Birth Control Pills: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

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BIRTH

CONTROL PILLS 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 2003 by ICON Group International, Inc. Copyright 2003 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., 1960Birth Control Pills: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83787-2 1. Birth Control Pills-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 birth control pills. 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 BIRTH CONTROL PILLS ............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Birth Control Pills ........................................................................ 4 The National Library of Medicine: PubMed .................................................................................. 7 CHAPTER 2. CLINICAL TRIALS AND BIRTH CONTROL PILLS .......................................................... 13 Overview...................................................................................................................................... 13 Recent Trials on Birth Control Pills ............................................................................................ 13 Keeping Current on Clinical Trials ............................................................................................. 14 CHAPTER 3. BOOKS ON BIRTH CONTROL PILLS.............................................................................. 17 Overview...................................................................................................................................... 17 Book Summaries: Federal Agencies.............................................................................................. 17 Book Summaries: Online Booksellers........................................................................................... 18 The National Library of Medicine Book Index ............................................................................. 18 Chapters on Birth Control Pills ................................................................................................... 19 CHAPTER 4. MULTIMEDIA ON BIRTH CONTROL PILLS ................................................................... 21 Overview...................................................................................................................................... 21 Audio Recordings......................................................................................................................... 21 Bibliography: Multimedia on Birth Control Pills ........................................................................ 21 CHAPTER 5. PERIODICALS AND NEWS ON BIRTH CONTROL PILLS ................................................ 23 Overview...................................................................................................................................... 23 News Services and Press Releases................................................................................................ 23 Academic Periodicals covering Birth Control Pills...................................................................... 25 CHAPTER 6. RESEARCHING MEDICATIONS .................................................................................... 27 Overview...................................................................................................................................... 27 U.S. Pharmacopeia....................................................................................................................... 27 Commercial Databases ................................................................................................................. 28 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 33 Overview...................................................................................................................................... 33 NIH Guidelines............................................................................................................................ 33 NIH Databases............................................................................................................................. 35 Other Commercial Databases....................................................................................................... 38 APPENDIX B. PATIENT RESOURCES ................................................................................................. 39 Overview...................................................................................................................................... 39 Patient Guideline Sources............................................................................................................ 39 Finding Associations.................................................................................................................... 44 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 47 Overview...................................................................................................................................... 47 Preparation................................................................................................................................... 47 Finding a Local Medical Library.................................................................................................. 47 Medical Libraries in the U.S. and Canada ................................................................................... 47 ONLINE GLOSSARIES.................................................................................................................. 53 Online Dictionary Directories ..................................................................................................... 54 BIRTH CONTROL PILLS DICTIONARY .................................................................................. 55 INDEX ................................................................................................................................................ 81

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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 birth control pills 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 birth control pills, 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 birth control pills, 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 birth control pills. 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 birth control pills, 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 birth control pills. 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 BIRTH CONTROL PILLS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on birth control pills.

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

Sports Pharmacology Source: Clinics in Sports Medicine. 17(2): i-xii, 211-396. April 1998. Summary: This journal provides health professionals with information on sports pharmacology. The first article discusses the distribution of prescription and nonprescription drugs in the training room. This is followed by an article that describes some of the medications commonly used to care for athletes, including analgesics, nonsteroidal anti-inflammatory drugs, muscle relaxants, antibiotics, hypnotics, antiemetics and antidiarrheals, antihistamines and decongestants, caffeine, cardiovascular drugs, oral birth control pills, and behavioral modification medications. An article on recreational drug use reviews the use of marijuana, cocaine, and alcohol among athletes and explores differences in usage among athletic and nonathletic groups and subgroups. This is followed by an article on the anabolic agents athletes use.

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Dehydroepiandrosterone, anabolic-androgenic steroids, human growth hormone, and insulinlike growth factor are discussed in terms of their basic chemistry and physiology, function, clinical uses, athletic uses, and side effects. The next article reviews some of the most popular ergogenic agents, focusing on creatine, beta-hydroxy-beta-methylbutyrate, chromium, erythropoietin, L-carnitine, dehydroepiandrosterone, antioxidants, boron, choline, inosine, and magnesium. The issue of athletic drug testing is the focus of the next article, which is followed by an article that discusses drug programs for those involved in sports and focuses on the components of such a program. Subsequent articles provide guidelines on the nonpharmacologic and pharmacologic management of athletic amenorrhea and the pharmacologic treatment of exercise-induced asthma. An article on the equipment and medications a team physician should take when traveling with a sports team follows. The final article discusses using nonsteroidal antiinflammatory drugs and corticosteroids as modulators of pain and inflammation resulting from sports injuries. 9 figures, 27 tables, and numerous references. •

Updated Multiple Language Health History for Dental Practice Source: CDA Journal. Journal of the California Dental Association. 28(7): 492-495, 497509. July 2000. Contact: Available from California Dental Association (CDA). 1201 K Street, Sacramento, CA 95814. (916) 443-0505. Summary: To properly assess a dental patient, a variety of questions are necessary to evaluate signs and symptoms of medical problems and to find out about diagnosed medical problems and specific medical treatments, including the use of drugs or medications. All of these factors can have a bearing on dental management. Because of the diversity of the population, a variety of languages are spoken in California and the United States. In order to help dentists communicate with the members of those diverse groups, a health history form developed at the University of the Pacific School of Dentistry has been translated into 10 languages. This article presents these translated forms, with the corresponding English form, and offers a rationale for their use. Section I of the health history form is designed to elicit general information about the patient's health and prior dental treatment. Section II focuses on various signs and symptoms that are indicative of medical problems. Section III concentrates on specific diseases that have been previously diagnosed and Section IV discusses medical treatments and prosthetic devices. Section V asks for information about prescription and over the counter medications, natural remedies, and any other drugs the patient might be taking. Section VI elicits specific information relative to women such as pregnancy, nursing, and use of birth control pills. Section VII offers space for patients to provide information that they think the dentist should have. The forms are included in English, Spanish, Chinese, Tagalog, Vietnamese, Korean, Japanese, Russian, Thai, Laotian, and Hmong. 1 table. 5 references.

Federally Funded Research on Birth Control Pills The U.S. Government supports a variety of research studies relating to birth control pills. 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 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration

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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 birth control pills. 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 birth control pills. The following is typical of the type of information found when searching the CRISP database for birth control pills: •

Project Title: CONSPIRACIES, PERCEIVED DISCRIMINATION & SEXUAL BEHAVIOR Principal Investigator & Institution: Bird, Sheryl T.; Public Health; Oregon State University Corvallis, or 973391086 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): African Americans are disproportionately affected by HIV, other STDs, and unintended pregnancy. Research has described conspiracy beliefs held by some African Americans regarding HIV/AIDS and birth control that may be barriers to HIV, STD, and pregnancy prevention. In addition, studies have shown that many Blacks have experiences when getting health care that they perceive as discriminatory. The proposed study will build on prior research by examining whether such beliefs and perceptions are associated with high-risk sexual behaviors among African Americans of reproductive age. We request support for two years to conduct a cross-sectional, anonymous telephone survey with a national sample of 500 African Americans, aged 15-44 years. The study will examine conspiracy beliefs regarding HIV/AIDS (e.g., "HIV is a manmade virus") and birth control (e.g., "The government is trying to limit the Black population by encouraging the use of condoms"). We will also assess Black women's perceptions of discrimination when getting family planning or contraceptive services. The overall goal of the proposed study is to improve understanding of the relationship of conspiracy beliefs and perceived discrimination to sexual behaviors related to HIV among African Americans. The specific aims are to 1) examine the relationship between conspiracy beliefs regarding HIV/AIDS and (a) attitudes toward condoms, (b) sexual behavior and intentions, and (c) use of contraceptive services and intentions to seek such services; 2) examine the relationship between conspiracy beliefs regarding birth control and (a) attitudes toward contraceptive methods (e.g., condoms, birth control pills, Norplant), (b) sexual behavior and intentions, and (c) use of contraceptive services and intentions to seek such services; and 3) examine the relationship between perceived discrimination when getting family planning or contraceptive services and (a) attitudes toward contraceptive methods (e.g., condoms, birth control pills, Norplant), (b) sexual behavior and intentions, and (c) use of contraceptive services and intentions to seek such services. Findings from this study will inform efforts to prevent HIV and other STDs, as well as unintended pregnancy, among African Americans nationally. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

(FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Project Title: ORAL CONTRACEPTIVE AND HORMONE REPLACEMENT IN SLE Principal Investigator & Institution: Petri, Michelle A.; Associate Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001 Summary: The overall goal of the current study is to address the effect of exogenous female hormones on disease activity and severity in patients with systemic lupus erythematosus (SLE), a disease which largely affects minority women. Oral contraceptives and estrogen replacement are generally not prescribed due to the practice is based only on the predominance of female gender, biologic abnormalities of estrogen metabolism, murine models of lupus, several anecdotes of patients having disease flares while receiving exogenous hormones, and one retrospective study in patients with preexisting renal disease. In contrast, a more recent retrospective study suggests that the rate of flare is not statistically increased in patients taking oral contraceptives. The preexisting data are insufficient to warrant the dismissal of a potentially important birth control option in a disease which predominantly affects women in their reporductive years and whose fertility is not appreciably altered by the disease. Moreover, the use of synthetic estrogens to preserve fertility in patients taking cyclophosphamide and the use of estrogens to prevent post-menopausal and steroid induced osteoporosis are timely considerations. Women with lupus who are fertile who choose to participate will be randomly divided into a group that takes birth control pills (oral contraceptives) and a group that does not. The women and their doctors will not know what grouop they are in, because both groups will take tablets that appear identical. Women with high blood pressure, a history of a blood clot, lupus antibodies that cause clot, cancer, heart disease, liver disease, diabetes, complicated migraines, and very active lupus cannot participate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: WOMEN'S HEALTH IN CYSTIC FIBROSIS Principal Investigator & Institution: Billings, Joanne L.; Medicine; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2001; Project Start 05-JUL-2001; Project End 30-JUN-2006 Summary: Dr. Billings is a fourth year pulmonary and critical care fellow at the University of Minnesota who will become an Instructor of Medicine on July 1, 2000. Her long term goal is to develop an independent academic career combining clinical research with clinical medicine. Her primary research and clinical field will be in cystic fibrosis (CF). The proposed career development plan combines an intense interdisciplinary patient-- oriented research experience in association with a comprehensive structured didactic curriculum. The candidate is particularly interested in the health of women with CF. Data from patients seen at the University of Minnesota CF Center demonstrate greater mortality in women compared to men which appears to increase near the time of puberty. Dr. Billings will explore the hypothesis that estrogen and progesterone may have a negative impact on CF lung disease. The present study will examine lung function during the follicular and luteal phases of the menstrual cycle in normally menstruating young women with CF. Lung function of women with CF on birth control pills will be compared to those who are not. Pilot information on the effect of menopause on lung function, bone health, lipid levels and cardiovascular disease will also be obtained. If there is evidence of hormonal influence on pulmonary function, there may be future therapeutic implications and the potential to improve survival in women with CF. The Mentored Patient-Oriented Development Award affords the opportunity for the PI to translate existing knowledge of cohort study design into the

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practical application of study conduct and implementation. The applicant will pursue additional courses in the School of Public Health in the areas of clinical research, biostatistics and ethics. She will have the opportunity to expand her knowledge of endocrinology and metabolism as well as research methodology with this study of women's health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

A case control study into the possible effects of birth control pills on pre-clinical carcinoma of the cervix. Author(s): Worth AJ, Boyes DA. Source: J Obstet Gynaecol Br Commonw. 1972 August; 79(8): 673-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5070879&dopt=Abstract

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A practical guide for prescribing birth control pills. Author(s): Abrams J. Source: N J Med. 1994 June; 91(6): 393-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8047304&dopt=Abstract

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A review of the birth control pill and its relationship to thrombophlebitis. Author(s): Julsrud ME. Source: J Am Podiatry Assoc. 1979 June; 69(6): 376-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=448035&dopt=Abstract

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

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An association with birth control pills. Moyamoya. Author(s): Sequeira W, Naseem M, Bouffard DA. Source: Imj Ill Med J. 1984 December; 166(6): 434-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6150921&dopt=Abstract

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Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities. Author(s): Hreshchyshyn MM, Hopkins A, Zylstra S, Anbar M. Source: American Journal of Obstetrics and Gynecology. 1988 August; 159(2): 318-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3407686&dopt=Abstract

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Birth control pills and pancreatitis. Author(s): Liu JW. Source: Md State Med J. 1982 February; 31(2): 66-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7070128&dopt=Abstract

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Birth control pills for minors. Author(s): Reid RL. Source: J Med Assoc Ga. 1968 March; 57(3): 149-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5641003&dopt=Abstract

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Birth control pills. Author(s): Vennard WO. Source: The American Journal of Psychiatry. 1966 June; 122(12): 1449. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5948770&dopt=Abstract

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By the way, doctor. I'm 47 and my menstrual periods are quite irregular, so my doctor started me on birth control pills. How will I know when I enter menopause and when to switch to HRT? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 1999 November; 7(3): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10521920&dopt=Abstract

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By the way, doctor. I've seen a lot in the news lately about women using birth control pills to delay their menstrual periods or avoid having them altogether. How does this work? Is it safe? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2000 December; 8(4): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11114881&dopt=Abstract

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Cervical cytology and sequential birth control pills. Author(s): Dougherty CM. Source: Obstetrics and Gynecology. 1970 November; 36(5): 741-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5474004&dopt=Abstract

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China invents male birth control pill. Author(s): Wen W. Source: The American Journal of Chinese Medicine. 1980 Spring-Summer; 8(1-2): 195-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7395797&dopt=Abstract

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Comparative analysis of the effectiveness of the diaphragm and birth control pill during the first year of use among suburban adolescents. Author(s): Fisher M, Marks A, Trieller K. Source: J Adolesc Health Care. 1987 September; 8(5): 393-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3667392&dopt=Abstract

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Contact lens wear problems: implications of penicillin allergy, diabetic relatives, and use of birth control pills. Author(s): Harrison DP. Source: Am J Optom Physiol Opt. 1984 November; 61(11): 674-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6517123&dopt=Abstract

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Development of a scale to measure attitudes toward using birth control pills. Author(s): Herold ES, Goodwin MS. Source: The Journal of Social Psychology. 1980 February; 110(First Half): 115-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7366184&dopt=Abstract

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Exploring risks and benefits of the birth control pill. Author(s): Dunn DA. Source: Health Educ. 1981 January-February; 12(1): 35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6792119&dopt=Abstract

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Factors predictive of adolescents' intentions to use birth control pills, condoms, and birth control pills in combination with condoms. Author(s): Craig DM, Wade KE, Allison KR, Irving HM, Williams JI, Hlibka CM. Source: Canadian Journal of Public Health. Revue Canadienne De Sante Publique. 2000 September-October; 91(5): 361-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11089290&dopt=Abstract

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Frequency and severity of premenstrual symptoms in women taking birth control pills. Author(s): Yuk VJ, Cumming CE, Fox EE, Cumming DC. Source: Gynecologic and Obstetric Investigation. 1991; 31(1): 42-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2010113&dopt=Abstract

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Interactions between carbamazepine and birth control pills. Author(s): Rapport DJ, Calabrese JR. Source: Psychosomatics. 1989 Fall; 30(4): 462-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2798744&dopt=Abstract

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Letter: Retinitis pigmentosa and birth control pills. Author(s): Pearlman JT, Saxton J. Source: Jama : the Journal of the American Medical Association. 1975 February 24; 231(8): 810. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1172745&dopt=Abstract

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Magnetic resonance imaging of cerebral venous thrombosis secondary to “low-dose” birth control pills. Author(s): Granato DB, Archer CR, Awwad EE. Source: Clinical Imaging. 1989 September; 13(3): 220-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2819587&dopt=Abstract

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Medicolegal file. Tell everything you know about birth control pills. Author(s): Winkelaar PG. Source: Can Fam Physician. 1999 February; 45: 299. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065301&dopt=Abstract

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Metabolic effects of the birth control pill. Author(s): Sondheimer S. Source: Clinical Obstetrics and Gynecology. 1981 September; 24(3): 927-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7026112&dopt=Abstract

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Proceedings: The contraceptive dilemma in adolescents. The birth control pill versus the intrauterine device. Author(s): Shearin RB. Source: Acta Paediatr Scand Suppl. 1975; (256): 53-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1065199&dopt=Abstract

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Serum gamma-glutamyl transpeptidase activity in viral hepatitis: suppression in pregnancy and by birth control pills. Author(s): Combes B, Shore GM, Cunningham FG, Walker FB, Shorey JW, Ware A. Source: Gastroenterology. 1977 February; 72(2): 271-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064&dopt=Abstract

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The birth control pill and its ophthalmologic side effects. Author(s): Levinson JM. Source: Del Med J. 1969 April; 41(4): 118-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5798034&dopt=Abstract

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The birth control pill revisited. Author(s): Harris CD. Source: Naacogs Clin Issu Perinat Womens Health Nurs. 1992; 3(2): 246-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1596433&dopt=Abstract

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The effect of the phase of the menstrual cycle and the birth control pill on athletic performance. Author(s): Lebrun CM. Source: Clinics in Sports Medicine. 1994 April; 13(2): 419-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8013042&dopt=Abstract

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The effects of gender and birth control pill use on spontaneous blink rates. Author(s): Yolton DP, Yolton RL, Lopez R, Bogner B, Stevens R, Rao D. Source: J Am Optom Assoc. 1994 November; 65(11): 763-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7822673&dopt=Abstract

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The use of birth control pills in women with medical disorders. Author(s): Decherney AH. Source: Clinical Obstetrics and Gynecology. 1981 September; 24(3): 965-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7026114&dopt=Abstract

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Topics in radiology/case of the month. Acute dyspnea in a young woman taking birth control pills. Author(s): Goffman TE, Bloom RL, Dvorak VC. Source: Jama : the Journal of the American Medical Association. 1984 March 16; 251(11): 1465-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6700044&dopt=Abstract

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Use of birth control pills and condoms among 17-19-year-old adolescents in Norway: contraceptive versus protective behaviour? Author(s): Traeen B, Lewin B, Sundet JM. Source: Aids Care. 1992; 4(4): 371-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1493144&dopt=Abstract

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Use of birth control pills, condoms, and withdrawal among U.S. high school students. Author(s): Everett SA, Warren CW, Santelli JS, Kann L, Collins JL, Kolbe LJ. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2000 August; 27(2): 112-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10899471&dopt=Abstract

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Which birth control pill should be prescribed? Author(s): Speroff L. Source: Fertility and Sterility. 1976 September; 27(9): 997-1008. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=786747&dopt=Abstract

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CHAPTER 2. CLINICAL TRIALS AND BIRTH CONTROL PILLS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning birth control pills.

Recent Trials on Birth Control Pills The following is a list of recent trials dedicated to birth control pills.4 Further information on a trial is available at the Web site indicated. •

Quick Start Approach to Birth Control Pills Condition(s): Pregnancy; Contraception Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: Women who choose to take birth control pills are currently instructed to begin taking the pills at the end of a menstrual cycle. This creates a window of time between when the woman is given the pills and when she begins taking them. Some women fail to begin taking the pills, placing them at increased risk of pregnancy. This study will evaluate a new approach to beginning birth control pills. Women will take the first pill in the doctor's office rather than waiting until the next menstrual cycle. Phase(s): Phase IV; MEDLINEplus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068848

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Safety of Estrogens in Lupus: Birth Control Pills Condition(s): Systemic Lupus Erythematosus Study Status: This study is no longer recruiting patients.

4

These are listed at www.ClinicalTrials.gov.

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Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); Office of Research on Women's Health (ORWH) Purpose - Excerpt: Safety of Estrogens in Lupus Erythematosus - National Assessment (SELENA) is a study to test whether women with systemic lupus erythematosus (SLE or lupus) can safely use estrogen. We will determine this by looking at the effects of oral contraceptives (birth control pills, also known as "the pill") on disease activity and severity in women with SLE. The results of the study will show whether it is safe for women with SLE to use the pill. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000420

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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CHAPTER 3. BOOKS ON BIRTH CONTROL PILLS Overview This chapter provides bibliographic book references relating to birth control pills. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on birth control pills include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Family planning methods at a glance Source: Flagstaff, AZ: North Arizona Area Health Education Center. 1994. 20 pp. Contact: Available from American Indian Outreach Division, North Arizona Area Health Education Center, 2501 North Fourth Street, Suite 9, Flagstaff, AZ 86004. Telephone: (602) 774-6687 / fax: (602) 774-1652. $7.00 plus $3.00 shipping and handling; make checks payable to NAAHEC.

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Summary: This book contains information for the use of resource mothers working with Native Americans in Arizona. It is a collection of charts that summarize the rationale for using family planning, describes in general terms how the various methods work, covers the menstrual cycle, and reviews various contraceptive techniques. For each, the charts describe the technique, cite advantages and disadvantages, indicate how it is used, identifies persons who should not use that technique, and provides a sketch to indicate what the device looks like. The techniques included are: abstinence, birth control pills, condoms, depo-provera, diaphragm, intrauterine devices, natural family planning, norplant, the sponge, tubal ligation, vasectomies, vaginal contraceptives, and withdrawal. Materials describing the Center's Resource Mothers Project and other outreach services are also available.

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

Breast Cancer: Its Link to Abortion and the Birth Control Pill by Kahlenborn, MD Chris (2001); ISBN: 0966977742; http://www.amazon.com/exec/obidos/ASIN/0966977742/icongroupinterna

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Does the Birth Control Pill Cause Abortions? by Randy Alcorn (2002); ISBN: 0970001606; http://www.amazon.com/exec/obidos/ASIN/0970001606/icongroupinterna

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The Male birth control pill; ISBN: 0842241108; http://www.amazon.com/exec/obidos/ASIN/0842241108/icongroupinterna

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The Pill, Pygmy Chimps, and Degas' Horse/the Remarkable Autobiography of the Award-Winning Scientist Who Synthesized the Birth Control Pill by Carl Djerassi (1998); ISBN: 0465057586; http://www.amazon.com/exec/obidos/ASIN/0465057586/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “birth control pills” (or synonyms) into the search box, and select “books

Books

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only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:5 •

Evaluation of birth control pill booklet for illiterate women. Draft report Author: Wilcock, K. E.; Year: 1992; 1992

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Facts about birth control pills Author: Khan, A. R.; Year: 1981; [Dacca], Bangladesh, Bangladesh Family Planning Social Marketing Project, [1981]

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Questions and answers about the birth control pills Author: Langmyhr, G. J.; Year: 1970; New York Planned Parenthood--World Population, 1970

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The truth about the new birth control pills, by John Devaney and Philip Reaves. Author: Devaney, John.; Year: 1961; New York [1961]

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

Effect of Medications on Diabetes Source: in Carlisle, B.A.; Kroon, L.A.; Koda-Kimble, M.A. 101 Medication Tips for People with Diabetes. Alexandria, VA: American Diabetes Association. 1999. p. 76-83. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 1580400329. Order number 483301. Summary: This chapter answers questions about the effects of common medications, alcohol, birth control pills, estrogen therapy, beta blockers, hydrochlorothiazide, and niacin on blood glucose levels. Common medications that can increase blood glucose include glucocorticoids, niacin, and protease inhibitors. Glucocorticoids taken as pills or by injection are likely to increase blood glucose levels if they are taken in large doses. If they are inhaled or applied to the skin, they are unlikely to increase blood glucose. The effect of alcohol on blood glucose depends on how much a person drinks during a particular timespan. Birth control pills will not generally make diabetes worse, and estrogen replacement therapy is safe for most women with diabetes. The benefits of beta blockers for people who have diabetes and who have had a heart attack far exceed the

5

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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risks; currently prescribed doses of hydrochlorothiazide used to control blood pressure have minimal effects on blood glucose level. The amount of niacin in multivitamins is not high enough to increase blood glucose levels. •

Diabetes and Sex Source: in American Diabetes Association. American Diabetes Association Complete Guide to Diabetes: The Ultimate Home Diabetes Reference. 2nd ed. Alexandria, VA: American Diabetes Association. 1999. p. 321-360. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $23.95 plus shipping and handling. ISBN: 1580400388. Summary: This chapter discusses the impact of diabetes on sexual health and pregnancy. Diabetes can affect a person's sexual performance, his or her choice of birth control, and his or her response to the aging of the reproductive system. Women need to deal with the effects of sex hormones on blood glucose levels throughout the menstrual cycle and as they go through menopause. For women whose blood glucose levels are affected by their menstrual cycle, steps for staying in control include controlling the symptoms of premenstrual syndrome and making changes in diet and physical activity in the days prior to the onset of menstruation. Menopause can also upset a diabetes management plan. Hormone replacement therapy may be an answer for some women. Practicing birth control and safe sex are especially important for people with diabetes. Birth control options for women include birth control pills, the intrauterine device, the diaphragm, the sponge and cervical cap, the female condom, and sterilization. Although men have more limited birth control options than women, the condom is the most popular. Sterilization is also an option for men. Sexual problems for women who have diabetes include poor vaginal lubrication and pain during intercourse or diminished sexual desire and problems achieving orgasm. For men, the major concern is impotence. Women also face challenges as they prepare for pregnancy and carrying a baby. Issues that women need to consider before they become pregnant include the genetic risk of passing diabetes to a child, the woman's health status and level of glucose control, and financial considerations. Once a woman becomes pregnant, she and her health care team need to choose blood glucose goals and she needs to consider her food and exercise habits, times for blood glucose testing, and obstetrical care. Other pregnancy related issues include delivery complications, postpartum care, and breastfeeding.

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CHAPTER 4. MULTIMEDIA ON BIRTH CONTROL PILLS Overview In this chapter, we show you how to keep current on multimedia sources of information on birth control pills. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “birth control pills” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on birth control pills: •

Listen Carefully Contact: Emory University, School of Medicine, Department of Gynecology/Obstetrics, 1462 Clifton Rd, Atlanta, GA, 30322, (404) 589-3556. Summary: This cassette contains information in a question-and-answer format about birth control pills and other forms of contraception. Special instructions for beginning oral contraceptives are given, as well as instructions on steps to be taken if pills are missed. Side effects and danger signs are also explained. While oral contraceptives are effective in preventing pregnancy, condoms are urged as an effective means of preventing sexually transmitted diseases (STD's), including HIV and AIDS.

Bibliography: Multimedia on Birth Control Pills The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the

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multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in birth control pills (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on birth control pills: •

A Client using birth control pills [electronic resource] Source: MEPC Software; Year: 1987; Format: Electronic resource; New York, N.Y.: Elsevier Science Pub. Co., c1987

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CHAPTER 5. PERIODICALS AND NEWS ON BIRTH CONTROL PILLS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover birth control pills.

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

Drug shows promise as male birth control pill Source: Reuters Health eLine Date: December 09, 2002

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•

Study: Birth control pill does not make teens fat Source: Reuters Health eLine Date: July 31, 2002

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Birth control pill reduces periods to four a year Source: Reuters Health eLine Date: May 07, 2002

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Birth control pills linked to thinner bones: study Source: Reuters Health eLine Date: November 08, 2001

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Birth control pill makers face lawsuit in UK Source: Reuters Health eLine Date: October 01, 2001

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Newer birth control pills up blood clot risk Source: Reuters Health eLine Date: September 28, 2001

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Older birth control pills linked to breast cancer Source: Reuters Health eLine Date: October 10, 2000

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Low-dose birth control pills can lower ovarian cancer risk Source: Reuters Health eLine Date: August 08, 2000

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Older types of birth control pills more harmful to smokers Source: Reuters Health eLine Date: January 11, 2000 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

Periodicals and News

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Market Wire’s home page at http://www.marketwire.com/mw/home, type “birth control pills” (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 “birth control pills” (or synonyms). If you know the name of a company that is relevant to birth control pills, 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 “birth control pills” (or synonyms).

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

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CHAPTER 6. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to birth control pills: Estrogens and Progestins Oral Contraceptives •

Systemic - U.S. Brands: Alesse; Brevicon; Demulen 1/35; Demulen 1/50; Desogen; Estrostep; Estrostep Fe; Genora 0.5/35; Genora 1/35; Genora 1/50; Intercon 0.5/35; Intercon 1/35; Intercon 1/50; Jenest; Levlen; Levlite; Levora 0.15/30; Lo/Ovral; Loestrin 1.5/30; Loestrin 1/20; Lo http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202228.html

Progestins for Contraceptive Use •

Systemic - U.S. Brands: Depo-Provera Contraceptive Injection; Micronor; NORPLANT System; Nor-QD; Ovrette; Plan B http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202757.html

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

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

Researching Medications

29

31

APPENDICES

33

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute6: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

6

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

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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.7 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:8 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

7

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 8 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “birth control pills” using the “Detailed Search” option. Go directly to the following hyperlink: 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 the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “birth control pills” (or synonyms) into the “For these words:” box. The following is a sample result: •

Colorado Hispanic Knowledge, Attitudes and Beliefs About AIDS: A Decision Making Guide Contact: Latin American Research and Service Agency, 309 W 1st Ave, Denver, CO, 80223, (303) 722-5150. Summary: This report presents the results of a study of Colorado Hispanics regarding their Knowledge, Attitudes, Behaviors, and Beliefs (KABB) about Acquired immunodeficiency syndrome (AIDS) and their sources of information about AIDS and general health issues. It also identifies trends on the basis of respondents' gender, age groups, and educational level. The demographics section presents for responders data on gender, age, marital status, educational level, income, ethnic identifiers, and country of birth. The cultural orientation section incorporates information about language usage, media, and social relations into the questionnaires. And the knowledge measurements section assesses general knowledge about AIDS, Human immunodeficiency virus (HIV) transmission, and use of safer sex practices to prevent pregnancy, such as diaphragms, birth control pills, condoms, spermicides, and sexual abstinence. The information section identifies sources for AIDS and health information.

The NLM Gateway9 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “birth control pills” (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. 9

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

10

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

Physician Resources

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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 360 4329 976 52 0 5717

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.13 Simply search by “birth control pills” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists14 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.15 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

11

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

12

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

13

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. 14 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 15

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 16 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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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/.

39

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 birth control pills can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

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

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•

Other guides Hormone Replacement Therapy http://www.nlm.nih.gov/medlineplus/hormonereplacementtherapy.html Ovarian Cancer http://www.nlm.nih.gov/medlineplus/ovariancancer.html Teen Sexual Health http://www.nlm.nih.gov/medlineplus/teensexualhealth.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 birth control pills. 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: •

Chlamydia : Questions and Answers Contact: Planned Parenthood of Federation of America Incorporated, PO Box 4457, New York, NY, 10163-4457, (800) 669-0156, http://www.plannedparenthood.org. Summary: This brochure presents general information about chlamydia using a question and answer format. The brochure presents the general symptoms of chlamydia and methods of transmission including unprotected vaginal or anal sex. Chlamydia is the most common sexually transmitted disease (STD) in the United States (US), and can lead to the development of pelvic inflammatory disease (PID), a condition that can block fallopian tubes in women. The symptoms of PID in women include longer and/or heavier periods, more cramping during periods, abnormal mucus discharge, lower abdomen pain, tiredness, weakness, fever, vomiting, and/or pain during vaginal intercourse or a pelvic exam. Chlamydia also can cause sterility or Reiter's syndrome in men. Chlamydia can be passed to infants from their mothers during pregnancy or childbirth leading to neonatal conjunctivitis, chlamydia pneumonia, miscarriage, or stillbirth. It can be diagnosed through a cervical exam; lab tests of cells from the penis, cervix, urethra, or anus; or tests of urine samples. Chlamydia can be treated easily using antibiotics such as doxycycline, azithromycin, ofloxacin, erythromycin, or erythromycin ethylsuccinate. Persons with chlamydia should adhere to their medical regimen, undergo follow-up visits with their physicians, and get their partner(s) treated at the same time. Persons who have a number of different sex partners, who don't use condoms, or who have a history of other STDs are most likely to get chlamydia. Persons with chlamydia can avoid spreading their infection to others by informing their sex

Patient Resources

41

partners about their condition, avoiding sex until treatment is complete, getting their partners tested and treated at the same time, and using female or male condoms during each sexual activity. Persons can prevent getting chlamydia by practicing safer sex or abstaining from intercourse altogether. Birth control pills may increase women's chances for contracting this STD, therefore, they should also use a male or female condoms. Concerned individuals can get tested for chlamydia at Planned Parenthood centers, their doctors' offices, health departments, and clinics. •

You Are Not Alone : A Guide to Safer Sex at the Turn of the Century Contact: Public Health Seattle/King County, HIV/AIDS Programs, 400 Yesler Way 3rd Fl, Seattle, WA, 98104-2615, (206) 296-4649, http://www.metrokc.gov/health/apu. Summary: This brochure provides information to the general public about the use of condoms to prevent sexually transmitted diseases (STDs). Latex condoms should be used during every sexual encounter with water-based lubricants, squeezed at the tip to let out air before being put on, and thrown away if accidentally put on inside out. Condoms should not be stored in very hot or cold places or used with vaseline, creams, or oils as lubricants. Birth control pills do not protect individuals from STDs, but they can prevent pregnancy. The brochure lists the symptoms and curability of chlamydia, genital herpes, genital warts, gonorrhea, hepatitis B, the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), syphilis, and trichomonas. Sexual abstinence is the only sure way to prevent STDs. The brochure provides contact information for services in the Seattle, WA area from which individuals can learn more about STDs.

•

Hair Loss Source: Schaumberg, IL: American Academy of Dermatology. 1999. 8 p. Contact: Available from American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumberg, IL 60168. (888) 462-DERM ext. 22. Website: www.aad.org. PRICE: Single copy free. Summary: This brochure reviews normal hair growth and causes of excessive hair loss. Hair loss can be caused by improper cosmetic use or improper hair care, hereditary thinning or baldness, alopecia areata, childbirth, high fever, severe infection, severe flu, thyroid disease, poor nutrition, medications, cancer treatments, birth control pills, fungus infections, chronic illness, major surgery, or hair pulling. Treatment for hereditary thinning or baldness includes hair transplantation and medications such as minoxidil and finasteride. 2 figures.

•

Hyperpigmentation Source: Kirksville, MO: American Osteopathic College of Dermatology (AOCD). 2001. 2 p. Contact: Available online from American Osteopathic College of Dermatology. 1501 East Illinois Street, P.O. Box 7525, Kirksville, MO 63501. (800) 449-2623 or (660) 665-2184. Fax (660) 627-2623. E-mail: [email protected]. Website: www.aocd.org/skin/dermatologic_diseases/ index.html. Summary: This fact sheet provides people who have hyperpigmentation with information on this common, harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when melanin forms deposits in the skin. Age spots, which occur as a result of sun damage, are a

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common form of hyperpigmentation. Melasma or chloasma spots are similar in appearance to age spots but are larger areas of darkened skin that occur as a result of hormonal changes. Women who are pregnant or who are taking birth control pills may develop hyperpigmentation because of hormonal changes. Skin diseases and injuries to the skin can also cause skin color changes. Exposure to sunlight can cause freckles, age spots, or other darkened skin patches to become darker or more pronounced, so wearing a broad spectrum sunscreen is important. Prescription and nonprescription creams containing hydroquinone are available to lighten the skin. Laser treatments are also effective in treating hyperpigmentation. 2 figures. •

Female Pattern Hair Loss Source: Kirksville, MO: American Osteopathic College of Dermatology (AOCD). 2001. 2 p. Contact: Available online from American Osteopathic College of Dermatology. 1501 East Illinois Street, P.O. Box 7525, Kirksville, MO 63501. (800) 449-2623 or (660) 665-2184. Fax (660) 627-2623. E-mail: [email protected]. Website: www.aocd.org/skin/dermatologic_diseases/ index.html. Summary: This fact sheet provides women who have female pattern hair loss with information on the etiology, symptoms, and treatment of this type of hair loss. Androgenetic alopecia, or female pattern alopecia, occurs most commonly after menopause. In women who have female pattern hair loss, gradual thinning occurs and some excess loss of hair is noted. Hair loss can also occur after pregnancy or following discontinuation of birth control pills. Any sudden physical or psychological stress to the body can also cause hair loss. These types of hair loss are usually temporary and are known as telogen effluvium. Treatment options include Rogaine (topical minoxidal 2 percent), Aldactone (spironolactone) pills, hormone replacement therapy plus Aldactone, and hair transplants. Perms, dyes, and other cosmetic options can give hair a fuller appearance. 2 figures.

•

Mycobacterium Avium Complex (MAC) Contact: University of New Mexico School of Medicine, New Mexico AIDS Education and Training Center, New Mexico AIDS InfoNet, PO Box 810, Arroyo Seco, NM, 87514, (505) 776-8032, http://www.aidsinfonet.org. Summary: This information sheet discusses mycobacterium avium complex (MAC), a common bacteria that causes serious illness to people with weakened immune systems. The bacteria are found in water, soil, dust, and food and almost everyone has the bacteria in their body. A healthy immune system keeps it under control, but people with AIDS may develop MAC, especially if their T-cell count is below 50. The information sheet describes the symptoms of MAC disease, treatment, prevention, and drug interaction problems between drugs used to treat MAC and other drugs including antiviral and antifungal drugs, and birth control pills.

•

Gallstones: Finding Relief for an Uncomfortable Problem Source: San Bruno, CA: StayWell Company. 1999. [2 p.]. Contact: Available from StayWell Company. Order Department, 1100 Grundy Lane, San Bruno, CA 94066-9821. (800) 333-3032. Fax (650) 244-4512. E-mail: [email protected]. Website: www.staywell.com. PRICE: $17.95 for pack of 50; plus shipping and handling.

Patient Resources

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Summary: This patient education brochure describes gallstones and their treatment. Written in nontechnical language, the brochure first lists the populations in which gallstones are more likely: women (especially those who have been pregnant), people of American Indian or Hispanic descent, people who are overweight, people who have lost weight quickly, women who have taken estrogen birth control pills or hormone replacement therapy, and people who eat a high fat diet. Common symptoms of gallstones range from no symptoms to disabling pain and can include mild to severe pain in the upper abdomen; frequent stomach upset, burping, or bloating; fever, nausea, or vomiting; or jaundice (a liver problem that makes the skin yellowish). Gallstones may be found on x rays done for other reasons, or symptoms may lead the physician to suspect gallstones. Diagnosis will include the patient's medical history and some diagnostic tests such as ultrasound, x rays, and endoscopic retrograde cholangiopancreatography (ERCP). Treatments for gallstones include monitoring (watchful waiting), medications to dissolve the stones, ERCP, or surgery (laparoscopic cholecystectomy or open cholecystectomy, both of which remove the gallbladder). One section of the brochure illustrates the gallbladder and surrounding organs and describes how gallstones form. The last page of the brochure summarizes the recommendations for preventing future gallstones, notably by eating a low fat diet. The brochure is illustrated with full color line drawings. 7 figures. 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 birth control pills. 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

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

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “birth control pills” (or a synonym) into the search box, and click “Submit Query.”

47

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.17

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

17

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

18

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

Finding Medical Libraries

49

•

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

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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/

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

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

•

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

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

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

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

•

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

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

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

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

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

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

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

•

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

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•

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

•

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

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

•

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

•

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

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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

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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/

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•

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

53

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Birth Control Pills Birth control pills overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002599.htm

•

Signs & Symptoms for Birth Control Pills Breast tenderness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003152.htm Discoloration of urine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003139.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Emesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

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Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Mental changes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Nausea and/or vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Rash Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Vaginal bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003156.htm •

Background Topics for Birth Control Pills Birth control Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001946.htm

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

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

•

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

•

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

•

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

55

BIRTH CONTROL PILLS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] 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] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] 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] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alopecia: Absence of hair from areas where it is normally present. [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] Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH]

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Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Androgenic: Producing masculine characteristics. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidiarrheals: Miscellaneous agents found useful in the symptomatic treatment of diarrhea. They have no effect on the agent(s) that cause diarrhea, but merely alleviate the condition. [NIH] Antiemetics: Drugs used to prevent nausea or vomiting. Antiemetics act by a wide range of mechanisms. Some act on the medullary contol centers (the vomiting center and the chemoreceptive trigger zone) while others affect the peripheral receptors. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte.

Dictionary 57

Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [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] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [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]

Beta blocker: A drug used to slow the heart rate and reduce pressure inside blood vessels. It also can regulate heart rhythm. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH]

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Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Boron Neutron Capture Therapy: A technique for the treatment of neoplasms, especially gliomas and melanomas in which boron-10, an isotope, is introduced into the target cells followed by irradiation with thermal neutrons. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile.

Dictionary 59

Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the 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] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Division: The fission of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also

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controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chlamydia: A genus of the family Chlamydiaceae whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative and produce glycogen. The type species is Chlamydia trachomatis. [NIH] Chloasma: Melasma c. hepaticum a term formerly used to refer to circumscribed facial hyperpigmentation resembling melasma that may occur as a cutaneous manifestation of chronic liver disease. [EU] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Coenzymes: Substances that are necessary for the action or enhancement of action of an enzyme. Many vitamins are coenzymes. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease

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inhibitor). [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] 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] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH]

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Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydroepiandrosterone: DHEA. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity

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aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Doxycycline: A synthetic tetracycline derivative with a range of antimicrobial activity and mode of action similar to that of tetracycline, but more effective against many species. Animal studies suggest that it may cause less tooth staining than other tetracyclines. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and the movement of wastes out of cells. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endopeptidases: A subclass of peptide hydrolases. They are classified primarily by their

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catalytic mechanism. Specificity is used only for identification of individual enzymes. They comprise the serine endopeptidases, EC 3.4.21; cysteine endopeptidases, EC 3.4.22; aspartic endopeptidases, EC 3.4.23, metalloendopeptidases, EC 3.4.24; and a group of enzymes yet to be assigned to any of the above sub-classes, EC 3.4.99. EC 3.4.-. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopic retrograde cholangiopancreatography: ERCP. A procedure to x-ray the pancreatic duct, hepatic duct, common bile duct, duodenal papilla, and gallbladder. In this procedure, a thin, lighted tube (endoscope) is passed through the mouth and down into the first part of the small intestine (duodenum). A smaller tube (catheter) is then inserted through the endoscope into the bile and pancreatic ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken. [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]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Erythromycin Ethylsuccinate: A macrolide antibiotic, produced by Streptomyces erythreus. This compound is an ester of erythromycin base and succinic acid. It acts primarily as a bacteriostatic agent. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, dyspareunia, and progressive development of osteoporosis. This may also include the use of progestational agents in combination therapy. [NIH]

Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Facial: Of or pertaining to the face. [EU]

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Fallopian Tubes: Two long muscular tubes that transport ova from the ovaries to the uterus. They extend from the horn of the uterus to the ovaries and consist of an ampulla, an infundibulum, an isthmus, two ostia, and a pars uterina. The walls of the tubes are composed of three layers: mucosal, muscular, and serosal. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Finasteride: An orally active testosterone 5-alpha-reductase inhibitor. It is used as a surgical alternative for treatment of benign prostatic hyperplasia. [NIH] Flagellum: A whiplike appendage of a cell. It can function either as an organ of locomotion or as a device for moving the fluid surrounding the cell. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genital: Pertaining to the genitalia. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or

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participate in blood production. [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] Gluconeogenesis: The process by which glucose is formed from a non-carbohydrate source. [NIH]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatic Duct, Common: Predominantly extrahepatic bile duct which is formed by the junction of the right and left hepatic ducts, which are predominantly intrahepatic, and, in turn, joins the cystic duct to form the common bile duct. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH]

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Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Human growth hormone: A protein hormone, secreted by the anterior lobe of the pituitary, which promotes growth of the whole body by stimulating protein synthesis. The human gene has already been cloned and successfully expressed in bacteria. [NIH] Hydrochlorothiazide: A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It has been used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. [NIH] Hyperaemia: An excess of blood in a part; engorgement. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [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] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunosuppressive: Describes the ability to lower immune system responses. [NIH]

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Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH]

Dictionary 69

Localized: Cancer which has not metastasized yet. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenitis: Inflammation of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Mannans: Polysaccharides consisting of mannose units. [NIH] Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH]

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MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [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] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Mycobacteriosis: Any disease caused by Mycobacterium other than M. tuberculosis, M. bovis, and M. avium. [NIH] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH]

Mycobacterium avium: A bacterium causing tuberculosis in domestic fowl and other birds. In pigs, it may cause localized and sometimes disseminated disease. The organism occurs occasionally in sheep and cattle. It should be distinguished from the M. avium complex, which infects primarily humans. [NIH] Mycobacterium avium Complex: A complex that includes several strains of M. avium. M. intracellulare is not easily distinguished from M. avium and therefore is included in the complex. These organisms are most frequently found in pulmonary secretions from persons with a tuberculous-like mycobacteriosis. Strains of this complex have also been associated with childhood lymphadenitis and AIDS. M. avium alone causes tuberculosis in a variety of birds and other animals, including pigs. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH]

Dictionary 71

Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Ofloxacin: An orally administered broad-spectrum quinolone antibacterial drug active against most gram-negative and gram-positive bacteria. [NIH] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH]

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Pancreatic Ducts: Ducts that collect pancreatic juice from the pancreas and supply it to the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Papilla: A small nipple-shaped elevation. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH]

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Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protease Inhibitors: Compounds which inhibit or antagonize biosynthesis or actions of proteases (endopeptidases). [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH]

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Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU] 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] 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] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Safe Sex: Sex behavior that prevents or decreases the spread of sexually transmitted diseases or pregnancy. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [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] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH]

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Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexual Abstinence: Refraining from sexual intercourse. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of

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a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spirochete: Lyme disease. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Systemic: Affecting the entire 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]

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Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombophlebitis: Inflammation of a vein associated with thrombus formation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a 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] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual,

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between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomonas: A genus of parasitic flagellate protozoans distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Tubal ligation: An operation to tie the fallopian tubes closed. This procedure prevents pregnancy by blocking the passage of eggs from the ovaries to the uterus. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] 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]

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Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] Watchful waiting: Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called observation. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

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INDEX A Abdomen, 40, 43, 55, 58, 68, 76, 77 Abdominal, 55, 62, 71, 72, 73 Acetylcholine, 55, 60 Adenosine, 55, 59 Adrenal Cortex, 55, 73 Adverse Effect, 55, 75 Aerobic, 55, 70 Age Groups, 36, 55 Aged, 80 and Over, 55 Alertness, 55, 58 Algorithms, 55, 58 Alkaloid, 55, 60 Alopecia, 41, 42, 55, 62 Alternative medicine, 24, 55 Amenorrhea, 4, 55 Amino Acid Sequence, 55, 56 Amino Acids, 55, 56, 64, 72, 73, 77, 78 Amphetamines, 56, 60 Ampulla, 56, 64, 65 Anabolic, 3, 56 Anal, 40, 56 Analgesics, 3, 56 Androgenic, 4, 56 Anesthesia, 56, 62 Antagonism, 56, 59 Antibacterial, 56, 71, 75 Antibiotic, 56, 57, 58, 64, 72, 75, 77 Antibodies, 6, 56, 73 Antibody, 56, 68 Anticonvulsant, 56, 59 Antidiarrheals, 3, 56 Antiemetics, 3, 56 Antifungal, 42, 56 Antigen, 56, 68 Anti-inflammatory, 3, 57, 66 Antimicrobial, 57, 63 Antineoplastic, 57, 62 Antioxidants, 4, 57 Antiviral, 42, 57 Anus, 40, 56, 57, 58 Aqueous, 57, 68 Arterial, 57, 61, 66, 67, 73 Arteries, 57, 58, 61, 70 Aseptic, 57, 76 Asymptomatic, 57, 72 Autodigestion, 57, 72 Azithromycin, 40, 57

B Bacteria, 42, 56, 57, 66, 67, 70, 71, 75, 78 Bacteriostatic, 57, 64 Bacterium, 57, 70 Base, 57, 64, 68, 78 Benign, 57, 65, 66, 79 Beta blocker, 19, 57 Bile, 57, 58, 64, 65, 66, 68, 76 Bile Ducts, 57, 65 Bile Pigments, 57, 68 Biliary, 57, 72 Biliary Tract, 57, 72 Bilirubin, 57, 58, 65, 67 Biosynthesis, 58, 73 Biotechnology, 7, 19, 24, 35, 58 Bladder, 58, 73, 78 Bloating, 43, 58 Blood Glucose, 19, 20, 58 Blood pressure, 6, 20, 58, 59, 66, 67, 75 Blood vessel, 57, 58, 59, 61, 75, 76, 77, 78 Body Mass Index, 58, 71 Bone Marrow, 58, 64, 69 Boron, 4, 58 Boron Neutron Capture Therapy, 58 Bowel, 56, 58, 63 Bowel Movement, 58, 63 Branch, 51, 58, 71, 75, 77 Broad-spectrum, 58, 71 Buccal, 58, 69 C Caffeine, 3, 58 Calcium, 59, 63 Carbamazepine, 10, 59 Carbohydrate, 59, 66 Carcinogenic, 59, 76 Carcinogens, 59, 60 Carcinoma, 7, 59 Cardiac, 58, 59, 61, 70, 76 Cardiovascular, 3, 6, 59 Cardiovascular disease, 6, 59 Carnitine, 4, 59 Cell, 42, 57, 58, 59, 65, 66, 68, 71, 72, 79 Cell Count, 42, 59 Cell Division, 57, 59, 72 Cellulose, 59, 65, 72 Central Nervous System, 55, 56, 58, 59, 60, 66 Cerebral, 10, 59, 74

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Cerebrovascular, 59 Cerebrum, 59 Cervical, 9, 20, 40, 60 Cervix, 7, 40, 60, 74 Chlamydia, 40, 41, 60 Chloasma, 42, 60 Chlorophyll, 60, 65 Cholecystectomy, 43, 60 Cholesterol, 57, 60, 61, 65, 76 Choline, 4, 60 Chromium, 4, 60 Chronic, 41, 60, 62, 68, 72, 76, 78 Clinical Medicine, 6, 60, 73 Clinical trial, 5, 13, 14, 35, 60 Cloning, 58, 60 Coca, 60 Cocaine, 3, 60 Coenzymes, 60, 71 Cofactor, 60, 73 Combination Therapy, 60, 64 Computational Biology, 35, 61 Conception, 61, 65, 76 Condoms, 5, 9, 12, 18, 21, 36, 40, 41, 61 Conjunctiva, 61 Conjunctivitis, 40, 61 Connective Tissue, 58, 61, 65, 66, 69, 76 Consciousness, 56, 61 Contraception, 13, 21, 61 Contraceptive, 5, 10, 12, 18, 28, 61 Contraindications, ii, 61 Cor, 61, 66 Coronary, 59, 61, 62, 70 Coronary heart disease, 59, 61 Coronary Thrombosis, 62, 70 Corpus, 62, 72, 73 Corpus Luteum, 62, 73 Corticosteroids, 4, 62, 66 Creatine, 4, 62 Creatinine, 62, 78 Critical Care, 6, 62 Cryptosporidiosis, 57, 62 Curare, 62, 70 Curative, 62, 71, 77 Cutaneous, 60, 62, 69 Cyclic, 59, 62 Cyclophosphamide, 6, 62 D Databases, Bibliographic, 35, 62 Degenerative, 62, 66 Dehydroepiandrosterone, 4, 62 Dentists, 4, 62 Diabetes Insipidus, 62, 67

Diagnostic procedure, 25, 62 Diaphragm, 9, 18, 20, 62 Diarrhea, 56, 62, 63 Digestion, 57, 58, 63, 68, 76 Digestive system, 15, 63 Direct, iii, 27, 60, 63, 74 Discrimination, 5, 63 Diuresis, 58, 63 Diuretic, 63, 67 Dopamine, 60, 63 Doxycycline, 40, 63 Drug Interactions, 28, 63 Duct, 56, 63, 64, 66, 74 Duodenum, 57, 63, 64, 72, 76 Dyes, 42, 63 Dyspareunia, 63, 64 Dyspnea, 11, 63 E Edema, 63, 67, 78 Electrolytes, 57, 63, 67 Endocrine System, 63 Endocrinology, 7, 63 Endometrium, 63, 69 Endopeptidases, 63, 73 Endoscope, 64 Endoscopic, 43, 64 Endoscopic retrograde cholangiopancreatography, 43, 64 Environmental Health, 34, 36, 64 Enzyme, 60, 64, 73, 74 Epidermal, 64, 69, 79 Epidermis, 64, 67 Erectile, 64, 72 Erythromycin, 40, 57, 64 Erythromycin Ethylsuccinate, 40, 64 Erythropoietin, 4, 64 Esophagus, 63, 64, 76 Estrogen, 6, 14, 19, 43, 64 Estrogen Replacement Therapy, 19, 64 Exogenous, 6, 64 F Facial, 60, 64 Fallopian Tubes, 40, 65, 74, 78 Family Planning, 5, 18, 19, 35, 65 Fat, 24, 43, 58, 61, 65, 66, 68, 71 Femoral, 8, 65 Femur, 65 Fetus, 64, 65, 72, 76, 78 Fibrosis, 6, 65 Finasteride, 41, 65 Flagellum, 65, 78 Forearm, 58, 65

Index 83

Friction, 65, 69 Fungi, 56, 65, 78, 79 Fungus, 41, 65 G Gallbladder, 43, 55, 57, 60, 63, 64, 65 Gallstones, 42, 43, 65 Gas, 65, 71, 78 Gastric, 57, 59, 65 Gastrin, 65, 67 Gene, 19, 58, 65, 67 Genital, 41, 65, 78 Gland, 55, 65, 69, 71, 73, 75, 77 Glucocorticoids, 19, 55, 66 Gluconeogenesis, 66 Glucose, 19, 20, 58, 59, 60, 66, 74 Glycogen, 60, 66 Gonadal, 66, 76 Gonorrhea, 41, 66 Governing Board, 66, 73 Gram-negative, 60, 66, 71 Gram-positive, 66, 70, 71 Gravidity, 66, 72 Growth, 4, 41, 56, 57, 66, 67, 72, 77 H Habitat, 66, 70 Headache, 54, 58, 66, 73 Health Status, 20, 66 Heart attack, 19, 59, 66 Hemorrhage, 66, 76 Hepatic, 64, 66 Hepatic Duct, Common, 64, 66 Hepatitis, 41, 66, 79 Hepatocytes, 66, 67 Hereditary, 41, 67 Heredity, 65, 67 Herpes, 41, 67 Herpes Zoster, 67 Hormonal, 6, 42, 64, 67 Hormone, 20, 40, 42, 43, 62, 64, 65, 67, 73, 77 Hormone Replacement Therapy, 40, 42, 43, 67 Human growth hormone, 4, 67 Hydrochlorothiazide, 19, 67 Hyperaemia, 61, 67 Hyperbilirubinemia, 67, 68 Hyperpigmentation, 41, 60, 67 Hyperplasia, 65, 67 Hypertension, 59, 61, 66, 67, 78 I Id, 43, 50, 52, 67 Immune response, 56, 67, 76, 79

Immune system, 42, 67, 79 Immunodeficiency, 36, 41, 67 Immunodeficiency syndrome, 36, 67 Immunosuppressive, 62, 67 Impairment, 68, 69 Impotence, 20, 64, 68 Indicative, 4, 18, 68, 78 Infant, Newborn, 55, 68 Infarction, 62, 68, 70 Infection, 40, 41, 57, 62, 67, 68, 69, 72, 76, 77, 79 Inflammation, 4, 57, 61, 65, 66, 67, 68, 69, 72, 76, 77, 78 Inorganic, 68, 70 Insomnia, 68, 73 Internal Medicine, 63, 68 Intoxication, 68, 79 Intracellular, 59, 68, 73 J Jaundice, 43, 67, 68 Joint, 68, 76 K Kb, 34, 68 L Large Intestine, 63, 68, 74, 75 Lens, 9, 68 Library Services, 50, 68 Ligation, 68 Lipid, 6, 60, 68 Liver, 6, 43, 55, 57, 59, 60, 62, 63, 64, 65, 66, 67, 68 Lobe, 67, 68 Localized, 68, 69, 70, 72 Lubricants, 41, 69 Lubrication, 20, 69 Lumbar, 8, 69 Lupus, 6, 13, 14, 69, 76 Luteal Phase, 6, 69 Lymph, 60, 69 Lymph node, 60, 69 Lymphadenitis, 69, 70 Lymphatic, 68, 69 Lymphoid, 56, 62, 69 M Mannans, 65, 69 Marital Status, 36, 69 Medical Records, 69, 74 MEDLINE, 35, 69 Medullary, 56, 69 Melanin, 41, 69 Melanocytes, 67, 69 Membrane, 61, 66, 69, 70, 72, 74, 78

84

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Menopause, 6, 8, 20, 42, 69, 73 Menstrual Cycle, 6, 11, 13, 18, 20, 69, 73 Menstruation, 20, 55, 69, 73 Mental Disorders, 15, 69 MI, 54, 70 Miscarriage, 40, 70 Modification, 3, 70 Molecular, 35, 37, 58, 61, 70 Morphological, 65, 69, 70 Motion Sickness, 70 Motor nerve, 70 Mucosa, 69, 70 Mucus, 40, 70 Muscle relaxant, 3, 70 Muscle tension, 70 Mycobacteriosis, 70 Mycobacterium, 42, 57, 70, 78 Mycobacterium avium, 42, 57, 70 Mycobacterium avium Complex, 42, 70 Myocardium, 70 N Nausea, 43, 54, 56, 70, 73, 78 NCI, 1, 14, 33, 70 Necrosis, 68, 70, 71 Need, 3, 17, 19, 20, 36, 44, 55, 66, 71 Neonatal, 40, 71 Neurons, 60, 70, 71 Niacin, 19, 71 Nitrogen, 55, 62, 71 O Ofloxacin, 40, 71 Ophthalmologic, 11, 71 Ophthalmology, 71 Orgasm, 20, 71 Osteoporosis, 6, 64, 71 Ovaries, 65, 71, 74, 75, 78 Overdose, 53, 71 Overweight, 43, 71 Ovulation, 69, 71 Ovum, 62, 71, 73, 79 Oxidation, 57, 71 P Palliative, 71, 77 Pancreas, 55, 63, 71, 72 Pancreatic, 59, 64, 71, 72 Pancreatic Ducts, 64, 72 Pancreatitis, 8, 72 Papilla, 64, 72 Parasitic, 62, 72, 78 Parity, 8, 72 Patient Education, 40, 43, 48, 50, 54, 72 Pelvic, 40, 72, 73

Pelvic inflammatory disease, 40, 72 Penicillin, 9, 56, 72 Penis, 40, 61, 72, 74 Peptide, 63, 72, 73 Pericardium, 72, 76 Pharmacologic, 4, 56, 72, 77 Phospholipids, 65, 72 Physiologic, 58, 69, 72 Physiology, 4, 63, 72 Pigmentation, 67, 72 Placenta, 72, 73 Plants, 55, 60, 66, 72, 74, 77 Plasma, 56, 73 Plasma cells, 56, 73 Poisoning, 68, 70, 73 Posterior, 56, 71, 73 Postmenopausal, 64, 71, 73 Potassium, 63, 67, 73 Practice Guidelines, 37, 73 Precursor, 60, 62, 63, 73 Premenstrual, 10, 20, 73 Premenstrual Syndrome, 20, 73 Progesterone, 6, 73, 76 Progressive, 64, 66, 71, 73 Prostate, 73, 74 Protease, 19, 60, 73 Protease Inhibitors, 19, 73 Protein S, 19, 58, 64, 67, 73, 77 Proteins, 55, 56, 64, 71, 72, 73, 74, 77, 78 Psychomotor, 59, 74 Puberty, 6, 74 Public Policy, 35, 74 Pulmonary, 6, 58, 61, 70, 74 Pulmonary Artery, 58, 74 R Radiology, 11, 74 Reabsorption, 67, 74 Rectum, 57, 58, 63, 65, 68, 73, 74 Reductase, 65, 74 Refer, 1, 58, 60, 65, 67, 69, 74 Refraction, 74, 75 Regimen, 40, 74 Relaxant, 74 Reproductive system, 20, 74 Retina, 68, 74 Retrograde, 74 Retrospective, 6, 74 Retrospective study, 6, 74 S Safe Sex, 20, 74 Salivary, 63, 74 Salivary glands, 63, 74

Index 85

Saponins, 74, 76 Schizoid, 74, 79 Schizophrenia, 75, 79 Schizotypal Personality Disorder, 75, 79 Screening, 60, 75 Secretion, 66, 70, 75 Seizures, 59, 75 Senile, 71, 75 Sex Characteristics, 74, 75, 77 Sexual Abstinence, 36, 75 Sexually Transmitted Diseases, 21, 41, 74, 75 Side effect, 4, 11, 21, 27, 55, 62, 75, 77 Signs and Symptoms, 4, 75, 78 Small intestine, 57, 63, 64, 67, 75 Smooth muscle, 56, 58, 75, 76 Sodium, 63, 67, 74, 75 Specialist, 44, 75 Species, 60, 62, 63, 70, 72, 75, 78 Spectrum, 42, 75 Sperm, 36, 76 Spirochete, 76 Stem Cells, 64, 76 Sterility, 12, 40, 62, 76 Sterilization, 20, 76 Steroid, 6, 74, 76 Stillbirth, 40, 76 Stimulant, 58, 76 Stomach, 43, 55, 57, 63, 64, 65, 67, 70, 75, 76 Stress, 42, 70, 76 Stroke, 15, 34, 59, 76 Subacute, 68, 76 Subclinical, 68, 75, 76 Substance P, 64, 75, 76 Suppression, 11, 76 Symptomatic, 56, 72, 76 Symptomatic treatment, 56, 76 Syphilis, 41, 76 Systemic, 6, 13, 14, 28, 58, 68, 76 Systemic lupus erythematosus, 6, 14, 76 T Testosterone, 65, 74, 77 Tetracycline, 63, 77 Therapeutics, 28, 77 Thigh, 65, 77 Thoracic, 62, 77, 79 Thorax, 55, 69, 77 Thrombophlebitis, 7, 77 Thrombosis, 73, 76, 77 Thrombus, 62, 68, 77, 78 Thyroid, 41, 77

Tissue, 56, 57, 58, 61, 62, 63, 65, 67, 69, 70, 71, 72, 74, 75, 76, 77 Topical, 42, 77 Toxic, iv, 62, 77 Toxicity, 63, 77 Toxicology, 36, 77 Toxins, 56, 68, 77 Toxoplasmosis, 57, 77 Trace element, 58, 60, 77 Trachea, 77 Transfection, 58, 77 Translation, 64, 77 Translocation, 64, 77 Transplantation, 41, 77 Trauma, 66, 71, 72, 78 Trichomonas, 41, 78 Trigger zone, 56, 78 Tubal ligation, 18, 78 Tuberculosis, 69, 70, 78 U Unconscious, 67, 78 Uraemia, 72, 78 Urethra, 40, 72, 73, 78 Urine, 40, 53, 58, 62, 63, 78 Urogenital, 66, 78 Uterus, 60, 62, 63, 65, 69, 71, 73, 74, 78 V Vaccines, 78, 79 Vagina, 60, 69, 74, 78 Vaginal, 18, 20, 40, 54, 69, 78 Vascular, 68, 72, 77, 78 Vasculitis, 72, 78 Vasomotor, 64, 78 VE, 8, 78 Vein, 77, 78 Venereal, 76, 78 Venous, 10, 73, 78 Venous Thrombosis, 10, 78 Veterinary Medicine, 35, 78 Viral, 11, 78, 79 Viral Hepatitis, 11, 79 Virus, 5, 36, 41, 78, 79 W Warts, 41, 79 Watchful waiting, 43, 79 White blood cell, 56, 69, 70, 73, 79 Windpipe, 77, 79 Withdrawal, 12, 18, 79 Womb, 74, 78, 79 X X-ray, 64, 74, 79

86

Y

Birth Control Pills

Yeasts, 65, 79

Index 87

88

Birth Control Pills

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