 106, 111, 116, 211, 268 Gland, 136, 232, 252, 268, 281, 291, 292, 293, 296, 300, 308, 313, 314, 317 Glossopharyngeal Nerve, 264, 268 Glucocorticoid, 255, 268 Glucose, 8, 21, 134, 138, 171, 174, 238, 242, 246, 268, 270, 273, 276, 307 Glucose tolerance, 21, 268 Glucose Tolerance Test, 268
333
Glucuronic Acid, 134, 268 Glucuronides, 268 Glutamate, 29, 147, 165, 268, 283 Glutamic Acid, 147, 268, 288, 300 Gluten, 245, 268 Glycine, 268, 288, 309 Glycols, 268, 272 Glycoprotein, 164, 264, 267, 269, 316, 319 Glycosidic, 246, 269, 287, 290 Glycosylation, 164, 269 Gonadal, 269, 313 Gonadotropin, 21, 269 Gout, 170, 269 Governing Board, 269, 299 Government Agencies, 178, 269, 299 Grade, 55, 120, 182, 269 Graft, 269, 272 Gram-negative, 269, 321 Granisetron, 32, 38, 39, 49, 50, 51, 78, 87, 137, 196, 269 Granule, 151, 165, 269 Granulocytes, 233, 269, 309, 323 Growth factors, 164, 269 Gynaecological, 66, 269 H Haematemesis, 260, 269 Hair follicles, 136, 269, 322 Half-Life, 11, 269, 274 Haloperidol, 45, 68, 269 Handwashing, 216, 269 Haploid, 269, 296 Haptens, 233, 270 Headache, 13, 22, 84, 98, 127, 132, 146, 148, 150, 154, 159, 167, 171 Headache Disorders, 150, 270 Heart failure, 134, 135, 136, 138, 156, 160, 187, 270 Heartburn, 123, 157, 161, 162, 172, 173, 175, 178, 270, 271, 275 Helminthiasis, 170, 246, 270 Hematemesis, 4, 270 Hemicrania, 270 Hemodialysis, 255, 270, 279 Hemodynamics, 17, 270 Hemoglobin, 235, 242, 262, 270, 280 Hemolysis, 154, 270 Hemolytic, 24, 270 Hemorrhage, 170, 175, 176, 253, 259, 270, 296, 313 Hemorrhoids, 97, 135, 170, 178, 270 Hemostasis, 270, 309 Hepatic, 165, 178, 179, 254, 268, 271
Hepatic Encephalopathy, 165, 271 Hepatitis, 97, 165, 170, 176, 178, 179, 182, 271, 322 Hepatitis A, 165, 271 Hepatocytes, 271 Hepatovirus, 271 Hereditary, 24, 247, 269, 271, 285, 287, 296 Heredity, 267, 271 Hernia, 172, 173, 176, 177, 271 Herpetiformis, 154, 155, 255, 271 Heterogeneity, 52, 233, 271 Heterotropia, 271, 313 Hiatal Hernia, 172, 173, 271 Hiccup, 257, 271 Histamine, 18, 164, 181, 235, 237, 253, 256, 271, 273 Histidine, 17, 271 Histology, 175, 271 Homeopathic remedies, 173, 271 Homeostasis, 28, 271, 310 Homogeneous, 130, 271, 295 Homologous, 25, 138, 164, 271, 315 Hormonal, 239, 252, 272 Hormone, 129, 135, 138, 140, 164 Hormone Replacement Therapy, 129, 272 Host, 11, 12, 28, 29, 138, 143, 240, 244, 272, 274, 322 Human growth hormone, 140, 272 Humeral, 272, 315 Hybrid, 25, 272 Hydration, 127, 152, 244, 272 Hydrochloric Acid, 231, 272 Hydrogel, 127, 152, 272 Hydrogen, 147, 161, 231, 232, 234, 240, 244, 255, 272, 284, 288, 301, 323 Hydrolysis, 135, 231, 246, 248, 272, 287, 295, 298, 301 Hydrophilic, 150, 151, 155, 272 Hydrophobic, 164, 272 Hydroxides, 272 Hydroxyl Radical, 18, 272 Hydroxylysine, 249, 272 Hydroxyproline, 249, 272 Hygienic, 216, 272 Hyperaemia, 251, 272 Hyperalgesia, 148, 272 Hyperbilirubinemia, 272, 278 Hypercholesterolemia, 170, 272 Hyperemesis, 58, 273 Hyperglycemia, 58, 171, 175, 273 Hyperphagia, 11, 273
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Hypersensitivity, 15, 145, 179, 233, 256, 273, 284, 307 Hypersensitivity, Immediate, 233, 273 Hypertension, 11, 18, 134, 135, 136, 138, 156, 160, 163, 164, 187 Hypertrophy, 134, 135, 136, 138, 156, 160, 163, 241, 252, 273, 318 Hyperuricemia, 269, 273 Hypesthesia, 273, 287 Hypnotic, 256, 273 Hypodermic, 125, 273 Hypoglycaemia, 147, 254, 273 Hypoglycemia, 171, 175, 273 Hypokinesia, 273, 293 Hypotension, 16, 17, 18, 53, 134, 135, 136, 138, 156, 160, 237, 251, 273 Hypothalamic, 13, 273 Hypothalamus, 136, 240, 255, 261, 273, 296, 316 Hypothermia, 273 Hypoxemia, 13, 17, 273 Hypoxia, 147, 254, 273, 316 Hysterectomy, 86, 273 Hysterotomy, 247, 273 I Iatrogenic, 11, 273 Ibuprofen, 193, 274, 278 Id, 80, 94, 210, 217, 218, 224, 226, 274 Idiopathic, 54, 134, 147, 274, 307 Ileostomy, 8, 178, 274 Ileum, 274, 278 Ileus, 8, 181, 274 Illusion, 274, 321 Iloprost, 78, 274 Imipramine, 22, 274 Immune response, 11, 12, 23, 232, 235, 237, 240, 252, 270, 274, 314, 322 Immune Sera, 274 Immune system, 242, 259, 271, 274, 281, 285, 320, 322 Immunization, 182, 274 Immunodeficiency, 214, 274 Immunologic, 16, 46, 175, 247, 274, 303, 323 Immunology, 24, 47, 84, 232, 233, 274 Immunosuppressant, 265, 274 Immunosuppressive, 253, 268, 274 Impaction, 175, 274 Impairment, 25, 132, 239, 241, 254, 258, 274, 277, 282, 283, 302 Implant radiation, 274, 277, 278, 303, 323 Impotence, 262, 274, 292
In vitro, 22, 29, 260, 274, 275 In vivo, 19, 22, 29, 274, 275 Incision, 273, 275, 277 Incompetence, 266, 275 Incontinence, 124, 146, 147, 166, 173, 175, 260, 275, 308 Indicative, 5, 179, 275, 293, 320 Indigestion, 161, 162, 170, 172, 173, 178, 275, 279 Indomethacin, 52, 78, 275 Induction, 16, 20, 235, 237, 275, 300 Infancy, 5, 48, 275 Infant Mortality, 10, 275 Infantile, 10, 275 Infarction, 88, 99, 134, 135, 136, 138, 156, 160, 163, 275, 305 Infectious Diarrhea, 175, 275 Infertility, 135, 275 Inflammatory bowel disease, 146, 147, 173, 179, 275 Influenza, 25, 98, 275 Information Centers, 170, 275 Infusion, 14, 44, 131, 275 Ingestion, 12, 18, 128, 129, 145, 176, 236, 268, 273, 276, 297, 316 Inhalation, 22, 120, 126, 233, 271, 276, 297 Initiation, 23, 28, 181, 276 Innervation, 243, 276, 282, 319 Inorganic, 126, 248, 272, 276, 281, 285, 295, 314 Inositol, 276, 283 Inotropic, 257, 276 Insight, 20, 25, 140, 276 Insomnia, 8, 11, 26, 127, 154, 276, 299 Insufflation, 126, 276 Insulator, 276, 285 Insulin, 138, 171, 174, 196, 268, 276 Insulin-dependent diabetes mellitus, 276 Intensive Care, 14, 50, 57, 276 Intensive Care Units, 14, 276 Interferon, 23, 276 Interferon-alpha, 276 Intermittent, 6, 55, 265, 276, 294 Internal Medicine, 28, 29, 266, 276 Internal radiation, 277, 278, 303, 323 Interstitial, 243, 263, 277, 278, 305, 323 Intervertebral, 277, 281 Intervertebral Disk Displacement, 277, 281 Intestinal Obstruction, 36, 175, 277 Intestinal Pseudo-Obstruction, 124, 178, 277
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Intoxication, 19, 254, 277, 323 Intracellular, 275, 277, 283, 298, 304, 309 Intracranial Pressure, 126, 277 Intramuscular, 158, 277, 292 Intraocular, 264, 277 Intrathecal, 64, 68, 92, 195, 277 Intrathecal chemotherapy, 92, 277 Intravenous, 17, 32, 45, 55, 56, 58, 71, 92, 145, 153, 176, 229, 265, 276, 277, 292 Intrinsic, 24, 40, 233, 240, 277 Invasive, 21, 120, 153, 277 Invertebrates, 277, 281 Involuntary, 240, 247, 264, 277, 286, 296, 305, 310, 311, 323 Ion Channels, 16, 147, 239, 277, 315 Ionization, 24, 277 Ionizing, 24, 234, 277, 303 Ions, 131, 231, 240, 256, 259, 272, 277, 284, 301 Irradiation, 28, 278, 323 Irritable Bowel Syndrome, 126, 134, 143, 144, 145, 173, 175, 178, 179, 189, 215, 265, 278 Irritants, 258, 278 Ischemia, 18, 134, 135, 163, 231, 239, 278, 288, 305 Ischemic stroke, 160, 278 Isoenzyme, 162, 278 Isonicotinic, 126, 278 J Jaundice, 170, 172, 176, 177, 272, 278 Jejunostomy, 8, 261, 278 Jejunum, 122, 147, 278 Jet lag, 152, 174, 278 Joint, 36, 238, 278, 281, 290, 312, 314 K Kb, 204, 278 Ketoprofen, 32, 278 Kidney Disease, 187, 204, 211, 212, 215, 217, 278 Kidney Failure, 187, 279 Kidney Failure, Acute, 279 Kidney Failure, Chronic, 187, 279 Kidney stone, 187, 279, 320 Kidney Transplantation, 279 Kinetic, 277, 279 L Labile, 249, 279 Laceration, 279, 316 Lactation, 279, 300 Lactose Intolerance, 173, 174, 178, 279, 284 Lactulose, 166, 279
Lag, 152, 174, 279 Lamivudine, 11, 279 Laparoscopy, 47, 56, 69, 70, 93, 279 Large Intestine, 249, 255, 261, 277, 279, 304, 310, 322 Laryngeal, 10, 279 Larynx, 9, 261, 279, 317, 318, 320 Lassitude, 127, 165, 279 Laxative, 170, 245, 279, 280 Leprosy, 154, 280 Lesion, 59, 280, 309, 315, 319 Lethal, 25, 240, 280 Lethargy, 19, 31, 160, 212, 213, 215, 280 Leucine, 241, 280 Leukemia, 258, 280 Leukocytes, 241, 242, 247, 261, 269, 275, 276, 280, 288, 319 Leukopenia, 280, 323 Library Services, 224, 280 Life cycle, 233, 265, 280 Ligament, 280, 300, 312 Ligands, 134, 156, 280, 304 Ligation, 139, 280 Linkages, 270, 280, 287, 323 Lipid, 247, 276, 280, 285 Lipophilic, 155, 280 Lithium, 237, 280 Liver Transplantation, 176, 280 Lobe, 272, 280, 293 Localization, 25, 280 Localized, 235, 260, 275, 280, 286, 296, 316, 319, 320 Locomotion, 280, 296 Loop, 19, 139, 271, 274, 280 Low Back Pain, 84, 280 Lower Esophageal Sphincter, 163, 188, 267, 281 Lumbar, 240, 277, 280, 281 Lumen, 9, 162, 281 Luminescence, 22, 281 Lupus, 98, 100, 173, 249, 281 Lutein Cells, 281, 300 Luxation, 256, 281 Lymph, 187, 246, 248, 261, 281, 307 Lymph node, 187, 246, 281, 307 Lymphatic, 98, 275, 281, 297, 310, 311, 317 Lymphatic system, 281, 310, 311, 317 Lymphocyte, 237, 281, 283 Lymphoid, 236, 281 Lymphokine, 23, 281 Lymphoma, 38, 78, 87, 281 Lytic, 281, 322
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M Malabsorption, 172, 175, 176, 245, 281, 309 Malabsorption syndrome, 281, 309 Malaise, 124, 258, 281 Malaria, 154, 155, 170, 281, 282 Malaria, Falciparum, 281, 282 Malaria, Vivax, 281, 282 Malignancy, 29, 282 Malignant, 175, 232, 237, 282, 287, 303, 307 Malignant tumor, 175, 282 Malnutrition, 53, 239, 244, 282 Mandible, 247, 282 Mandibular Nerve, 69, 282 Mania, 126, 127, 132, 152, 282 Manic, 134, 135, 136, 156, 160, 163, 237, 280, 282, 302 Manic-depressive psychosis, 282, 302 Manifest, 240, 282, 313 Marijuana Abuse, 25, 282 Mastectomy, 243, 282 Mastication, 282, 319 Meatus, 282, 320 Mechanical ventilation, 11, 282 Median Nerve, 185, 245, 282 Mediate, 147, 257, 282 Mediator, 13, 18, 26, 282, 309 Medical Staff, 257, 283 MEDLINE, 205, 283 Meiosis, 283, 315, 319 Melanin, 283, 295, 319 Memory, 25, 132, 147, 152, 154, 166, 236, 254, 283 Meninges, 246, 252, 258, 283 Meningitis, 98, 283, 296 Menstrual Cycle, 21, 173, 283, 299 Menstruation, 234, 283, 299 Mental Disorders, 273, 283, 296, 302 Mental Health, iv, 7, 204, 206, 283, 302 Mental Processes, 256, 283, 302 Mental Retardation, 134, 135, 137, 156, 160, 163, 283 Mesolimbic, 237, 283 Meta-Analysis, 42, 49, 51, 283 Metabolic disorder, 189, 212, 215, 269, 283 Metabolite, 142, 256, 283, 289, 299 Metabotropic, 147, 165, 283 Metastasis, 283, 284 Metastatic, 28, 284 Methionine, 241, 256, 284, 314 Metoclopramide, 32, 38, 43, 47, 50, 54, 59, 61, 65, 66, 69, 78, 87, 113, 121, 126, 167, 284
MI, 146, 177, 229, 284 Microbe, 284, 317 Microbiological, 37, 284 Microbiology, 37, 232, 239, 284 Microorganism, 249, 284, 322 Microscopy, 25, 241, 284 Milk Hypersensitivity, 16, 284 Mineralocorticoids, 232, 252, 284 Mitochondrial Swelling, 284, 286 Mobility, 24, 284 Mobilization, 28, 284 Modeling, 17, 284 Modification, 267, 284, 303, 323 Molecular, 12, 17, 21, 22, 127, 130, 137, 152, 205, 207, 242, 250, 264, 268, 284, 285, 296, 297, 298, 300, 304, 307, 314, 317, 318, 319 Molecular Structure, 284, 318 Molecule, 133, 237, 240, 249, 250, 256, 259, 263, 269, 272, 284, 303, 304, 309, 318, 321 Monitor, 253, 285, 289 Monoclonal, 278, 285, 303, 323 Mononuclear, 28, 285, 319 Monophosphate, 18, 285 Mood Disorders, 120, 285 Morphine, 11, 59, 68, 133, 148, 153, 161, 238, 248, 285, 286, 290 Motilin, 182, 285 Motion Sickness, 41, 99, 122, 124, 145, 146, 285, 286, 308 Motor Activity, 251, 285 Movement Disorders, 73, 237, 285, 316 Mucociliary, 285, 310 Mucosa, 136, 141, 155, 245, 261, 266, 281, 285, 300 Mucus, 258, 285, 319 Multicenter study, 70, 93, 285 Multiple sclerosis, 6, 78, 146, 285 Muscle relaxant, 236, 285, 292 Muscle Relaxation, 84, 93, 285 Muscle Spasticity, 120, 285 Muscle tension, 124, 285 Musculature, 9, 273, 285, 312 Myalgia, 275, 285 Mydriatic, 256, 286, 308 Myelin, 285, 286 Myenteric, 162, 286 Myocardial infarction, 39, 88, 134, 135, 136, 138, 156, 160, 163, 238, 252, 284, 286 Myocardial Ischemia, 17, 235, 286 Myocardium, 235, 284, 286
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N Nadir, 20, 286 Naloxone, 241, 286 Naltrexone, 148, 286 Narcosis, 286 Narcotic, 11, 133, 153, 264, 285, 286, 288, 318 Nasal Mucosa, 275, 286 Nasogastric, 55, 261, 286 NCI, 1, 174, 203, 248, 286, 293 Neck Pain, 6, 286 Necrosis, 28, 275, 284, 286, 305, 307 Neonatal, 11, 275, 286, 287 Neonatal Abstinence Syndrome, 11, 287 Neoplasm, 248, 287, 307 Neoplastic, 235, 264, 281, 287 Nephropathy, 279, 287 Nerve Endings, 287, 289 Nervous System, 6, 10, 16, 25, 121, 126, 132, 133, 147, 161, 166 Nervousness, 154, 287 Neural, 9, 233, 244, 255, 287 Neuraminidase, 25, 287 Neuritis, 154, 287 Neurodegenerative Diseases, 134, 135, 160, 163, 240, 287 Neuroendocrine, 13, 287 Neurogenic, 135, 136, 287, 320 Neurogenic Inflammation, 135, 136, 287 Neuroleptic, 22, 181, 233, 237, 287, 290 Neurologic, 11, 236, 287 Neurology, 5, 6, 18, 74, 121, 287 Neuromuscular, 19, 61, 231, 287, 319 Neuromuscular Junction, 231, 287 Neuronal, 18, 131, 148, 286, 288, 294 Neurons, 19, 25, 29, 148, 162, 254, 263, 266, 285, 287, 288, 314, 315 Neuropathy, 161, 171, 288, 294 Neuropeptide, 138, 143, 147, 244, 288 Neuropharmacology, 71, 121, 288 Neuroprotective Agents, 125, 288 Neurosis, 288 Neurotic, 166, 236, 288, 320 Neurotransmitter, 147, 231, 232, 244, 257, 263, 268, 271, 277, 288, 289, 309, 314, 315 Neutrons, 234, 278, 288, 303 Neutrophils, 136, 233, 269, 280, 288 Niacin, 80, 288, 319 Nicotine, 132, 147, 152, 173, 288 Nitrogen, 158, 165, 187, 233, 234, 235, 253, 279, 288, 291, 319 Nitrous Oxide, 43, 44, 73, 113, 288
Nociceptors, 18, 289 Nonulcer Dyspepsia, 172, 289 Norepinephrine, 142, 232, 234, 255, 257, 288, 289, 304 Nortriptyline, 215, 289 Nosocomial, 12, 13, 289 Nuclear, 46, 240, 259, 264, 266, 286, 289 Nuclear Family, 264, 289 Nuclei, 234, 259, 267, 288, 289, 290, 301 Nucleic acid, 136, 138, 267, 288, 289, 303, 323 Nursing Staff, 159, 289 Nutritional Status, 46, 176, 289 Nutritional Support, 8, 267, 289 O Occipital Lobe, 256, 289, 322 Occult, 178, 289 Ocular, 146, 262, 263, 289 Oculomotor, 256, 289 Oculomotor Nerve, 256, 289 Odour, 238, 289, 319 Ointments, 257, 290 Olfaction, 58, 290 Oligosaccharides, 287, 290 Oliguria, 279, 290 Oncology, 30, 34, 35, 45, 53, 55, 60, 64, 65, 70, 87, 92, 93, 290 Ondansetron, 20, 78, 85, 86, 87, 88, 92, 132, 157, 158 Oocytes, 16, 139, 290 Opacity, 254, 290 Opiate, 58, 142, 144, 147, 149, 153, 241, 261, 285, 286, 290 Opium, 11, 285, 290, 292 Opsin, 290, 306, 307 Optic Chiasm, 273, 290 Optic Nerve, 290, 291, 306, 308 Orbit, 124, 231, 290, 319 Orbital, 65, 231, 290, 319 Orofacial, 264, 290 Orthostatic, 237, 290 Osteoarthritis, 84, 142, 262, 278, 290 Osteoclasts, 244, 290 Osteoporosis, 134, 135, 136, 138, 156, 160, 163, 164, 291 Outpatient, 39, 70, 73, 93, 291 Ovary, 252, 291, 297 Overdosage, 170, 291 Overdose, 18, 58, 291 Ovum, 252, 280, 291, 299, 300, 323 Oxygenation, 17, 273, 291
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P Pacemaker, 7, 291 Pachymeningitis, 283, 291 Paediatric, 32, 43, 54, 55, 59, 60, 62, 64, 75, 90, 91, 291 Palate, 159, 268, 291 Palliative, 45, 72, 291, 316 Pancreas, 32, 176, 231, 255, 266, 276, 291, 308 Pancreatic, 28, 172, 173, 179, 245, 266, 291 Pancreatic cancer, 28, 173, 291 Pancreatic Insufficiency, 179, 291 Pancreatic Juice, 266, 291 Pancreatitis, 99, 176, 179, 291 Panic, 274, 291, 292 Panic Disorder, 274, 292 Papaverine, 290, 292 Papilla, 48, 292 Paralysis, 253, 262, 292, 311 Paranasal Sinuses, 292, 310 Parasite, 292, 318 Parasitic, 175, 258, 270, 292 Parasitic Diseases, 175, 292 Parathyroid, 65, 165, 292, 316 Parathyroid Glands, 292 Parathyroid hormone, 165, 292 Parenteral, 8, 154, 176, 292 Parenteral Nutrition, 8, 292 Paresis, 287, 292 Paresthesias, 287, 292, 293 Parietal, 293, 294, 297 Parkinsonism, 147, 164, 166, 237, 238, 293 Parotid, 268, 293, 307 Paroxysmal, 235, 239, 270, 293 Partial response, 6, 293 Particle, 22, 293, 318 Parturition, 293, 300 Patch, 25, 293 Pathogenesis, 13, 19, 293 Pathologic, 36, 231, 244, 252, 272, 273, 293 Pathophysiology, 5, 20, 179, 181, 293 Patient Advocacy, 218, 293 Patient Education, 182, 211, 214, 216, 222, 224, 229, 293 Patient Satisfaction, 54, 293 Patient Selection, 215, 293 PDQ, 210, 293 Pediatric Gastroenterologist, 5, 293 Pelvic, 293, 300, 306 Penicillin, 293, 320 Pepsin, 13, 293, 308
Peptic, 4, 10, 29, 99, 172, 179, 181, 189, 293, 294, 322 Peptic Ulcer, 10, 29, 99, 172, 179, 181, 294, 322 Peptide, 125, 138, 241, 244, 294, 298, 301, 314 Perception, 31, 36, 250, 251, 294, 308 Perforation, 265, 294, 322 Perfusion, 273, 294 Periodontal disease, 135, 294 Peripheral blood, 28, 124, 276, 294 Peripheral Nerves, 280, 294, 311 Peripheral Nervous System, 136, 138, 287, 288, 294, 314 Peripheral Neuropathy, 294, 323 Peristalsis, 122, 294 Peritoneal, 55, 131, 238, 255, 294 Peritoneal Cavity, 238, 294 Peritoneal Dialysis, 55, 131, 255, 294 Peritoneum, 294, 306 Peritonitis, 99, 294, 322 Perivascular, 244, 295 Pernicious, 181, 295 Pernicious anemia, 181, 295 Perspiration, 255, 295 Pharmaceutical Preparations, 246, 262, 267, 295 Pharmaceutical Solutions, 257, 295 Pharmacodynamics, 11, 295 Pharmacokinetic, 12, 145, 295 Pharmacologic, 46, 181, 217, 235, 239, 269, 295, 317, 320 Pharmacotherapy, 51, 165, 188, 295 Pharynx, 267, 275, 295, 320 Phenotype, 29, 137, 161, 295 Phenyl, 146, 295 Phenylalanine, 295, 319 Pheromone, 165, 295 Phosphates, 295 Phosphodiesterase, 135, 156, 161, 162, 164, 295 Phospholipases, 163, 295, 309 Phospholipids, 264, 276, 295 Phosphoric Acids, 126, 295 Phosphorus, 244, 292, 295 Photocoagulation, 248, 296 Photophobia, 150, 159, 296 Photoreceptor, 296, 307 Photosensitization, 22, 296 Physical Examination, 15, 181, 296 Physiologic, 123, 233, 242, 269, 273, 283, 296, 304, 318
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Physiology, 22, 36, 136, 172, 175, 176, 178, 259, 266, 296 Pigmentation, 296, 322 Piloerection, 273, 296 Pilot study, 43, 84, 88, 296 Pituitary Gland, 252, 296 Placenta, 296, 299 Plant Diseases, 261, 296 Plants, 170, 233, 239, 241, 245, 247, 248, 268, 289, 296, 297, 307, 317, 318 Plaque, 236, 296 Plasma, 12, 120, 127, 128, 131, 152, 153, 165, 236, 244, 264, 267, 268, 270, 279, 284, 296, 297, 301, 308, 322 Plasma cells, 236, 296 Plasmids, 24, 296 Plasmin, 24, 296, 297 Plasminogen, 296, 297 Plasminogen Activators, 296, 297 Platelet Activation, 297, 309 Platelet Aggregation, 235, 262, 274, 297 Platelets, 18, 297, 316 Platinum, 248, 280, 297 Pleura, 297 Pleural, 165, 297 Pleural cavity, 297 Pleural Effusion, 165, 297 Plexus, 162, 243, 297 Pneumonia, 13, 154, 155, 251, 297 Pneumonitis, 9, 13, 297 Poison Control Centers, 170, 297 Poisoning, 12, 97, 173, 177, 186, 210, 238, 254, 266, 277, 286, 297, 312 Policy Making, 269, 297 Pollen, 145, 297 Polyethylene, 297, 298, 314 Polyethylene Glycols, 298, 314 Polymorphic, 157, 298 Polypeptide, 138, 160, 167, 234, 249, 264, 285, 296, 298, 300, 301, 323 Polyposis, 175, 249, 298 Polysaccharide, 237, 246, 298 Pons, 231, 243, 265, 298, 306, 307 Pontine, 59, 298 Portal Hypertension, 179, 298 Portal Vein, 298 Posterior, 235, 239, 240, 246, 248, 257, 268, 286, 289, 291, 298, 306, 308 Postmenopausal, 291, 298 Postoperative, 8, 31, 79, 84, 85, 86, 87, 88, 89, 91, 92, 93, 142, 154, 158, 181
Postoperative Nausea and Vomiting, 31, 79, 84, 85, 86, 88, 89, 91, 93 Postprandial, 21, 161, 162, 298 Postsynaptic, 298, 309, 315 Post-traumatic, 270, 285, 298 Potassium, 81, 82, 187, 284, 298 Potentiates, 255, 298 Potentiating, 234, 298 Potentiation, 299, 309 Practicability, 299, 318 Practice Guidelines, 206, 216, 299 Precipitating Factors, 270, 299 Precursor, 238, 247, 253, 257, 259, 261, 289, 295, 297, 299, 301, 319, 320 Pregnancy Outcome, 78, 299 Prejudice, 170, 299 Premedication, 65, 299, 308 Premenstrual, 160, 299 Premenstrual Syndrome, 160, 299 Presynaptic, 287, 288, 299, 315 Prevalence, 5, 14, 27, 160, 178, 299 Proctocolitis, 16, 299 Prodrug, 299 Progesterone, 21, 63, 299, 300, 313 Progression, 28, 236, 299 Progressive, 6, 84, 93, 187, 246, 248, 254, 258, 262, 269, 279, 286, 287, 290, 297, 299, 305 Projection, 254, 289, 290, 300, 304, 317 Prolactin, 63, 300 Proline, 249, 272, 300 Promoter, 12, 136, 155, 300 Propanolol, 128, 153, 300 Prophase, 290, 300, 315, 319 Prophylaxis, 32, 33, 39, 42, 45, 49, 54, 56, 67, 68, 72, 73, 86, 88, 137, 300 Propofol, 44, 56, 57, 68, 300 Proportional, 9, 300 Propulsive, 133, 300 Prospective Studies, 15, 300 Prospective study, 27, 53, 63, 300 Prostaglandins, 18, 238, 275, 300 Prostaglandins A, 18, 275, 300 Prostaglandins D, 300 Prostate, 136, 241, 300, 301, 305 Prostate gland, 136, 300, 301 Prostatic Hyperplasia, 147, 301 Prosthesis, 162, 163, 301 Protease, 11, 24, 249, 301, 307 Protein C, 16, 135, 143, 156, 160, 234, 240, 301, 319 Protein Conformation, 234, 301
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Protein Kinases, 163, 301 Protein S, 135, 164, 242, 267, 272, 301 Proteins, 16, 135, 137, 143, 156, 163, 164 Proteolytic, 24, 234, 250, 264, 296, 297, 301 Prothrombin, 301, 316 Protocol, 11, 21, 34, 70, 120, 301 Protons, 18, 22, 234, 272, 277, 301, 303 Protozoa, 242, 258, 284, 301 Protozoal, 301 Protozoan, 134, 136, 156, 160, 246, 281, 301, 318 Proximal, 8, 32, 257, 299, 301 Proxy, 13, 188, 301 Pruritic, 144, 145, 166, 255, 258, 301 Pruritus, 64, 134, 145, 238, 256, 301, 319 Psychiatric, 215, 283, 302 Psychiatry, 5, 20, 35, 58, 71, 74, 121, 302, 313, 321 Psychic, 288, 302, 308 Psychoactive, 120, 146, 302, 316, 323 Psychogenic, 4, 34, 121, 302, 320 Psychology, 5, 173, 256, 302 Psychomotor, 254, 287, 302 Psychopathology, 178, 302 Psychosis, 138, 146, 154, 166, 237, 238, 302 Psychosomatic, 46, 63, 147, 302 Psychotherapy, 264, 302 Public Health, 10, 27, 182, 206, 302 Public Policy, 205, 302 Publishing, 4, 30, 123, 157, 169, 173, 302 Pulmonary, 9, 13, 136, 242, 243, 251, 252, 261, 262, 279, 302, 306, 321 Pulmonary Artery, 242, 302, 321 Pulmonary Edema, 279, 302 Pulmonary hypertension, 252, 262, 302 Pulmonary Ventilation, 302, 306 Pulse, 7, 22, 285, 302 Purgative, 280, 303 Purines, 303, 309 Purulent, 303, 320 Pustular, 154, 155, 271, 303 Pyloric Sphincter, 21, 303 Pylorus, 122, 141, 258, 303 Pyramidal Tracts, 264, 303 Q Quality of Life, 8, 14, 23, 26, 28, 30, 31, 40, 44, 167, 303, 314 Quaternary, 126, 301, 303, 308 R Race, 132, 142, 255, 303 Racemic, 132, 142, 255, 303
Radiation, 100, 126, 132, 172, 214, 217, 235, 259, 263, 266, 277, 278, 303, 323 Radiation therapy, 126, 132, 172, 214, 217, 263, 277, 278, 303, 323 Radioactive, 269, 272, 274, 277, 278, 289, 303, 323 Radioimmunotherapy, 303 Radiolabeled, 17, 278, 303, 323 Radiotherapy, 23, 158, 159, 243, 278, 303, 323 Randomized, 8, 11, 13, 14, 15, 20, 28, 30, 85, 86, 88, 92 Randomized clinical trial, 14, 28, 30, 304 Randomized Controlled Trials, 42, 49, 68, 92, 304 Reactive Oxygen Species, 18, 304 Reality Testing, 302, 304 Receptors, Adrenergic, 255, 304 Receptors, Serotonin, 304, 309 Recombinant, 136, 138, 160, 164, 304, 321 Recovery Room, 127, 304 Rectal, 170, 173, 304, 314 Rectum, 236, 238, 243, 249, 255, 265, 266, 275, 279, 299, 300, 304, 314 Recurrence, 5, 282, 304 Red blood cells, 187, 262, 270, 304, 307 Red Nucleus, 239, 304 Refer, 1, 243, 249, 257, 265, 280, 287, 288, 289, 302, 303, 305, 317, 321 Reflex, 16, 18, 29, 58, 141, 147, 305 Reflux, 9, 122, 161, 162, 163, 176, 266, 267, 305 Refraction, 305, 311 Refractive Errors, 256, 305 Refractory, 8, 64, 259, 305 Regimen, 15, 30, 128, 151, 259, 295, 305 Regurgitation, 40, 267, 270, 305 Rehydration, 216, 305 Rehydration Solutions, 216, 305 Remission, 282, 304, 305 Renal failure, 254, 305, 319 Renal pelvis, 279, 305 Reperfusion, 17, 305 Reperfusion Injury, 305 Reproduction Techniques, 299, 305 Reproductive system, 300, 305 Resection, 305, 309 Residual Volume, 13, 305 Respiration, 238, 245, 247, 253, 285, 305, 306 Respirator, 282, 306, 321 Respiratory Physiology, 306, 321
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Respiratory System, 9, 285, 306 Restoration, 305, 306, 323 Resuscitation, 260, 306 Retching, 50, 73, 306 Retina, 136, 248, 290, 306, 307, 322 Retinal, 250, 265, 290, 306, 307, 322 Retinol, 306, 307 Retinopathy, 147, 166, 296, 306 Retrobulbar, 62, 306 Retrograde, 9, 162, 306 Retroperitoneal, 306 Retroperitoneal Space, 306 Retropneumoperitoneum, 35, 306 Retrospective, 6, 306 Rheumatism, 274, 306, 307 Rheumatoid, 146, 147, 154, 155, 249, 262, 278, 307 Rheumatoid arthritis, 146, 147, 154, 155, 249, 262, 278, 307 Rhinitis, 136, 146, 284, 307 Rhodopsin, 164, 290, 306, 307 Rhombencephalon, 265, 307 Ribose, 232, 307 Rigidity, 149, 277, 293, 296, 307 Risk factor, 4, 14, 27, 42, 257, 300, 307 Risk patient, 54, 65, 307 Ritonavir, 11, 307 Rod, 240, 248, 296, 307 Rotavirus, 142, 307 Rubber, 139, 232, 307 S Salicylic, 126, 307 Saline, 13, 32, 59, 68, 307 Salivary, 253, 255, 291, 307 Salivary glands, 253, 255, 307 Sanitation, 141, 307 Saponins, 307, 313 Sarcoidosis, 187, 307 Sarcoma, 154, 155, 176, 307 Schizoid, 308, 323 Schizophrenia, 121, 126, 132, 134, 135, 136, 147, 152, 156, 160, 163, 164 Schizotypal Personality Disorder, 308, 323 Sclera, 248, 251, 308 Sclerosis, 6, 78, 146, 160, 166, 249, 285, 308 Scopolamine, 79, 121, 181, 241, 308 Screening, 19, 134, 136, 156, 178, 248, 293, 308 Sebaceous, 278, 308, 322 Secretin, 165, 308 Secretion, 138, 140, 162, 231, 252, 271, 276, 279, 284, 285, 291, 295, 308
Secretory, 136, 175, 308, 315, 322 Sedative, 18, 234, 248, 255, 256, 274, 308, 320 Sedatives, Barbiturate, 240, 308 Sedentary, 170, 308 Seizures, 11, 18, 53, 54, 171, 254, 293, 308 Self Care, 232, 308 Semen, 101, 102, 105, 140, 259, 300, 308 Seminiferous tubule, 308, 311 Senile, 238, 291, 308 Sensibility, 234, 272, 308 Sensor, 12, 309 Septic, 238, 309 Sequencing, 17, 309 Serine, 24, 309 Serotonin, 18, 125, 126, 132, 142, 164 Serum, 11, 235, 249, 250, 269, 274, 279, 284, 294, 309, 319 Sex Characteristics, 232, 235, 309 Sexually Transmitted Diseases, 175, 309 Shedding, 10, 29, 309 Shock, 100, 144, 145, 265, 309, 318 Short Bowel Syndrome, 175, 176, 178, 181, 309 Signal Transduction, 135, 143, 156, 164, 276, 309 Signs and Symptoms, 11, 305, 309, 319 Sinusitis, 54, 310 Skeletal, 235, 248, 253, 310, 311 Skeleton, 278, 310 Skull, 253, 277, 290, 310, 315 Sleep apnea, 126, 310 Small intestine, 129, 175, 241, 258, 261, 272, 274, 277, 278, 286, 303, 310, 321 Smooth muscle, 134, 135, 136, 162, 163 Snails, 125, 310 Sneezing, 309, 310 Social Environment, 303, 310 Social Support, 23, 310, 313 Sodium, 127, 128, 152, 262, 269, 284, 310, 314 Soft tissue, 242, 310 Solid tumor, 235, 258, 310 Solitary Nucleus, 29, 240, 310 Solvent, 128, 153, 262, 295, 310 Soma, 311 Somatic, 20, 140, 232, 268, 283, 294, 311, 320 Somnolence, 22, 142, 148, 311 Spasm, 166, 238, 271, 311, 316 Spasmodic, 231, 311 Spastic, 278, 311
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Spasticity, 120, 311 Spatial disorientation, 257, 311 Specialist, 219, 256, 311 Species, 12, 116, 138, 142, 143, 164 Specificity, 24, 233, 311 Spectrometer, 24, 311 Spectrum, 15, 311 Sperm, 129, 235, 297, 308, 311 Spermatozoa, 136, 308, 311 Sphincter, 21, 124, 163, 188, 279, 311 Spinal cord, 147, 153, 239, 243, 246, 247, 258, 261, 277, 282, 283, 287, 288, 291, 294, 303, 305, 311, 314 Spinal Cord Injuries, 147, 311 Spinal Nerves, 294, 311 Spleen, 187, 253, 281, 307, 311 Splint, 139, 312 Spondylitis, 262, 312 Spontaneous Abortion, 299, 312 Sporadic, 32, 287, 312 Sprains and Strains, 175, 281, 312 Squamous, 34, 261, 312 Squamous cell carcinoma, 34, 261, 312 Squamous cells, 312 Stabilizer, 245, 312 Staphylococcal Food Poisoning, 12, 312 Stasis, 13, 28, 161, 181, 312 Steel, 248, 312 Stem cell transplantation, 48, 50, 312 Stem Cells, 312 Stenosis, 99, 163, 312, 313 Stent, 162, 312 Sterile, 238, 292, 312 Sterility, 253, 275, 312 Sterilization, 131, 312 Steroid, 137, 252, 268, 307, 312 Stillbirth, 299, 313 Stimulant, 120, 253, 271, 313, 320 Stimulus, 147, 163, 243, 258, 259, 263, 276, 277, 279, 287, 293, 305, 313, 316 Stomach, 5, 8, 29, 100, 122, 123, 129, 141, 157, 161, 162, 170, 171, 172, 173, 175, 176, 177, 179, 212, 214, 228 Stomach Ulcer, 173, 313 Stool, 227, 249, 274, 275, 278, 279, 313, 315 Strabismus, 43, 51, 57, 58, 59, 60, 64, 65, 72, 89, 256, 313 Stress, 4, 5, 23, 159, 173, 212, 213, 215 Stress management, 23, 313 Stricture, 312, 313 Stroke, 17, 84, 100, 134, 135, 136, 144, 145, 156, 160, 163, 166, 175, 204
Stroke Volume, 17, 245, 313 Stupor, 280, 286, 313 Styrene, 307, 313 Subacute, 6, 275, 310, 313 Subarachnoid, 265, 270, 296, 313 Subclinical, 275, 308, 313 Subcutaneous, 235, 259, 292, 313, 317 Subspecies, 311, 313 Substance P, 136, 283, 308, 314 Substrate, 287, 314 Suction, 141, 265, 314 Sulfonic Acids, 126, 314 Sulfur, 82, 279, 284, 314 Superantigens, 12, 314 Supportive care, 293, 314 Suppositories, 267, 314 Suppository, 168, 298, 314 Suppression, 29, 252, 314, 323 Supratentorial, 67, 314 Sweat, 60, 90, 273, 295, 314 Sweat Glands, 314 Sympathectomy, 17, 314 Sympathetic Nervous System, 11, 240, 314 Sympathomimetic, 257, 262, 289, 314 Symphysis, 247, 300, 314 Symptomatic, 10, 125, 126, 181, 236, 243, 291, 315 Symptomatic treatment, 125, 126, 236, 315 Symptomatology, 5, 315 Synapsis, 315 Synaptic, 16, 18, 288, 309, 315 Synaptic Transmission, 16, 18, 288, 315 Synergistic, 148, 168, 300, 315 Systemic therapy, 155, 315 Systolic, 273, 315 T Tachycardia, 11, 154, 315 Tardive, 237, 315 Telencephalon, 240, 246, 315 Temporal, 19, 20, 26, 53, 54, 270, 282, 315 Temporal Lobe, 53, 54, 315 Tenesmus, 258, 315 Tennis Elbow, 84, 315 Terminator, 315, 323 Tetani, 315 Tetanic, 315, 316 Tetanus, 16, 25, 315, 316 Tetany, 292, 316 Tetrahydrocannabinol, 120, 244, 316 Thalamic, 239, 316 Thalamic Diseases, 239, 316
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Therapeutics, 32, 43, 45, 50, 66, 68, 122, 133, 166, 199, 316 Third Ventricle, 273, 316 Thoracic, 240, 243, 255, 282, 297, 316, 323 Thorax, 231, 281, 316, 320 Threonine, 309, 316 Threshold, 263, 273, 316 Thrombin, 164, 264, 297, 301, 316 Thrombocytes, 297, 316 Thrombomodulin, 301, 316 Thrombosis, 301, 313, 316 Thrombus, 252, 275, 278, 286, 297, 316 Thrush, 176, 244, 316 Thymus, 115, 274, 281, 317 Thyroid, 10, 53, 65, 244, 292, 317, 319 Thyroid Cartilage, 10, 317 Thyroid Gland, 292, 317 Thyrotoxicosis, 68, 317 Time Management, 313, 317 Tin, 171, 245, 294, 297, 317 Tissue, 18, 25, 28, 131, 136, 149, 161, 187 Tolerance, 8, 16, 21, 25, 148, 268, 317 Tone, 27, 122, 258, 311, 317 Tonicity, 258, 270, 317 Tonus, 317 Tooth Preparation, 232, 317 Topical, 62, 145, 155, 177, 262, 317 Torsion, 275, 317 Toxic, iv, 22, 125, 126, 166, 188, 239, 253, 254, 261, 263, 288, 313, 317, 323 Toxicity, 123, 155, 157, 167, 187, 258, 317 Toxicology, 25, 35, 181, 206, 317 Toxin, 12, 21, 156, 261, 315, 317 Toxoid, 16, 317 Trace element, 317, 318 Trachea, 243, 279, 295, 317, 318 Traction, 248, 318 Tramadol, 142, 148, 318 Transcriptase, 279, 318, 323 Transcutaneous, 7, 71, 94, 318 Transduction, 135, 143, 156, 164, 309, 318 Transfection, 242, 318 Transfer Factor, 274, 318 Transferases, 269, 318 Transmitter, 231, 239, 257, 263, 277, 283, 289, 318 Transplantation, 176, 188, 260, 274, 318 Trauma, 14, 28, 133, 144, 145, 175, 187, 254, 262, 264, 286, 288, 291, 318 Treatment Outcome, 6, 318 Trees, 307, 318 Tremor, 293, 318
Trichomoniasis, 173, 318 Tricuspid Atresia, 252, 318 Tricyclic, 192, 215, 234, 255, 274, 318 Trigeminal, 264, 282, 318 Trigger zone, 121, 126, 158, 237, 319 Trochlear Nerve, 256, 319 Trochlear Nerve Diseases, 256, 319 Tryptophan, 125, 249, 309, 319 Tuberculosis, 251, 278, 281, 307, 319 Tubocurarine, 16, 319 Tumor Necrosis Factor, 28, 319 Tyrosine, 115, 257, 319 U Ulcer, 10, 29, 99, 135, 141, 175, 179, 181, 228, 258, 289, 313, 319 Ulceration, 294, 319 Ulcerative colitis, 175, 176, 178, 275, 319 Unconscious, 235, 254, 274, 319 Univalent, 272, 319 Uraemia, 291, 319 Urea, 187, 279, 314, 319 Uremia, 126, 279, 305, 319 Ureters, 279, 319, 320 Urethra, 241, 300, 320 Uric, 269, 273, 303, 320 Urinary Retention, 134, 135, 136, 138, 156, 160, 163, 320 Urinary tract, 174, 175, 320 Urinary tract infection, 175, 320 Urinate, 320 Urine, 151, 187, 238, 241, 242, 253, 268, 275, 279, 290, 305, 319, 320 Urogenital, 267, 320 Urticaria, 16, 320 Uterus, 246, 247, 252, 260, 273, 283, 299, 305, 320 V Vaccine, 232, 301, 320 Vagal, 18, 20, 27, 29, 320 Vagina, 129, 155, 244, 247, 273, 283, 305, 320 Vaginal, 129, 155, 174, 314, 320 Vaginitis, 175, 244, 320 Vagus Nerve, 20, 310, 320 Valerian, 169, 320 Valine, 165, 320 Vascular, 17, 85, 136, 160, 234, 235, 248, 262, 265, 270, 273, 275, 287, 296, 297, 316, 317, 320 Vascular Resistance, 17, 320 Vasculitis, 291, 320 Vasodilation, 138, 274, 292, 320
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Vasodilator, 136, 139, 244, 257, 271, 292, 321 Vector, 292, 318, 321 Vein, 131, 235, 277, 289, 293, 298, 321 Venlafaxine, 127, 128, 152, 321 Venom, 102, 125, 321 Venous, 17, 242, 270, 301, 318, 321 Ventilation, 11, 321 Ventilator, 282, 306, 321 Ventricle, 239, 252, 302, 315, 318, 321 Ventricular, 160, 252, 318, 321 Vertebrae, 277, 311, 312, 321 Vertigo, 100, 181, 321 Vesicular, 244, 255, 271, 321 Vesicular Exanthema of Swine, 244, 321 Vesicular Exanthema of Swine Virus, 244, 321 Vestibular, 61, 321 Vestibule, 321 Veterinary Medicine, 131, 205, 321 Vibrio, 25, 247, 321 Vibrio cholerae, 247, 321 Villi, 321 Villous, 106, 245, 248, 321 Viral, 11, 134, 136, 156, 160, 178, 179, 267, 275, 318, 322, 323 Viral Hepatitis, 178, 179, 322 Viral Load, 11, 322 Virulence, 12, 317, 322 Virulent, 12, 322 Virus, 25, 96, 214, 240, 246, 261, 267, 276, 296, 318, 321, 322 Viscera, 126, 311, 322
Visceral, 5, 35, 100, 143, 240, 268, 294, 320, 322 Visceral Afferents, 240, 268, 320, 322 Visual Cortex, 256, 322 Vitamin U, 67, 92, 322 Vitreoretinal, 32, 322 Vitreous Body, 306, 322 Vitro, 22, 29, 322 Vivo, 19, 22, 29, 322 Volvulus, 4, 322 Vomitus, 10, 29, 322 Vulgaris, 115, 322 W Wakefulness, 254, 322 Weight Gain, 26, 174, 264, 322 Wheezing, 284, 322 White blood cell, 231, 236, 261, 280, 281, 285, 296, 322 Windpipe, 295, 317, 323 Withdrawal, 11, 18, 132, 147, 254, 287, 323 Womb, 140, 305, 320, 323 Wound Healing, 28, 134, 135, 160, 163, 323 Wounds, Gunshot, 311, 323 X Xenograft, 236, 323 X-ray, 58, 266, 278, 289, 303, 312, 323 X-ray therapy, 278, 323 Y Yawning, 121, 287, 323 Yeasts, 244, 265, 295, 323 Z Zalcitabine, 198, 279, 323 Zidovudine, 11, 323 Zymogen, 301, 323
