Achilles Tendinitis: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

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ACHILLES TENDINITIS 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., 1960Achilles Tendinitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00011-3 1. Achilles Tendinitis-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Achilles tendinitis. 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 ACHILLES TENDINITIS .............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Achilles Tendinitis ........................................................................ 5 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. BOOKS ON ACHILLES TENDINITIS .............................................................................. 15 Overview...................................................................................................................................... 15 Chapters on Achilles Tendinitis................................................................................................... 15 CHAPTER 3. PERIODICALS AND NEWS ON ACHILLES TENDINITIS ................................................. 19 Overview...................................................................................................................................... 19 News Services and Press Releases................................................................................................ 19 Newsletter Articles ...................................................................................................................... 21 Academic Periodicals covering Achilles Tendinitis ..................................................................... 21 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 25 Overview...................................................................................................................................... 25 NIH Guidelines............................................................................................................................ 25 NIH Databases............................................................................................................................. 27 Other Commercial Databases....................................................................................................... 29 APPENDIX B. PATIENT RESOURCES ................................................................................................. 31 Overview...................................................................................................................................... 31 Patient Guideline Sources............................................................................................................ 31 Finding Associations.................................................................................................................... 34 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 37 Overview...................................................................................................................................... 37 Preparation................................................................................................................................... 37 Finding a Local Medical Library.................................................................................................. 37 Medical Libraries in the U.S. and Canada ................................................................................... 37 ONLINE GLOSSARIES.................................................................................................................. 43 Online Dictionary Directories ..................................................................................................... 43 ACHILLES TENDINITIS DICTIONARY ................................................................................... 45 INDEX ................................................................................................................................................ 63

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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 Achilles tendinitis 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 Achilles tendinitis, 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 Achilles tendinitis, 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 Achilles tendinitis. 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 Achilles tendinitis, 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 Achilles tendinitis. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON ACHILLES TENDINITIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Achilles tendinitis.

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

Muscoloskeletal Manifestations in Inflammatory Bowel Disease Source: Canadian Journal of Gastroenterology. 15(6): 399-403. June 2001. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Fax (905) 829-4799. E-mail: [email protected]. Summary: This article reviews the musculoskeletal manifestations of inflammatory bowel disease (IBD), the most common extraintestinal complications of the condition. Wide ranges in prevalence have been reported, depending on the criteria used to define spondylarthropathy. In 1991, the European Spondylarthropathy Study Group developed classification criteria that included previously neglected cases of undifferentiated spondylarthropathies, which had been ignored in most of the oldest

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epidemiological studies on IBD. The spectrum of musculoskeletal manifestations in IBD patients includes all of the clinical features of spondylarthropathies: peripheral arthritis, inflammatory spinal pain, dactylitis, enthesitis (Achilles tendinitis and plantar fasciitis), buttock pain, and anterior chest wall pain. Radiological evidence of sacroiliitis is common, but not obligatory. The articular manifestations begin either at the same time or subsequent to the bowel disease; however, the onset of spinal disease often precedes the diagnosis of IBD. The prevalence of the different musculoskeletal manifestations is similar in ulcerative colitis and Crohn's disease (the two categories of IBD). Symptoms usually disappear after proctocolectomy (removal of the affected portion of the colon). The pathogenetic mechanisms (how the disease causes the complications) that produce the musculoskeletal manifestations in IBD are unclear. Several arguments favor an important role of the intestinal mucosa in the development of spondylarthropathy. The natural history of the disease is characterized by periods of flares and remission; therefore, the efficacy of treatment is difficult to establish. Most patients respond to rest, physical therapy, and nonsteroidal antiinflammatory drugs (NSAIDs), but these drugs may activate the bowel disease. Sulfasalazine may be recommended in some patients; however, there is no indication for the systemic use of steroids. 6 tables. 43 references. •

Skating Injuries: A Guide to Prevention and Management Source: Journal of Musculoskeletal Medicine. 14(12):10-12, 21-22,24,29; December 1997. Summary: This journal article for health professionals focuses on the prevention and management of figure skating injuries. Most figure skating injuries result from poor boot fit or from overtraining. The nature of injuries can vary with the skater's discipline, that is, injuries among single skaters may differ from those sustained by pairs, dance, and precision skaters. Boot-related injuries include pump bump, tenosynovitis, malleolar bursae, and Achilles tendinitis. Most of these injuries can be managed by modifying the boot padding or adding wedges. The most common overuse injuries are knee pain, stress fracture, and spondylolysis. Prevention involves making sure that the boot fits properly and that it is broken in with the tongue of the boot in a neutral position. It is also important that the skater maintain strong ankle and quadriceps muscles. Staying fit enough to use a more flexible boot helps as well. 8 references, 6 figures, and 1 table. (AA-M).

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Advising the Patient Who Presents With Heel Pain Source: The Practitioner. 244(1610): 472-477. May 2000. Summary: This journal article provides health professionals with information on the diagnosis and management of heel pain. The most common cause of heel pain is lesions of the plantar fascia at the calcaneal enthesis. Achilles tendinitis is also a frequent cause of heel pain. Clinical examination is important, particularly to diagnose the extent of problems around the hindfoot. Possible systemic factors should also be considered. Although clinical diagnosis may be sufficient, further tests may be needed if the problem persists, if unexplained factors are present, or if there is evidence of systemic disease. Useful tests include x rays, biochemical analyses, and magnetic resonance imaging. Bone scans and electromyography may also be helpful. Many heel conditions will resolve quickly if the patient learns how to stretch the Achilles tendon and plantar ligament, wears shoes that incorporate shock absorption principles, uses nonsteroidal antiinflammatory drugs, undergoes physiotherapy, uses below knee molded walking casts, has steroid injections, and undergoes radiation therapy. Surgery is usually reserved for a minority of cases with intractable pain. 3 figures, 2 tables, and 12 references.

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Federally Funded Research on Achilles Tendinitis The U.S. Government supports a variety of research studies relating to Achilles tendinitis. 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 Achilles tendinitis. 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 Achilles tendinitis.

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

Achilles tendinitis and peritendinitis: etiology and treatment. Author(s): Clement DB, Taunton JE, Smart GW. Source: The American Journal of Sports Medicine. 1984 May-June; 12(3): 179-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6742297

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). 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication. 2

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Achilles tendinitis and ruptures. Author(s): Kahn MF. Source: British Journal of Sports Medicine. 1998 September; 32(3): 266. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9773187

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Achilles tendinitis and tendon rupture due to fluoroquinolone antibiotics. Author(s): Huston KA. Source: The New England Journal of Medicine. 1994 September 15; 331(11): 748. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8058092

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Achilles tendinitis and tenosynovitis. A diagnostic manifestation of familial type II hyperlipoproteinemia in children. Author(s): Shapiro JR, Fallat RW, Tsang RC, Glueck CJ. Source: Am J Dis Child. 1974 October; 128(4): 486-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4369742

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Achilles tendinitis as a severe clinical feature of diffuse idiopathic skeletal hyperostosis. Author(s): Gerster JC. Source: The Journal of Rheumatology. 1995 June; 22(6): 1212-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7674264

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Achilles tendinitis as the presentation form of Lofgren's syndrome. Author(s): Ortiz V, Holgado S, Olive A, Fite E. Source: Clinical Rheumatology. 2000; 19(2): 169-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10791635

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Achilles tendinitis associated with chondrocalcinosis. Author(s): Gerster JC, Lagier R, Boivin G. Source: The Journal of Rheumatology. 1980 January-February; 7(1): 82-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7354473

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Achilles tendinitis associated with fluoroquinolones. Author(s): van der Linden PD, van de Lei J, Nab HW, Knol A, Stricker BH. Source: British Journal of Clinical Pharmacology. 1999 September; 48(3): 433-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10510157

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Achilles tendinitis in ballet dancers. Author(s): Fernandez-Palazzi F, Rivas S, Mujica P. Source: Clinical Orthopaedics and Related Research. 1990 August; (257): 257-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2379363

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Achilles tendinitis in psoriasis: clinical and sonographic findings. Author(s): De Simone C, Guerriero C, Giampetruzzi AR, Costantini M, Di Gregorio F, Amerio P. Source: Journal of the American Academy of Dermatology. 2003 August; 49(2): 217-22. Erratum In: J Am Acad Dermatol. 2004 May; 50(5): 733. Giampietruzzi Anna Rita [corrected to Giampetruzzi Anna Rita]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12894068

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Achilles tendinitis in running athletes. Author(s): Nichols AW. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1989 July-September; 2(3): 196-203. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2665426

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Achilles tendinitis in spondyloarthropathy. Author(s): McGonagle D, Emery P. Source: The Journal of Rheumatology. 1999 March; 26(3): 754-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10090200

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Achilles tendinitis. Author(s): Scioli MW. Source: The Orthopedic Clinics of North America. 1994 January; 25(1): 177-82. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8290227

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Achilles tendinitis. Author(s): Clain MR, Baxter DE. Source: Foot Ankle. 1992 October; 13(8): 482-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1483611

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Achilles tendinitis. Author(s): Leach RE, James S, Wasilewski S. Source: The American Journal of Sports Medicine. 1981 March-April; 9(2): 93-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7223927

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Achilles tendonitis in runners: a report of five cases. Author(s): Clancy WG Jr, Neidhart D, Brand RL. Source: The American Journal of Sports Medicine. 1976 March-April; 4(2): 46-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=961968

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Achilles tendonitis. Author(s): DeMaio M, Paine R, Drez DJ Jr. Source: Orthopedics. 1995 February; 18(2): 195-204. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7746756

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Achilles tendonitis: an unusual complication of amlodipine therapy. Author(s): Zambanini A, Padley S, Cox A, Feher M. Source: Journal of Human Hypertension. 1999 August; 13(8): 565-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10455480

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Achilles tendonitis: are corticosteroid injections useful or harmful? Author(s): Shrier I, Matheson GO, Kohl HW 3rd. Source: Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 1996 October; 6(4): 245-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8894337

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Acute Achilles tendonitis following oral isotretinoin therapy for acne vulgaris. Author(s): Bottomley WW, Cunliffe WJ. Source: Clinical and Experimental Dermatology. 1992 July; 17(4): 250-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1451314

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Bilateral Achilles tendinitis with spontaneous rupture induced by levofloxacin in a patient with systemic sclerosis. Author(s): de La Red G, Mejia JC, Cervera R, Llado A, Mensa J, Font J. Source: Clinical Rheumatology. 2003 October; 22(4-5): 367-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14579169

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Case report: can sacroiliac joint dysfunction cause chronic Achilles tendinitis? Author(s): Voorn R. Source: The Journal of Orthopaedic and Sports Physical Therapy. 1998 June; 27(6): 43643. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9617730

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Chronic Achilles tendinitis and calf muscle strength. Author(s): Alfredson H, Pietila T, Lorentzon R. Source: The American Journal of Sports Medicine. 1996 November-December; 24(6): 82933. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8947407

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Chronic achilles tendonitis. Author(s): Berkebile DE. Source: S D J Med. 1991 November; 44(11): 311-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1775963

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Ciprofloxacin, bilateral Achilles tendonitis and unilateral tendon rupture--a case report. Author(s): West MB, Gow P. Source: N Z Med J. 1998 January 23; 111(1058): 18-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9484431

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Clinical survey of Achilles tendinitis in athletes. Author(s): Welsh RP, Clodman J. Source: Can Med Assoc J. 1980 January 26; 122(2): 193-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7363214

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Current treatment options for ankle injuries: lateral ankle sprain, Achilles tendonitis, and Achilles rupture. Author(s): Cohen RS, Balcom TA. Source: Curr Sports Med Rep. 2003 October; 2(5): 251-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12959705

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Disorders of the Achilles tendon insertion and Achilles tendinitis. Author(s): Myerson MS, McGarvey W. Source: Instr Course Lect. 1999; 48: 211-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10098046

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Etiologic factors associated with Achilles tendinitis in runners. Author(s): McCrory JL, Martin DF, Lowery RB, Cannon DW, Curl WW, Read HM Jr, Hunter DM, Craven T, Messier SP. Source: Medicine and Science in Sports and Exercise. 1999 October; 31(10): 1374-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10527307

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Fast scan magnetic resonance of Achilles tendonitis. Author(s): Berthoty D, Sartoris DJ, Resnick D. Source: J Foot Surg. 1989 March-April; 28(2): 171-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2738299

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

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Injection for Achilles tendinitis. Author(s): Murtagh J. Source: Aust Fam Physician. 1992 June; 21(6): 798. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1622363

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Interventions for treating acute and chronic Achilles tendinitis. Author(s): McLauchlan GJ, Handoll HH. Source: Cochrane Database Syst Rev. 2001; (2): Cd000232. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11405956

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Isolated HLA-B27 associated Achilles tendinitis. Author(s): Olivieri I, Gemignani G, Gherardi S, Grassi L, Ciompi ML. Source: Annals of the Rheumatic Diseases. 1987 August; 46(8): 626-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3499125

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Isolated HLA-B27 cross reactive group (CREG) associated Achilles tendinitis. Author(s): Nolla Sole JM, Juanola Roura X, Valverde Garcia J, Roig Escofet D. Source: Annals of the Rheumatic Diseases. 1988 July; 47(7): 615. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3261157

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Levofloxacin-induced bilateral Achilles tendonitis. Author(s): Lewis JR, Gums JG, Dickensheets DL. Source: The Annals of Pharmacotherapy. 1999 July-August; 33(7-8): 792-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10466906

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Longstanding HLA-B27 associated Achilles tendinitis. Author(s): Olivieri I, Padula A, Lisanti ME, Braccini G. Source: Annals of the Rheumatic Diseases. 1992 November; 51(11): 1265. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1466609

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Longstanding isolated bilateral Achilles tendinitis. Author(s): Haberhauer G, Wandner G, Dax K. Source: Zeitschrift Fur Rheumatologie. 1990 March-April; 49(2): 103-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2349838

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•

Long-term results of surgical management of Achilles tendinitis in runners. Author(s): Leach RE, Schepsis AA, Takai H. Source: Clinical Orthopaedics and Related Research. 1992 September; (282): 208-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1516314

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Magnetic resonance imaging may be an asset to diagnose and classify fluoroquinolone-associated Achilles tendinitis. Author(s): Gillet P, Blum A, Hestin D, Pourel J, Pierfitte C, Mainard D, Kessler M, Netter P. Source: Fundamental & Clinical Pharmacology. 1995; 9(1): 52-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7768488

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Management of a patient with a diagnosis of bilateral plantar fasciitis and Achilles tendinitis. A case report. Author(s): Riddle DL, Freeman DB. Source: Physical Therapy. 1988 December; 68(12): 1913-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3194454

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Management of pain beneath the heel and Achilles tendonitis with visco-elastic heel inserts. Author(s): MacLellan GE, Vyvyan B. Source: British Journal of Sports Medicine. 1981 June; 15(2): 117-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7272653

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Percutaneous longitudinal tenotomy in chronic Achilles tendonitis. Author(s): Testa V, Maffulli N, Capasso G, Bifulco G. Source: Bull Hosp Jt Dis. 1996; 54(4): 241-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8731418

•

Plantar fasciitis and Achilles tendinitis among 150 cases of seronegative spondarthritis. Author(s): Gerster JC. Source: Rheumatol Rehabil. 1980 November; 19(4): 218-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7209286

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Repeated Achilles tendinitis after high dose methotrexate. Author(s): Toverud EL, Landaas S, Hellebostad M. Source: Medical and Pediatric Oncology. 2001 August; 37(2): 156. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11496361

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Achilles Tendinitis

•

Sarcoidosis presenting as Achilles tendinitis. Author(s): Crowder SW, Jaffey LH. Source: Journal of the Royal Society of Medicine. 1995 June; 88(6): 335-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7629765

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Seven Achilles tendinitis including 3 complicated by rupture during fluoroquinolone therapy. Author(s): Ribard P, Audisio F, Kahn MF, De Bandt M, Jorgensen C, Hayem G, Meyer O, Palazzo E. Source: The Journal of Rheumatology. 1992 September; 19(9): 1479-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1433021

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Surgical management of Achilles tendinitis. Author(s): Schepsis AA, Leach RE. Source: The American Journal of Sports Medicine. 1987 July-August; 15(4): 308-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3661810

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Surgical treatment of Achilles tendinitis by decompression of the retrocalcaneal bursa and the superior calcaneal tuberosity. Author(s): Yodlowski ML, Scheller AD Jr, Minos L. Source: The American Journal of Sports Medicine. 2002 May-June; 30(3): 318-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12016069

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Surgical treatment of chronic Achilles tendinitis. Author(s): Nelen G, Martens M, Burssens A. Source: The American Journal of Sports Medicine. 1989 November-December; 17(6): 7549. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2624286

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The effect of heel pads on the treatment of Achilles tendinitis: a double blind trial. Author(s): Lowdon A, Bader DL, Mowat AG. Source: The American Journal of Sports Medicine. 1984 November-December; 12(6): 4315. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6507711

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Tibialis posterior nerve schwannoma mimicking Achilles tendinitis: ultrasonographic diagnosis. Author(s): Cantos-Melian B, Arriaza-Loureda R, Aisa-Varela P. Source: Journal of Clinical Ultrasound : Jcu. 1990 October; 18(8): 671-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2172317

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13

Ultrasonography as a tool for diagnosis, guidance of local steroid injection and, together with pressure algometry, monitoring of the treatment of athletes with chronic jumper's knee and Achilles tendinitis: a randomized, double-blind, placebocontrolled study. Author(s): Fredberg U, Bolvig L, Pfeiffer-Jensen M, Clemmensen D, Jakobsen BW, Stengaard-Pedersen K. Source: Scandinavian Journal of Rheumatology. 2004; 33(2): 94-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15163110

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CHAPTER 2. BOOKS ON ACHILLES TENDINITIS Overview This chapter provides bibliographic book references relating to Achilles tendinitis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Achilles tendinitis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Chapters on Achilles Tendinitis In order to find chapters that specifically relate to Achilles tendinitis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Achilles tendinitis 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 “Achilles tendinitis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on Achilles tendinitis: •

Regional Problems of the Arm and Leg in Adults Source: in Maddison, P.J.; et al., Eds. Oxford Textbook of Rheumatology. Volume 1. New York, NY: Oxford University Press, Inc. 1993. p. 70-79. Contact: Available from Oxford University Press, Inc., New York, NY. Summary: This chapter for health professionals describes regional problems of the arm and leg in adults. General features of discomfort in the arm or leg are highlighted. Common causes of pain in the arm and leg are identified. The principal regional musculoskeletal conditions of bursitis, tendinitis, enthesitis, capsulitis, and nerve entrapment are discussed. The features of these conditions as they affect the arm and leg are detailed, focusing on the features of bicipital tendinitis, rotator cuff syndrome, lateral and medial epicondylitis, trigger finger, De Quervain's disease, Achilles tendinitis, plantar fasciitis, reflex algodystrophy, frozen shoulder, and Dupuytren's

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contracture. Features of entrapment of various nerves in the arm and leg are also highlighted. 62 references, 12 figures, and 1 table. •

Chapter 8-D: Musculoskeletal Signs and Symptoms: Regional Rheumatic Pain Syndromes Source: in Klippel, J.H., et al., eds. Primer on the Rheumatic Diseases. 12th ed. Atlanta, GA: Arthritis Foundation. 2001. p. 174-188. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. Website: www.arthritis.org. PRICE: $69.95 plus shipping and handling. ISBN: 0912423293. Summary: This chapter provides health professionals with information on the symptoms, causes, diagnosis, and management of regional rheumatic pain syndromes, focusing on disorders involving the muscles, tendons, entheses, joints, cartilage, ligaments, fascia, bone, and nerves. Disorders of the shoulder region include rotator cuff tendinitis, rotator cuff tear, bicipital tendinitis, adhesive capsulitis, suprascapular neuropathy, long thoracic nerve paralysis, brachial plexopathy, and thoracic outlet syndrome. Various conditions affect the elbow region, including olecranon bursitis, lateral and medial epicondylitis, tendinitis of musculotendinous insertion of biceps, and ulnar nerve entrapment. Disorders affecting the wrist and hand include ganglion, de Quervain's tenosynovitis, tenosynovitis of the wrist, pronator teres syndrome, anterior and posterior interosseous nerve syndrome, radial nerve palsy, superficial radial neuropathy, carpal tunnel syndrome, ulnar nerve entrapment at the wrist, volar flexor tenosynovitis, and Dupuytren's contracture. Disorders of the hip region include trochanteric, iliopsoas, and ischial bursitis; piriformis syndrome; and meralgia paresthetica. Disorders affecting the knee region include popliteal cysts, anserine and prepatellar bursitis, medial plica syndrome, popliteal tendinitis, Pellegrini-Stieda syndrome, patellar tendinitis, rupture of the quadriceps tendon and infrapatellar tendon, peroneal nerve palsy, and patellofemoral pain syndrome. Disorders of the ankle and foot include Achilles tendinitis, retrocalcaneal and subcutaneous Achilles bursitis, plantar fasciitis, Achilles tendon rupture, tarsal tunnel syndrome, posterior tibial tendinitis, peroneal tendon dislocation and peroneal tendinitis, hallux valgus, bunionette, hammertoe, Morton's neuroma, metatarsalgia, pes planus, pes cavus, and posterior tibialis tendon rupture. Various disorders may affect the anterior chest wall, among them Tietze's syndrome, costochondritis, xiphoid cartilage syndrome, and conditions affecting the sternoclavicular joint. The chapter also identifies general causative factors and presents general management concepts, focusing on drug therapy, intralesional injections, and physical therapy. 3 figures and 26 references.

•

Chapter 57: Sports Injuries Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 15 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who experience sports related injuries with information on their causes, diagnosis, and treatment. Sports injuries can be attributed to faulty training methods; structural abnormalities; and weakness of the muscles, tendons, and ligaments. Faulty training methods, that is, the failure of the exerciser to allow for adequate recovery after a workout or to stop

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exercising when pain develops, are the most common cause of muscle and joint injuries. Allowing at least 2 days between intensive workouts or alternating workouts that stress different parts of the body can help prevent chronic injury. Structural abnormalities can make a person susceptible to a sports injury by stressing certain parts of the body more than others. Muscles, tendons, and ligaments that are too weak or tight for the exercise being attempted may be injured. Exercising against progressively greater resistance strengthens muscles and can help prevent injuries. Diagnosis of a sports or other musculoskeletal injury is based on the medical history, a physical examination, and tests. Sports injuries can be prevented by warming up before beginning strenuous exercise. Cooling down after strenuous exercise is helpful for preventing dizziness. Orthotics can often correct foot problems that make a person susceptible to injury. Immediate treatment for almost all sports injuries involves rest, ice, compression, and elevation. Corticosteroid injections relieve pain and reduce swelling. Physical therapists use various modalities to treat sports injuries. Although the activity or sport that caused the injury should be avoided until it has healed, substituting activities that do not stress the injured part is preferable to abstaining from all physical activity. The chapter also describes common sports injuries and highlights their symptoms, diagnosis, and treatment. Injuries include stress fractures of the foot, anterolateral and posteromedial shin splints, popliteus tendinitis, Achilles tendinitis, runner's knee, hamstring injury, weight lifter's back, backhand and forehand tennis elbow, and rotator cuff tendinitis. 5 figures.

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CHAPTER 3. PERIODICALS AND NEWS ON ACHILLES TENDINITIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Achilles tendinitis.

News Services and Press Releases One of the simplest ways of tracking press releases on Achilles tendinitis 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 “Achilles tendinitis” (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 Achilles tendinitis. 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 “Achilles tendinitis” (or synonyms).

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

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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 “Achilles tendinitis” (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 Achilles tendinitis: •

Bursitis and Tendonitis in Systemic Lupus Erythematosus Source: Lupus News. 17(3):10-11; Autumn 1997. Contact: Lupus Foundation of America, Inc., 1300 Piccard Drive, Suite 200, Rockville, MD 20850-4303. (301) 670-9292. (301) 670-9486 (fax). Summary: This newsletter article for individuals with lupus discusses the occurrence of bursitis and tendinitis in systemic lupus erythematosus (SLE). It describes both conditions and identifies their causes. The article presents the signs and symptoms of tendinitis and bursitis and describes the features of olecranon bursitis, trochanteric bursitis, Achilles tendinitis, and tenosynovitis of the fingers. In addition, the article discusses the diagnosis and treatment of tendinitis and bursitis, and it explains tendon rupture, a serious but rare complication of SLE.

Academic Periodicals covering Achilles Tendinitis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Achilles tendinitis. In addition to these sources, you can search for articles covering Achilles tendinitis 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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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 Institute4: •

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

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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

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

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

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

•

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

4

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 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:6 •

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

•

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

•

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

•

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

•

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

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

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

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

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

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

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

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). 6 See http://www.nlm.nih.gov/databases/databases.html. 5

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•

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

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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The NLM Gateway7

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.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Achilles tendinitis” (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 478 0 294 3 2 777

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 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.11 Simply search by “Achilles tendinitis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. 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). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 The HSTAT URL is http://hstat.nlm.nih.gov/. 11 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. 7 8

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Coffee Break: Tutorials for Biologists12 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.13 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.14 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/.

Adapted 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. 14 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. 12

13

31

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 Achilles tendinitis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Achilles tendinitis. 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 Achilles tendinitis. 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 “Achilles tendinitis”:

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Achilles Tendinitis

Ankle Injuries and Disorders http://www.nlm.nih.gov/medlineplus/ankleinjuriesanddisorders.html Foot Injuries and Disorders http://www.nlm.nih.gov/medlineplus/footinjuriesanddisorders.html Heel Injuries and Disorders http://www.nlm.nih.gov/medlineplus/heelinjuriesanddisorders.html Leg Injuries and Disorders http://www.nlm.nih.gov/medlineplus/leginjuriesanddisorders.html Sports Injuries http://www.nlm.nih.gov/medlineplus/sportsinjuries.html Tendinitis http://www.nlm.nih.gov/medlineplus/tendinitis.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The 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 Achilles tendinitis. 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: •

Ankle Owner's Manual: A Guide to Common Ankle Injuries Source: San Bruno, CA: StayWell Company. 1999. 8 p. Contact: Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 940663030. (800) 333-3032. Website: www.staywell.com. PRICE: Call or write for current pricing on single and bulk orders. Summary: This booklet provides people with information on common ankle problems and their treatment. The structures of the ankle joint include bones, tendons, and ligaments. Diagnosis of an ankle problem requires a medical history, a physical examination, and laboratory and diagnostic imaging studies. The booklet describes common ankle problems and outlines possible ways to treat them. Common ankle injuries include sprains, fractures, and Achilles tendon problems. Sprains may be mild, moderate, or severe. Fractures can be nondisplaced or displaced. Achilles tendon problems include Achilles tendinitis and Achilles rupture. The goal of treatment is to restore ankle function as soon as possible. After an ankle injury or surgery, a person should exercise the ankle and lower leg as soon as safely possible to restore strength and flexibility. Strengthening exercises include calf raises and ankle curls. Range of motion

Patient Resources

33

exercises improve flexibility and mobility. Calf stretches increase flexibility. Taping the ankle may provide added stability. •

Foot Owner's Manual: A Guide to Good Foot Care Source: San Bruno, CA: StayWell Company. 1996. 16 p. Contact: Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 940663030. (800) 333-3032. Website: www.staywell.com. PRICE: Call or write for current pricing on single and bulk orders. Summary: This booklet provides the general public with information on how to protect the feet from unnecessary wear and tear. The booklet describes the anatomy of the foot and explains the mechanics of walking. This is followed by a checklist people can use to ensure that shoes fit properly. Other topics include using the forefoot test to determine whether shoes fit properly and using orthotic devices to relieve pain. The booklet then describes common foot problems and outlines methods of self care and physician based care. Common foot problems are ingrown toenails, blisters, corns and calluses, soft corns, athlete's foot, and plantar warts. Other foot problems include metatarsalgia, plantar neuroma, hammer and claw toes, bunions, bunionettes, hallux rigidus, heel pain, plantar fasciitis, and Achilles tendinitis. In addition, the booklet presents general foot care tips and suggests stretching exercises that people can do before and after exercising.

•

Your Podiatric Physician Talks About Women's Feet Source: American Podiatric Medical Association. 200x. 4 p. Contact: Available online from American Podiatric Medical Association. Website: www.apma.org. Summary: This fact sheet provides women with information on foot health. Many of the foot problems that women experience are caused by wearing shoes with heels higher than 2 inches. These types of shoes are considered biomechanically and structurally unsound by podiatrists. In time, wearing high heels may cause enough problems to impair foot function. Women can reduce the abusive effects of high heels include by limiting the amount of time they are worn, selecting shoes with other heel heights, and making sure that the shoes fit properly. Nylon pantyhose may also cause foot problems because nylon generates and traps heat that causes excessive perspiration. This environment is ideal for the growth of fungal infections. Nylon may also abrade skin. Inexpensive pantyhose may cause forefoot problems by constricting the normal expansion of the foot when walking. Guidelines for observing foot health in pregnant women and women over 65 are addressed. In addition, the pamphlet describes women's foot ailments, such as Achilles tendinitis, bunions, hammertoe, metatarsalgia, neuromas, plantar fasciitis, and Haglund's deformity.

•

Baseball and Your Feet Source: Bethesda, MD: American Podiatric Medical Association. 1995. 6 p. Contact: Available from American Podiatric Medical Association. 9312 Old Georgetown Road, Bethesda, MD 20814-1698. (800) 275-2762 or (301) 581-9277. Fax (301) 530-2752. Website: www.apma.org. PRICE: Single copy free; bulk orders available at cost. Summary: This pamphlet provides the general public with information about the effect of playing baseball on the feet. The pamphlet offers guidelines on warming up before

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Achilles Tendinitis

playing baseball and selecting and using cleats and spikes, as well as preventing baseball-related foot and ankle injuries. Other topics are the cause, features, and treatment of lower-extremity injuries seen in baseball players, such as contusions, sprains and fractures, plantar fasciitis, heel spur syndrome, Achilles tendinitis, and shin splints. 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 Achilles tendinitis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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35

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 “Achilles tendinitis” (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 “Achilles tendinitis”. 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 “Achilles tendinitis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “Achilles tendinitis” (or a synonym) into the search box, and click “Submit Query.”

37

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.15

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

15

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)16: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

16

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

Finding Medical Libraries

39

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

41

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

42

Achilles Tendinitis

•

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

•

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

•

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

•

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

43

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

45

ACHILLES TENDINITIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abduction: Forcible pulling of a limb away from its natural position, a risk in road accidents and disasters; move outwards away from middle line. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amlodipine: 2-((2-Aminoethoxy)methyl)-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5pyridinedicarboxylic acid 3-ethyl 5-methyl ester. A long-acting dihydropyridine calcium channel blocker. It is effective in the treatment of angina pectoris and hypertension. [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] 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] Ankle: That part of the lower limb directly above the foot. [NIH] Ankle Injuries: Harm or hurt to the ankle or ankle joint usually inflicted by an external

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source. [NIH] Ankle Joint: The joint that is formed by the inferior articular and malleolar articular surfaces of the tibia, the malleolar articular surface of the fibula, and the medial malleolar, lateral malleolar, and superior surfaces of the talus. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] 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]

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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Articular: Of or pertaining to a joint. [EU] Axilla: The underarm or armpit. [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 Infections: Infections by bacteria, general or unspecified. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU]

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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] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial 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] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bunion: A swelling of the bursa mucosa of the ball of the great toe, with thickening of the overlying skin and forcing of the toe outward. [NIH] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] 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] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [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] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU]

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Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [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] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [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] Chronic: A disease or condition that persists or progresses over a long period of time. [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] Colitis: Inflammation of the colon. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] 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] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] 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]

Dictionary 49

Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Contusions: Injuries resulting in hemorrhage, usually manifested in the skin. [NIH] 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] Cutaneous: Having to do with the skin. [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] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [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] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]

Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [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] 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]

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Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [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] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] 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] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Epicondylitis: Inflammation of the epicondyle or of the tissues adjoining the epicondyle of the humerus. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] 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] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ,

Dictionary 51

usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Flexor: Muscles which flex a joint. [NIH] Foot Care: Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [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] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] 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]

Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Hallux Rigidus: A condition caused by degenerative arthritis (osteoarthritis) of the metatarsophalangeal joint of the great toe and characterized by pain and limited dorsiflexion, but relatively unrestricted plantar flexion. [NIH] Hallux Valgus: Lateral displacement of the great toe, producing deformity of the first metatarsophalangeal joint with callous, bursa, or bunion formation over the bony prominence. [NIH] Hammer: The largest of the three ossicles of the ear. [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]

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Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] 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] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hyperostosis: Increase in the mass of bone per unit volume. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] 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] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] 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]

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] 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] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin

Dictionary 53

or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischial: A pointed projection on the posterior margin of the ischium. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [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] Levofloxacin: A substance used to treat bacterial infections. It belongs to the family of drugs called quinolone antibiotics. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [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] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Metatarsophalangeal Joint: The articulation between a metatarsal bone and a phalanx. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] 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] Mobility: Capability of movement, of being moved, or of flowing freely. [EU]

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Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] 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] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] 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] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroma: A tumor that arises in nerve cells. [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] 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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Orthotic Devices: Apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. [NIH] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Paralysis: Loss of ability to move all or part of the body. [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] Paresthesia: Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to

Dictionary 55

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

Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [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] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Perspiration: Sweating; the functional secretion of sweat. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

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

Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [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] Pneumonia: Inflammation of the lungs. [NIH] Popliteal: Compression of the nerve at the neck of the fibula. [NIH] Popliteal Cyst: A synovial cyst in the popliteal space arising from the semimembranous bursa or the knee joint. [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] 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] 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] Proctocolectomy: An operation to remove the colon and rectum. Also called coloproctectomy. [NIH]

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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] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Pronator: A muscle which turns a part into the prone position. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prone Position: The posture of an individual lying face down. [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] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] 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] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Radial Nerve: A major nerve of the upper extremity. In humans the fibers of the radial nerve originate in the lower cervical and upper thoracic spinal cord (usually C5 to T1), travel via the posterior cord of the brachial plexus, and supply motor innervation to extensor muscles of the arm and cutaneous sensory fibers to extensor regions of the arm and hand. [NIH]

Radial Neuropathy: Disease involving the radial nerve. Clinical features include weakness of elbow extension, elbow flexion, supination of the forearm, wrist and finger extension, and thumb abduction. Sensation may be impaired over regions of the dorsal forearm. Common sites of compression or traumatic injury include the axilla and radial groove of the humerus. [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] 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

Dictionary 57

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] 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] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] 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] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [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] Rotator: A muscle by which a part can be turned circularly. [NIH] Rotator Cuff: The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the head of the humerus in the glenoid fossa and allow for rotation of the shoulder joint about its longitudinal axis. [NIH] Sacroiliac Joint: The immovable joint formed by the lateral surfaces of the sacrum and ilium. [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] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schwannoma: A tumor of the peripheral nervous system that begins in the nerve sheath (protective covering). It is almost always benign, but rare malignant schwannomas have been reported. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH]

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Achilles Tendinitis

Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [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] 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] 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]

Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [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] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] 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] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spondylolysis: Dissolution of a vertebra, especially the pars interarticularis. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or

Dictionary 59

tension. Stress may be either physical or psychologic, or both. [NIH] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb. [NIH] Subclavian Vein: The continuation of the axillary vein which follows the subclavian artery and then joins the internal jugular vein to form the brachiocephalic vein. [NIH] Subcutaneous: Beneath the skin. [NIH] Supination: Applies to the movements of the forearm in turning the palm forward or upward and when applied to the foot, a combination of adduction and inversion of the foot. [NIH]

Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Cyst: A nodular, tumorlike lesion in or about a tendon sheath or joint capsule, especially of the hands, wrists, or feet. It is not a true cyst as it lacks an epithelial wall, and it does not communicate with the underlying synovial space. The lesion represents a focal accumulation of mucin in the dermis of the dorsal aspect of the distal phalanges or, less often, other portions of the extremities. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Tarsal Tunnel Syndrome: A syndrome produced by entrapment neuropathy of posterior tibial nerve. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Tendonitis: Inflammation of tendons attached to the biceps muscle, i. e. the main flexor muscle of the upper arm. [NIH] 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] Tenosynovitis: Inflammation of a tendon sheath. [EU] Tenotomy: The cutting of a tendon. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Thoracic: Having to do with the chest. [NIH]

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Thoracic Outlet Syndrome: A neurovascular syndrome associated with compression of the brachial plexus; subclavian artery; and subclavian vein at the superior thoracic outlet. This may result from a variety of anomalies such as a cervical rib (cervical rib syndrome), anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, paresis or paralysis of brachial plexus innervated muscles, paresthesia, loss of sensation, reduction of arterial pulses in the affected extremity, ischemia, and edema. (Adams et al., Principles of Neurology, 6th ed, pp214-5). [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] 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] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] 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] Ulnar Nerve: A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH]

Dictionary 61

X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

63

INDEX A Abdominal, 45, 60 Abdominal Pain, 45, 60 Abduction, 45, 56 Acne, 8, 45, 53 Acne Vulgaris, 8, 45, 53 Adrenal Cortex, 45, 49, 56 Adverse Effect, 45, 53 Algorithms, 45, 47 Alpha Particles, 45, 56 Alternative medicine, 20, 45 Amlodipine, 8, 45 Anatomical, 45, 58 Androgens, 45, 49 Angina, 45 Angina Pectoris, 45 Ankle, 4, 7, 9, 16, 32, 34, 45, 46 Ankle Injuries, 9, 32, 34, 45 Ankle Joint, 32, 45, 46 Anomalies, 46, 59, 60 Antiallergic, 46, 49 Antibacterial, 46, 58 Antibiotic, 46, 58 Antibody, 46, 52, 54, 56, 57 Anti-inflammatory, 46, 49, 51 Anti-Inflammatory Agents, 46, 49 Antimetabolite, 46, 53 Antineoplastic, 46, 49, 53 Anus, 46, 48 Aponeurosis, 46, 51 Arterial, 46, 51, 52, 56, 60 Articular, 4, 46, 54 Axilla, 46, 47, 56 B Bacteria, 46, 58 Bacterial Infections, 46, 53 Basal Ganglia, 46, 51 Base, 46, 53 Benign, 46, 51, 56, 57, 60 Bilateral, 8, 9, 10, 11, 46, 54 Bile, 46, 53, 58 Biochemical, 4, 46, 54 Biotechnology, 5, 20, 27, 47 Bone scan, 4, 47, 57 Bowel, 3, 4, 47, 52, 58, 60 Brachial, 16, 47, 52, 53, 56, 60 Brachial Plexus, 47, 53, 56, 60 Brachytherapy, 47, 52, 56

Buccal, 47, 53 Bunion, 47, 51 Bursitis, 15, 16, 21, 47 C Calcium, 45, 47 Carbohydrate, 47, 49, 51 Carcinogenic, 47, 58 Cardiac, 47, 58 Carpal Tunnel Syndrome, 16, 47 Case report, 8, 9, 11, 47 Caudal, 47, 55 Cell, 46, 47, 48, 51, 54 Central Nervous System, 48, 51 Cervical, 47, 48, 53, 56, 60 Chest wall, 4, 16, 48 Cholesterol, 46, 48, 52, 58 Chronic, 8, 9, 10, 11, 12, 13, 17, 45, 48, 52, 56, 58, 59, 60 Clinical trial, 5, 27, 48, 49, 57 Cloning, 47, 48 Colitis, 48 Colon, 4, 48, 52, 55, 60 Complete remission, 48, 57 Computational Biology, 27, 48 Computed tomography, 48, 57 Computerized axial tomography, 48, 57 Connective Tissue, 48, 50, 51, 59 Contracture, 16, 48 Contraindications, ii, 48 Controlled study, 13, 49 Contusions, 34, 49 Corticosteroid, 8, 17, 49 Cutaneous, 49, 53, 54, 56 D Decompression, 12, 49 Decompression Sickness, 49 Degenerative, 49, 51, 54 Diagnostic Imaging, 32, 49 Diagnostic procedure, 20, 49 Digestion, 46, 47, 49, 52, 53 Direct, iii, 49, 57, 59 Discrete, 49, 59 Dislocation, 16, 49 Dizziness, 17, 49 Dorsal, 49, 55, 56, 59 Dorsum, 49, 51 Double-blind, 13, 49

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E Edema, 50, 60 Efficacy, 4, 50 Elastic, 11, 50 Electrolyte, 49, 50, 53 Electromyography, 4, 50 Electrons, 46, 50, 56, 57 Environmental Health, 26, 28, 50 Eosinophilia, 50 Epicondylitis, 15, 16, 50 Epidemiological, 4, 50 Epidermal, 50, 60 Extensor, 50, 56, 59 External-beam radiation, 50, 56 Extremity, 34, 47, 50, 53, 54, 56, 57, 60 F Family Planning, 27, 50 Fasciitis, 4, 11, 15, 16, 33, 34, 50 Fat, 49, 50, 51, 58, 60 Fibroblasts, 50 Fibrosarcoma, 50 Fibrosis, 48, 50, 58 Fibula, 46, 51, 55, 60 Flexion, 51, 56 Flexor, 16, 50, 51, 59 Foot Care, 33, 51 Forearm, 50, 51, 53, 56, 59, 60 Fossa, 51, 57 G Gamma Rays, 51, 56, 57 Ganglion, 16, 51 Gene, 47, 51, 52 Glucocorticoids, 45, 49, 51 Gonadal, 51, 58 Governing Board, 51, 55 H Hallux Rigidus, 33, 51 Hallux Valgus, 16, 51 Hammer, 33, 51, 54 Hemolytic, 50, 51 Hemorrhage, 49, 51 Heredity, 45, 51, 52 Hormonal, 49, 52 Hormone, 49, 52, 56 Humeral, 52, 59 Hyperlipoproteinemia, 6, 52 Hyperostosis, 6, 52 Hypertension, 8, 45, 52 I Idiopathic, 6, 52 Immune response, 49, 52 Immune system, 52

Immunosuppressant, 52, 53 Implant radiation, 52, 56 Infection, 50, 52, 54 Inflammation, 45, 46, 47, 48, 50, 51, 52, 55, 59, 60 Inflammatory bowel disease, 3, 52 Innervation, 47, 52, 53, 55, 56, 57, 60 Internal radiation, 52, 56 Intestinal, 4, 52 Intestinal Mucosa, 4, 52 Intestine, 47, 52, 57 Invasive, 52, 53 Involuntary, 53, 57 Ischemia, 45, 53, 60 Ischial, 16, 53 Isotretinoin, 8, 53 K Kb, 26, 53 L Levofloxacin, 8, 10, 53 Ligament, 4, 53 Liver, 45, 46, 51, 53, 57 Liver scan, 53, 57 Lupus, 21, 53, 59 Luxation, 49, 53 M Magnetic Resonance Imaging, 4, 53, 57 Malignant, 46, 50, 53, 56, 57 Medial, 15, 16, 46, 53, 60 Median Nerve, 47, 53 MEDLINE, 27, 53 Metatarsophalangeal Joint, 51, 53 Methotrexate, 11, 53 Mineralocorticoids, 45, 49, 53 Mobility, 33, 53 Molecular, 27, 29, 47, 48, 54 Monoclonal, 54, 56 Mononuclear, 50, 54 Mucinous, 51, 54 Mucosa, 47, 53, 54 Mucus, 54, 60 N Necrosis, 50, 54 Nervous System, 48, 54, 55 Neuroma, 16, 33, 54 Neuropathy, 16, 54, 59 Neutrons, 45, 54, 56 Nuclear, 46, 50, 51, 54 Nuclei, 45, 50, 53, 54, 56 O Orthotic Devices, 33, 54 Ossicles, 51, 54

65

Osteoarthritis, 51, 54 P Palsy, 16, 54 Paralysis, 16, 54, 60 Paresis, 54, 60 Paresthesia, 54, 60 Partial remission, 54, 57 Pathologic, 55, 56 Patient Education, 32, 38, 40, 43, 55 Pericardium, 55, 59 Peripheral Nervous System, 54, 55, 57 Peroneal Nerve, 16, 55, 57 Perspiration, 33, 55 Pharmacologic, 55, 60 Physical Examination, 17, 32, 55 Physical Therapy, 4, 8, 11, 16, 55 Physiologic, 49, 55 Pituitary Gland, 49, 55 Plasma, 52, 53, 55 Pneumonia, 48, 55 Popliteal, 16, 55 Popliteal Cyst, 16, 55 Posterior, 12, 16, 49, 53, 55, 56, 59 Practice Guidelines, 28, 55 Prevalence, 3, 55 Proctocolectomy, 4, 55 Progesterone, 56, 58 Projection, 53, 56 Pronator, 16, 56 Prone, 56 Prone Position, 56 Protein S, 47, 56 Protons, 45, 56 Psoriasis, 7, 56 Public Policy, 27, 56 Pustular, 45, 56 R Radial Nerve, 16, 56 Radial Neuropathy, 16, 56 Radiation, 4, 45, 50, 51, 52, 56, 57, 61 Radiation therapy, 4, 50, 52, 56 Radioactive, 47, 52, 53, 54, 56, 57 Radiolabeled, 56 Radiotherapy, 47, 56 Randomized, 13, 50, 57 Rectum, 46, 48, 52, 55, 57 Reductase, 53, 57 Refer, 1, 47, 49, 54, 57 Reflex, 15, 57 Refraction, 57, 58 Regimen, 50, 57 Remission, 4, 57

Rotator, 15, 16, 17, 57 Rotator Cuff, 15, 16, 17, 57 S Sacroiliac Joint, 8, 57 Saponins, 57, 58 Scans, 57 Schwannoma, 12, 57 Sciatic Nerve, 55, 57, 60 Scleroderma, 50, 58 Sclerosis, 8, 58 Screening, 48, 58 Sebum, 45, 58 Secretion, 45, 49, 51, 53, 54, 55, 58 Self Care, 33, 58 Shock, 4, 58 Signs and Symptoms, 16, 21, 57, 58 Skeletal, 6, 45, 58 Skeleton, 58, 60 Soft tissue, 50, 58 Spatial disorientation, 49, 58 Specialist, 34, 58 Spectrum, 4, 58 Spinal cord, 47, 48, 51, 53, 54, 55, 56, 57, 58, 59, 60 Spondylolysis, 4, 58 Staging, 57, 58 Steroid, 4, 13, 57, 58 Stimulus, 52, 57, 58 Stool, 48, 58 Stress, 4, 17, 58 Subclavian, 59, 60 Subclavian Artery, 59, 60 Subclavian Vein, 59, 60 Subcutaneous, 16, 50, 59 Supination, 56, 59 Suppression, 49, 59 Sweat, 55, 59 Synovial, 55, 59 Synovial Cyst, 55, 59 Systemic, 4, 8, 21, 52, 56, 58, 59 Systemic disease, 4, 59 Systemic lupus erythematosus, 21, 59 T Talus, 46, 59, 60 Tarsal Tunnel Syndrome, 16, 59 Tendon, 4, 6, 9, 16, 21, 32, 47, 51, 59 Tendonitis, 7, 8, 9, 10, 11, 21, 59 Tennis Elbow, 17, 59 Tenosynovitis, 4, 6, 16, 21, 59 Tenotomy, 11, 59 Teratogenic, 53, 59 Thoracic, 16, 47, 53, 56, 59, 60

66

Achilles tendinitis

Thoracic Outlet Syndrome, 16, 60 Tibia, 46, 51, 60 Tibial Nerve, 57, 59, 60 Tissue, 46, 48, 49, 50, 53, 55, 58, 59, 60 Topical, 53, 60 Toxic, iv, 54, 60 Toxicology, 28, 60 Transfection, 47, 60 Triglyceride, 52, 60 Tuberculosis, 53, 60 Tumour, 51, 60

U Ulcerative colitis, 4, 52, 60 Ulnar Nerve, 16, 60 Ultrasonography, 10, 13, 60 V Veterinary Medicine, 27, 60 Viral, 60 W Warts, 33, 60 X X-ray, 48, 51, 54, 56, 57, 61

67

68

Achilles tendinitis

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