Blood Tests - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

LOOD ESTS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. ...

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LOOD ESTS 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., 1960Blood Tests: 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: 0-597-83795-3 1. Blood Tests-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 blood tests. 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 BLOOD TESTS ............................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Blood Tests .................................................................................. 15 E-Journals: PubMed Central ....................................................................................................... 28 The National Library of Medicine: PubMed ................................................................................ 29 CHAPTER 2. NUTRITION AND BLOOD TESTS .................................................................................. 57 Overview...................................................................................................................................... 57 Finding Nutrition Studies on Blood Tests................................................................................... 57 Federal Resources on Nutrition ................................................................................................... 58 Additional Web Resources ........................................................................................................... 58 CHAPTER 3. DISSERTATIONS ON BLOOD TESTS .............................................................................. 61 Overview...................................................................................................................................... 61 Dissertations on Blood Tests........................................................................................................ 61 Keeping Current .......................................................................................................................... 61 CHAPTER 4. PATENTS ON BLOOD TESTS ......................................................................................... 63 Overview...................................................................................................................................... 63 Patents on Blood Tests ................................................................................................................. 63 Patent Applications on Blood Tests ............................................................................................. 78 Keeping Current .......................................................................................................................... 85 CHAPTER 5. BOOKS ON BLOOD TESTS ............................................................................................ 87 Overview...................................................................................................................................... 87 Book Summaries: Federal Agencies.............................................................................................. 87 Book Summaries: Online Booksellers........................................................................................... 91 Chapters on Blood Tests............................................................................................................... 93 CHAPTER 6. MULTIMEDIA ON BLOOD TESTS .................................................................................. 95 Overview...................................................................................................................................... 95 Video Recordings ......................................................................................................................... 95 Audio Recordings......................................................................................................................... 97 Bibliography: Multimedia on Blood Tests.................................................................................... 98 CHAPTER 7. PERIODICALS AND NEWS ON BLOOD TESTS ............................................................... 99 Overview...................................................................................................................................... 99 News Services and Press Releases................................................................................................ 99 Newsletter Articles .................................................................................................................... 101 Academic Periodicals covering Blood Tests ............................................................................... 103 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 105 Overview.................................................................................................................................... 105 U.S. Pharmacopeia..................................................................................................................... 105 Commercial Databases ............................................................................................................... 107 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 111 Overview.................................................................................................................................... 111 NIH Guidelines.......................................................................................................................... 111 NIH Databases........................................................................................................................... 113 Other Commercial Databases..................................................................................................... 119 APPENDIX B. PATIENT RESOURCES ............................................................................................... 121 Overview.................................................................................................................................... 121 Patient Guideline Sources.......................................................................................................... 121 Finding Associations.................................................................................................................. 128 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 131 Overview.................................................................................................................................... 131

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Preparation................................................................................................................................. 131 Finding a Local Medical Library................................................................................................ 131 Medical Libraries in the U.S. and Canada ................................................................................. 131 ONLINE GLOSSARIES................................................................................................................ 137 Online Dictionary Directories ................................................................................................... 137 BLOOD TESTS DICTIONARY................................................................................................... 139 INDEX .............................................................................................................................................. 203

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with blood tests 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 blood tests, 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 blood tests, 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 blood tests. 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 blood tests, 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 blood tests. 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 BLOOD TESTS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on blood tests.

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

Understanding Pancreatitis and Pancreatic Cancer Source: Digestive Health and Nutrition. 3(3): 17-20. May-June 2001. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: Acute pancreatitis (inflammation of the pancreas) can happen to anyone, anytime. However, repeated episodes put the patient at risk for chronic pancreatitis and pancreatic cancer, so it is important to learn about the risk factors and symptoms of these diseases. This article reviews the presenting symptoms of pancreatitis, the anatomy and physiology of the healthy pancreas, treatment options, and the risk factors for pancreatic cancer. The most common cause of acute pancreatitis is gallstones that get

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caught at the opening into the small intestine. Excessive alcohol use is another common cause of the disease. Diagnosis can include blood tests, an abdominal CT (computed tomography) scan, and endoscopic ultrasound. Treatment for acute pancreatitis is usually relatively low tech, featuring hydration (adequate fluids), pain management, and nutrition support (intravenous). During an episode of acute pancreatitis, which can last days or even a week, patients usually do not eat any food at all initially. Clear liquids and then low fat foods are added gradually as symptoms improve. When gallstones cause pancreatitis, surgery to remove them is usually necessary. For those who already have chronic pancreatitis or are at risk for developing it, a healthy lifestyle and positive attitude are essential. Many people with pancreatitis find that a low fat diet helps reduce the severity of acute episodes and also slows the progression of the chronic disease. One sidebar offers a description of hereditary pancreatitis, which is a rare condition. The final section of the article discusses pancreatic cancer, noting that both chronic and hereditary pancreatitis put people at higher risk for developing pancreatic cancer. Appended to the article is a list of websites for readers who want to locate additional information about pancreatitis. 2 figures. •

Gastrointestinal Safety and Tolerance of Ibuprofen at Maximum Over-the-Counter Dose Source: Alimentary Pharmacology and Therapeutics. 13(7): 897-906. July 1999. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Determining nonsteroidal antiinflammatory drug (NSAID) gastrointestinal toxicity has largely depended on retrospective epidemiologic studies that demonstrate that lower doses of NSAIDs pose a lower risk of gastrointestinal toxicity. Ibuprofen, a proprionic acid NSAID has, in most such studies, exhibited a favorable profile in terms of gastrointestinal bleeding. This article reports on a study that prospectively evaluated the gastrointestinal tolerability, as compared to placebo, of the maximum nonprescription dose and duration of ibuprofen use in healthy subjects representative of a nonprescription analgesic user population. Gastrointestinal adverse experiences were similar in the placebo and ibuprofen groups (67 out of 413 patients, 16 percent with placebo versus 161 out of 833 patients, 19 percent with ibuprofen). There was no difference between the two groups in the proportion discontinuing due to a gastrointestinal event. Gastrointestinal adverse experiences reported by more than 1 percent of subjects were dyspepsia (heartburn), abdominal pain, nausea, diarrhea, flatulence (gas), and constipation. Seventeen (1.4 percent) subjects had positive occult blood tests; their frequency was comparable between treatments. The authors conclude that, when used as directed to treat episodic pain, nonprescription ibuprofen at the maximum dose (1200 mg per day for 10 days) is well tolerated. 4 tables. 22 references.

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Post-Treatment Diagnostic Accuracy of a New Enzyme Immunoassay to Detect Helicobacter Pylori in Stools Source: Alimentary Pharmacology and Therapeutics. 15(3): 395-401. March 2001. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Helicobacter pylori has attracted increasing attention among gastroenterologists because of its pathogenic (disease causing) potential, stimulating the

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search for non invasive diagnostic tests. This article reports on a study undertaken to evaluate the efficacy of a new enzyme immunoassay designed to detect H. pylori antigens in stools (HpSA), before and after eradication therapy. HpSA was performed on stool samples collected from 268 patients whose H. pylori status was defined on the basis of concordant results for the 13C urea breath test, rapid urease test, and histology. The H. pylori positive patients were treated with a 1 week triple therapy to eradicate the infection. One (T30) and 3 months (T90) after the end of therapy. 13C urea breath tests and HpSA were repeated in the treated patients. The overall diagnostic accuracy of HpSA at T30 (83 percent) was significantly lower in comparison to the values obtained at baseline (94 percent) and at T90 (97 percent). No significant difference was found between the diagnostic accuracy of HpSA at baseline and at T90. The authors conclude that these data suggest HpSA provides a low diagnostic accuracy when used shortly after treatment. It needs a longer period of followup (8 to 12 weeks) to reach a reliability comparable to the 13C urea breath test. In regards to the issue of cost effectiveness, the kit and technical support for the HpSA is approximately $27 per test; this cost is higher than serology (blood tests), which cannot be reliably used in the post treatment phase, but lower than the 13C urea breath test, at approximately $50. The authors believe that HpSA can be reasonably included among non invasive tests as an accurate and cost effective alternative to the 13C urea breath test for the pretreatment diagnosis of H. pylori infection; for the assessment of eradication, it can be highly reliable, provided that it is performed 3 months after the end of treatment. 5 figures. 25 references. •

Noninvasive Monitoring of Patients with Chronic Hepatitis C Source: Hepatology. 36(5 Supplemental 1): S57-S64. November 2002. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 19106-3399. (800) 654-2452 or (407) 345-4000. Summary: Hepatic (liver) fibrosis is the main determinant of clinical outcomes of chronic hepatitis C. Liver biopsy is frequently considered the gold standard for assessing hepatic fibrosis. However, liver biopsy is associated with sampling error, interobserver variability, and potential complications. This article considers the options for noninvasive monitoring of and assessing disease severity in patients with chronic hepatitis C. Clinical examination is unreliable in differentiating different stages of compensated liver disease. Among the routine laboratory tests, decreased platelet count, increase in the ratio of aspartate to alanine aminotransferase (AST ALT), and prolonged prothrombin time are the earliest indicators of cirrhosis and portal hypertension. Individual serum fibrosis markers (blood tests) have limited accuracy in predicting hepatic fibrosis. Indices composed of a panel of markers correlate better with histological fibrosis, but their reliability requires further validation. Currently, noninvasive monitoring of patients with chronic hepatitis C relies on clinical evaluation, routine laboratory tests, and ultrasound and endoscopic surveillance in patients with cirrhosis. Initial evaluation should focus on assessment of activity and stage of liver disease for prognosis and decisions regarding treatment, and to rule out coinfections and other causes of liver disease. Subsequent follow up should focus on detection of liver disease progression and the need for treatment. The frequency of monitoring and the tests used will depend on the patient's age, stage of liver disease, and comorbid conditions. The authors conclude that there is an urgent need to develop and validate noninvasive tests that can accurately reflect the full spectrum of hepatic inflammation and fibrosis in chronic hepatitis C. 5 tables. 37 references.

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Hemorrhoids and More: Common Causes of Blood in the Stool Source: Digestive Health and Nutrition. 3(4): 24-26. July-August 2001. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: Most rectal bleeding is caused by hemorrhoids, which usually can be simply and effectively treated. This article reviews the many other conditions, including some serious disorders, that can cause blood in the stool. The author reminds readers that bleeding from any part of the nearly 40 foot long digestive tract can cause blood in the stool. Accurate and timely diagnostic tests are important to determine the cause of any bleeding. Bleeding higher up in the gut, from the esophagus or stomach, can result in stools with a black, tarry appearance. Bleeding from the lower end, such as the colon, or in large amounts, can appear as pure blood, blood clots, or as blood mixed with or streaking the stool. Another kind of blood, occult or hidden blood, may not be visible at all. A number of prescription and over the counter (OTC) medications can cause bleeding in the stomach and small intestine. The blood thinning drug warfarin also can induce bleeding in the intestine, as can some antibiotics. Other causes of bleeding can include ulcers, gastritis (inflammation of the stomach lining), ulcerative colitis, Crohn's disease, polyps (small growths inside the intestine), diverticular disease, abnormalities in the blood vessels (vascular anomalies), anal fissures (tears) and fistulas (abnormal openings between the anal canal and other organs, such as the bladder), and abscesses (pockets of infection. The author reiterates the importance of timely diagnosis, including a thorough patient history and evaluation of symptoms. Diagnostic tests can include blood tests, digital rectal examination, endoscopy, colonoscopy, sigmoidoscopy, fecal occult blood test, barium x rays, angiography (x rays of blood vessels), and nuclear scanning. Treatment depends on the source and extent of the bleeding.

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Effect of HFE Genotypes on Measurements of Iron Overload in Patients Attending a Health Appraisal Clinic Source: Annals of Internal Medicine. 133(5): 329-337. September 5, 2000. Contact: Available from American College of Physicians. American Society of Internal Medicine. 190 North Independence Mall West, Philadelphia, PA 19106-1572. Website: www.acponline.org. Summary: The gene that causes most cases of hereditary hemochromatosis (HH, an inherited propensity to absorb excess iron) is designated HFE. Three mutations exist at this locus at a relatively high gene frequency. This article reports on a study undertaken to determine the gene frequency of the three HFE mutations and to relate genotypes to various clinical and laboratory variables. The observational study included 10,198 adults who registered for health appraisal and consented to DNA examination for hemochromatosis. Consenting patients were slightly older and had attained a slightly higher educational level than nonconsenting patients. In white participants, the gene frequencies were 0.063 for the C282Y mutation, 0.152 for the H63D mutation, and 0.016 for the S65C mutation. Gene frequencies were lower in other ethnic groups. In participants with HFE mutations, blood tests showed that the average serum transferrin saturation and ferritin levels were slightly increased, as were mean hemoglobin levels and mean corpuscular volume. The prevalence of iron deficiency anemia was lower in women who carried HFE mutations. The authors conclude that screening for transferrin saturation and ferritin levels does not detect all homozygotes for the major hemochromatosis mutation. The authors briefly discuss the ongoing question of

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determining which screening practices are most practical and effective for identifying HH. 1 figure. 6 tables. 33 references. •

Progressive Sensorineural Hearing Loss, Subjective Tinnitus and Vertigo Caused By Elevated Blood Lipids Source: ENT. Ear, Nose, and Throat Journal. 76(10): 716-730. October 1997. Summary: The otologist frequently sees patients with progressive sensorineural hearing loss, subjective aural tinnitus, and vertigo with no apparent cause. Elevated blood lipids may be a cause of inner ear malfunction on a biochemical basis. This article reports on a study undertaken to establish the true incidence of this condition. All new patients (n = 4,251) seen during an eight-year period were evaluated; of these, 2,332 patients had complaints of inner ear disease. All the patients had a complete neurotologic examination, appropriate audiometric and vestibular studies and imaging, and blood tests including lipid phenotype studies. Hyperlipoproteinemia was found in 120 patients (5.1 percent). Most patients were found to be overweight and had additional coexisting conditions such as diabetes mellitus. Treatment with vasodilators and a 500 calorie, high-protein, low-carbohydrate diet yielded improvement of symptoms in 83 percent of patients within five months of initiation of treatment. The authors include three detailed case studies. The authors conclude that the cause-and-effect relationship between hyperlipoproteinemia and dysfunction of the inner ear is indisputable. 6 figures. 14 references. (AA-M).

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Review Article: Invasive and Non-Invasive Tests for Helicobacter Pylori Infection Source: Alimentary Pharmacology and Therapeutics. 14(Supplement 3): 13-22. October 2000. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: There are two general ways in which a diagnosis of infection by Helicobacter pylori can be made: by using either an invasive or a noninvasive procedure. This article reviews the current thinking on the use of these tests. The invasive procedures involve an endoscopy and biopsy. A biopsy is essential because often the mucosa may appear macroscopically normal but nevertheless be inflamed. A biopsy is obtained by histological examination, culture, polymerase chain reaction (PCR), or detection of the presence of urease activity in biopsy material. The noninvasive tests that can be used to diagnose the infection are serology (blood tests); detection of labeled metabolic products of urea hydrolysis in the breath, the urine, or the blood; and detection of H. pylori antigen in a stool specimen. The authors conclude that at present, no single test can be relied upon to detect definitely colonization by H. pylori, and a combination of two is recommended if this is feasible. The choice of the test to be used is not straightforward and may vary according to the clinical condition and local expertise. 8 tables. 95 references.

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Inside the Billion - Dollar Business of Blood Source: Money; March 1986. Contact: Time, Incorporated, Time and Life Bldg, Rockefeller Ctr, New York, NY, 10020, (212) 522-3082.

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Summary: This article examines the blood bank industry's initial response to the AIDS crisis in the early 1980's. Following a trail of events, meetings, and documentations of transfusion-associated AIDS cases, the author concludes that the blood bankers acted too slowly in alerting the public about contamination of the blood supply with the AIDS virus and in responding to protect the safety of that supply. She charges that the not-forprofit blood centers mishandled the AIDS crisis in the beginning by: 1) refusing initially to accept evidence that the AIDS virus could be transmitted by transfusion; 2) delaying the implementation of active screening procedures designed to discourage blood donations from people at high risk for AIDS; 3) resisting the use of surrogate blood tests that could be used as stopgap measures to reduce risk until a more specific AIDS screening test became available; and 4) making exaggerated claims about the antibody test's ability to identify AIDS-contaminated blood. The author traces the history and growth of the blood business, particularly the American Red Cross, focusing on the profit margins and competitive nature of the industry. •

Protect Your Liver from Potentially Harmful Medications, Vitamins and Supplements Source: Digestive Health and Nutrition. 3(5): 27-29. September-October 2001. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This article helps readers protect their livers from potentially harmful medications, vitamins and supplements. Written particularly for people with chronic liver diseases, such as viral hepatitis, cirrhosis (liver scarring), or other liver diseases, the article reviews how the liver works and why it is vulnerable to drug complications. Many seemingly innocuous products can cause significant injury if the liver is not able to properly process them. For example, liver patients and people with alcohol abuse can only tolerate the common medication, acetaminophen (Tylenol) at lower doses. And while acetaminophen can be tolerated in small doses in liver patients, ibuprofen products (Advil, Motrin) as well as other nonsteroidal antiinflammatory drugs (NSAIDs) should be avoided by those with hepatitis and cirrhosis. Some herbal supplements and vitamins also can damage the liver if taken in higher than recommended amounts or if there is an existing liver disease. When potentially hepatotoxic (liver damaging) medications are required to treat a patient's disease, the patient should consult with their physician about performing regular blood tests to monitor liver enzyme levels. One sidebar lists products containing acetaminophen and NSAIDs. The article concludes with a list of five websites for readers who wish to obtain more information. 1 table.

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Bacterial Osteomyelitis in Adults: Evolving Considerations in Diagnosis and Treatment Source: American Journal of Medicine. 101:550-561. November 1996. Summary: This article presents pathophysiologic and clinical aspects of an adult patient with bacterial osteomyelitis and considerations for its diagnosis and treatment. Diagnostic methods to be considered include radiologic evaluation, nonspecific blood tests, and establishing a microbiologic diagnosis. Also explored are the selection of the optimal antimicrobial regimen, monitoring the adequacy of therapy, and the use of hyperbaric oxygen therapy. The authors indicate that the approach to osteomyelitis depends upon the route by which bacteria gained access to bone, bacterial virulence, local and systemic host immune factors, and patient age. While imaging studies and

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nonspecific blood tests may suggest the diagnosis, an invasive technique is generally required to identify the causative pathogens. Given the paucity of comparative clinical trials, antibacterial regimen selection has been largely guided by knowledge of the relative activities and pharmacokinetics of individual drugs which are supported by data from animal models. Definitive therapy often requires a combined medical and surgical approach. Currently, there are newer microvascular and distraction osteogenesis techniques, including use of laser doppler, that allow more complete surgical resection of infected material while maintaining function. Despite recent advances, many patients with osteomyelitis fail aggressive medical and surgical therapy. More accurate diagnostic methods, better was to assess and monitor the effectiveness of therapy, and novel approaches to eradicate sequestered bacteria are still needed. 4 tables, and 117 references. (AA-M). •

Helicobacter Pylori Testing in the Primary Care Setting: Which Diagnostic Test Should be Used? Source: Alimentary Pharmacology and Therapeutics. 15(8): 1205-1210. August 2001. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: This article reports on a study undertaken to identify the most accurate and efficient test for diagnosing Helicobacter pylori infection in primary care patients. A whole blood test, an ELISA, and carbon 13 urea breath test (CUBT) were evaluated in a primary care setting and validated against two different gold standards that used gastric (stomach) biopsies. The study included primary care patients who had complaints of dyspepsia lasting at least 2 weeks (n = 136) and who were referred for endoscopy. Data from these patients were compared with data from the gold standards. The positive predictive value of the whole blood test was in the range 71 to 75 percent, the ELISA 83 to 86 percent, and the CUBT 88 to 92 percent, while the negative predictive values were in the ranges 72 to 77 percent, 96 to 100 percent, and 95 to 98 percent, respectively. The sensitivity of the whole blood test was in the range 36 to 42 percent, the ELISA 93 to 100 percent, and the CUBT 92 to 97 percent, while the specificities were in the ranges 92 to 93 percent, 90 to 91 percent, and 93 to 95 percent, respectively. The positive predictive value of the ELISA dropped significantly at lower H. pylori infection rates. The authors conclude that both the ELISA and CUBT are effective in the primary care setting, while the whole blood tests produces inferior results. ELISA might, however, be less suitable for detecting H. pylori infection in a population with a low rate of infection. 1 figure. 3 tables. 24 references.

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Stepwise Approach to the Diagnosis and Treatment of Hereditary Hearing Loss Source: Pediatric Clinics of North America. 46(1): 35-48. February 1999. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This article, from a monograph on hearing loss in children, suggests a stepwise approach to the diagnosis and treatment of hereditary hearing loss. The authors stress that the pediatrician can play a major role in the diagnosis, workup, and treatment of hereditary hearing impairment. Armed with the proper degree of suspicion, careful elicitation of family history, meticulous physical examination, evaluation of the audiogram, and adequate fund of knowledge of common types of genetic deafness, the pediatrician can make a timely diagnosis and appropriate referrals.

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This avoids delay in detection of significant hearing impairment and the associated lack of essential skills in speech, language, and social interaction. Early detection and intervention are best done with a multidisciplinary team approach. In the future, blood tests using genetic probes may be available to screen for many types of hereditary hearing impairment. The article also describes the work of the Hereditary Hearing Impairment Resource Registry (HHIRR), a registry that collects information about individuals with hearing impairment or deafness, matches families with appropriate research projects, and disseminates information to professionals and families about hereditary hearing impairment. An appendix lists helpful sources for additional information. 1 table. 25 references. •

New Safety Recommendations for Use of Cisapride (Propulsid) Source: Harvard Heart Letter. 10(8): 7. April 2000. Contact: Available from Harvard Medical School Health Publications Group. Harvard Heart Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail: [email protected]. Website: www.health.harvard.edu. Summary: This brief newsletter article, from the Harvard Heart Letter, reminds readers of the new safety recommendations for the use of cisapride (Propulsid). Cisapride is used to treat severe nighttime heartburn, usually caused by gastroesophageal reflux disease (GERD), a condition where the band of muscle that prevents stomach acid from leaking back into the esophagus relaxes spontaneously, creating a painful heartburn like sensation. Cisapride works by moving gastric acids through the digestive tract, thereby preventing their painful reflux into the esophagus. Because this drug has some risks, it is generally reserved for patients who have not responded well to lifestyle changes or other medications used to manage GERD. Serious adverse reactions occurring in patients on cisapride have included heart rhythm disorders and death (most often occurring in people with certain health problems or who were taking other medications). Although it could not find a direct link between the reported problems and cisapride, the U.S. Food and Drug Administration (FDA) did strengthen the precautions on using this drug. In January 2000, the FDA bolstered its efforts to reduce the likelihood of complications from cisapride by recommending that physicians consider performing an electrocardiogram and certain blood tests before prescribing it. The article lists the drugs that should not be combined with cisapride, as well as the complicating medical conditions that contraindicate its use.

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Liver Disease: Fat Inflames the Liver Source: Harvard Health Letter. 26(4): 4. February 2001. Contact: Harvard Health Letter. P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 8299045. Website: www.health.harvard.edu/newsletters/subinfo.html. Summary: This health education newsletter article describes nonalcoholic steatohepatitis (NASH), a common form of chronic liver disease in which the liver has excess fat cells and those cells cause inflammation. The author contends that NASH is another result of the epidemics of obesity and diabetes sweeping the United States. NASH is found most often in people who are 10 to 40 percent of their ideal body weight, or have diabetes, or both. At the cellular level, the changes produced by NASH resemble the liver tissue inflammation caused by alcohol. For up to 20 percent of people with NASH, the condition is the beginning of a dangerous cycle that leads to fibrosis (a buildup of fibrous tissue in the liver) and that can lead to life threatening cirrhosis (scarring of the liver). Most people with NASH have no symptoms, or vague symptoms, such as fatigue,

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an achy feeling on the right side of the abdomen, and malaise (generally feeling bad). Liver function tests (blood tests) can show the first signs of trouble, but a liver biopsy must be used to confirm the diagnosis of NASH. Treatment involves weight loss, close monitoring of blood glucose levels in patients with diabetes, and cessation of alcohol consumption. Present research studies are investigating the role of vitamin E and ursodeoxycholic acid as possible drug therapies for NASH. •

15-Year Longitudinal Study of Blood Pressure and Dementia Source: Lancet. 347: 1141-1145. April 27, 1996. Summary: This journal article describes a 15-year study of the association between blood pressure and the development of dementia in older people. Residents of Goteborg, Sweden, who were 70 years in 1970-1972 participated in this study. A random subsample of 382 residents who did not have dementia on psychiatric evaluation at age 70 years were followed for 15 years with repeated neuropsychiatric examination and physical examination, electrocardiogram, chest radiograph, and blood tests. The results suggest that participants who developed dementia at age 79-85 years had significantly higher systolic blood pressure at age 70 years and significantly higher diastolic blood pressure at ages 70 and 75 years than did those who did not develop dementia. A significant association was found between higher diastolic blood pressure at age 70 years and subsequent development of Alzheimer's disease, and between higher diastolic blood pressure at age 75 years and subsequent development of vascular dementia. Participants with white matter lesions on computed tomography at age 85 years had higher blood pressure at age 70 than those without such lesions. In participants who developed dementia, blood pressure declined just before dementia onset and was then similar to or lower than that in participants without dementia. The authors conclude that increased blood pressure at age 70 years may increase the risk of developing dementia 10 to 15 years later. 4 figures, 1 table, 30 references.

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Music Therapy Increases Serum Melatonin Levels in Patients With Alzheimer's Disease Source: Alternative Therapies. 5(6): 49-57. November 1999. Summary: This journal article describes a study of the effects of music therapy on neurotransmitters and neurohormones in patients with Alzheimer's disease (AD). Participants were 20 male patients at the Miami Veterans Administration Medical Center. The researchers took blood tests to determine the concentrations of melatonin, norepinephrine, epinephrine, serotonin, and prolactin in the patients before initiating the therapy, immediately at the end of four weeks of therapy, and at a six week followup after cessation of the therapy sessions. Melatonin concentration increased significantly after therapy and had increased further at the six week follow-up. Norepinephrine and epinephrine levels increased after four weeks of music therapy, but returned to pre-therapy levels at the follow-up. Prolactin and platelet serotonin levels were unchanged. The authors conclude that increased levels of melatonin following the therapy may have contributed to patients' relaxed and calm mood. 2 tables, 86 references.

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Symptomatic Treatment of Elderly Patients With Early Alzheimer's Disease at a Memory Clinic Source: Journal of Geriatric Psychiatry and Neurology. 10: 33-38. 1997.

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Summary: This journal article discusses the treatment of excess disability in patients with early Alzheimer's disease (AD). Researchers conducted a prospective study of 117 patients referred to a Dutch memory clinic in the Netherlands. Ninety-nine patients had minimal or mild dementia, and 18 had moderate dementia. Excess disability, defined as treatable coexisting physical and psychiatric disorders, was assessed by neurologists with the Dutch version of the Cambridge Examination for Mental Disorders of the Elderly, a standardized medical history and physical examination, and measures of cognitive function, impairment in activities of daily living, behavioral changes, and caregiver burden. Seventy-seven forms of excess disability were already diagnosed and treated before referral in 61 of the 117 patients. Further clinical examinations and ancillary tests revealed 48 new diagnoses in 38 AD patients. Overall, 78 patients (66.6 percent of the sample) had a total of 125 conditions comprising excess disability. Of the ancillary tests performed, only the blood tests produced unexpected results with consequences for diagnosis, treatment, or outcome. The authors conclude that patients with AD should receive a careful examination with attention to secondary pathology and noncognitive symptoms; and they recommend doing blood tests in all AD patients. The question of which tests to routinely administer merits further study. 4 tables, 30 references. •

Dementia of the Alzheimer Type: Identification and Management of Neuropsychiatric Features Source: Older Patient. 4(3): 4-8. Fall 1990. Summary: This journal article examines the diagnosis, management, and clinical features of dementia of the Alzheimer type (DAT). In 1989, it was estimated that 4 million cases of DAT existed in the United States. The diagnosis of DAT involves documentation of intellectual decline, physical and laboratory examinations, blood tests, and neuroimaging. DAT has an insidious onset and is progressive, leading to eventual death in 6 to 12 years after onset. Patients with DAT experience memory loss, language and comprehension disturbances, spatial difficulties, mood disturbances, and psychoses. Management of psychoses is primarily pharmacologic, using neuroleptics (haloperidol, thiothixene, and thioridazine) with only a modest amount of benefit and numerous side effects. Nonpharmacologic interventions include gentle reassurance and distraction in an attempt to prevent a confrontation with the patient. The pharmacologic management of depression in DAT is similar to that employed in the nondemented depressed elderly. If a patient is physically violent, the caregiver should remove any potentially dangerous objects and assure his or her own safety. Restlessness, anxiety, and irritability are not always responsive to direct pharmacologic treatment. While the disorder is presently incurable, some of the pathologic behaviors commonly encountered can be manageable if appropriately identified and treated.

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Acute Monoarthritis: A Practical Approach to Assessment and Treatment Source: American Family Physician. 54(7):2239-2243. November 15, 1996. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article for health professionals presents a practical approach to the assessment and treatment of acute monoarthritis. A basic approach to the patient presenting with acute monoarthritis includes a careful history, a physical examination, and a selected battery of laboratory tests and radiographs. Rapid assessment and

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treatment are required because of the possibility of septic joint. The most common causes of acute monoarthritis are trauma, crystals, and infection. The most important cause of acute monoarthritis is infection, which must be excluded through the use of diagnostic joint aspiration and culture of synovial fluid. Other investigations include blood tests and radiographs of the involved joint. General principles of patient care management include joint rest, application of ice, and physiotherapy to help maintain joint range of motion and minimize muscle atrophy. Specific therapy includes antibiotics for bacterial monoarthritis, nonsteroidal anti-inflammatory drugs or intraarticular steroid injections for noninfectious inflammatory monoarthritis, and arthroscopy for internal derangement. Patients suspected of having septic arthritis should be started on empiric antibiotic therapy, pending synovial fluid Gram stain and culture results. 9 references, 1 figure, and 3 tables. (AA-M). •

Arthritis: Types and Diagnosis Source: Women's Health Digest. 2(2):122-125; 1996. Summary: This journal article for the general public and individuals with arthritis describes common rheumatic diseases. Connective tissue diseases include juvenile arthritis, lupus erythematosus, scleroderma, and Sjogren's syndrome. Examples of arthritis associated with spondylitis are ankylosing spondylitis and psoriatic arthritis. Types of infectious arthritis include Lyme disease and Reiter's syndrome. Metabolic diseases associated with rheumatic states are gout and pseudogout. Extra-articular disorders include bursitis and tendinitis. A common condition that may or may not be a specific disease is fibromyalgia. The major warning signs of arthritis are outlined. Techniques commonly used in the diagnosis of arthritis are discussed, focusing on the physical examination; laboratory tests, such as blood tests and joint aspiration; and radiologic studies, such as conventional x-rays, an arthrogram, radionuclide bone scans, computerized axial tomography, magnetic resonance imaging, and arthroscopy. 4 references and 2 figures.

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Osteoarthritis: Current Concepts in Diagnosis and Management Source: American Family Physician. 61(6): 1795-1804. March 15, 2000. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article provides health professionals with information on the pathophysiology, clinical features, diagnosis, and management of osteoarthritis (OA). Cartilage destruction is the main feature of OA. Biomechanical and biochemical forces are involved in cartilage destruction. The typical patient who has OA is middle aged or elderly and complains of pain in the knee, hip, hand, or spine. Pain typically worsens with use of the affected joint and is alleviated with rest. The physical examination should include a careful assessment of the affected joints, surrounding soft tissue, and bursal areas. Although radiographs can usually confirm the diagnosis of OA, the findings are nonspecific. The cardinal radiographic features of OA are a loss of joint space and the presence of new bone formation or osteophytes. Most routine blood tests are normal in patients who have uncomplicated OA. Treatment of OA should be individualized. The safest initial approach is to use a simple oral analgesic such as acetaminophen. If pain relief is inadequate, oral nonsteroidal antiinflammatory drugs or intraarticular injections of hyaluronic acid like products should be considered. Intraarticular corticosteroid injections may provide short term pain relief in disease

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flares. Alleviation of pain does not alter the underlying disease. Attention must also be given to nonpharmacologic measures such as patient education, weight loss, and exercise. Relief of pain and restoration of function can be achieved in some patients with early OA, particularly if an integrated approach is used. Patients with advanced disease may eventually require surgery, which generally provides excellent results. 2 figures, 5 tables, and 39 references. (AA-M). •

Arthritis 101: Sjogren's SyndroMen Source: Arthritis Today. 14(4): 32-33. July-August 2000. Summary: This journal article uses a question and answer format to provide people who have Sjogren's syndrome with information on the etiology, epidemiology, diagnosis, and treatment of this arthritis related disease affecting several organs. Sjogren's syndrome is an autoimmune disease in which lymphocytes attacks moisture producing glands, and, in some cases, the lungs, kidneys, liver, skin, nerves, or joints. Risk factors include being a postmenopausal woman, having an autoimmune disease, and having a family member with Sjogren's. Diagnosis is based on a complete physical examination; medical history evaluation; and various diagnostic tests, including the slit lamp test, the Schirmer test, a lip biopsy, and blood tests to detect antibodies. Although there is no cure for Sjogren's syndrome, it can be treated with medications and other measures to relieve the common symptoms of the condition. The article presents some general treatment modalities as well as treatments for some of the specific symptoms of Sjogren's. 1 figure.

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What Is Alkaline Phosphatase and What Does an Elevated Level Mean to Paget 's Patients? Source: Update. (18)1:4. Spring 1996. Contact: Paget Foundation for Paget 's Disease of 200 Varick Street, Suite 1004. New York, NY 10014-4810. (212) 229-1582 or Fax (212) 229-1502. Price: Free. Summary: This question-and-answer session explains what alkaline phosphatase (AP) is, and its use in diagnosing Paget 's disease ( PD ) and monitoring therapy. It reveals that this naturally produced enzyme in bone cells, once elevated, can point to a diagnosis of PD if blood tests show it is coming from the bone. Once diagnosed, successful treatment should show a drop in AP levels. In some cases, PD can be present (inactive or in small amounts) even when AP levels are normal.

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Role of Liver Biopsy in Management of Chronic Hepatitis C: A Systematic Review Source: Hepatology. 36(5 Supplemental 1): S161-S172. November 2002. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 19106-3399. (800) 654-2452 or (407) 345-4000. Summary: This review article considers two topics pertinent to the need for pretreatment liver biopsy in patients with chronic hepatitis C: how liver biopsy results predict treatment outcomes; and how well biochemical blood tests and serological measures of fibrosis predict biopsy findings in chronic hepatitis C. The authors searched MEDLINE and other electronic databases from January 1985 to March 2002. Additional articles were sought in references of pertinent articles and recent journals and by querying experts. Articles were eligible for review if they reported original human data from a study that used virological, histological, pathologic, or clinical outcome measures. Studies suggested that advanced fibrosis or cirrhosis (scarring) on initial liver

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biopsy is associated with a modestly decreased likelihood of a sustained virological response (SVR) to treatment. Also, studies relatively consistently showed that serum aminotransferases have modest value in predicting fibrosis on biopsy; that extracellular matrix tests hyaluronic acid and laminin may have value in predicting fibrosis; and that panels of tests may have the greatest value in predicting fibrosis or cirrhosis. Biochemical and serologic tests were best at predicting no or minimal fibrosis, or at predicting advanced fibrosis or cirrhosis, and were poor at predicting intermediate levels of fibrosis. Thus, evidence suggests that liver biopsy may have some usefulness in predicting efficacy of treatment in patients with chronic hepatitis C, and biochemical blood tests and serologic tests currently have only modest value in predicting fibrosis on liver biopsy. 2 tables. 81 references. •

AGA Technical Review on Constipation Source: Gastroenterology. 119(6): 1766-1778. December 2000. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 19106-3399. (800) 654-2452 or (407) 345-4000. Summary: This technical review identifies a rational, effective, and cost effective approach to the patient presenting with constipation. The authors review the epidemiology of constipation, risk factors, the economic impact of constipation, the clinical features and pathophysiology, clinical evaluation, secondary encounters and referral consultations, diagnostic tests (balloon expulsion test, defecography, colonic transit, and anorectal manometry), medical management, and the role of surgery in treating constipation. Constipation is associated with inactivity, low caloric intake, the number of medications being taken, low income, and a low education level. Constipation is also associated with depression as well as with physical and sexual abuse. These are noted as risk factors, not necessarily as causative agents. The review summarizes three patient care algorithms. After the initial history and physical examination, patients can be classified into one of several subgroups. Standard blood tests and a colonic structural evaluation should be performed to rule out organic causes of the constipation. If the initial evaluation is normal or negative, an empiric trial of fiber (and or dietary changes) can be followed by simple osmotic laxatives. Most patients will obtain symptom relief with these measures. Patients who fail to respond to this initial approach are appropriate candidates for more specialized testing. 5 tables. 95 references.

Federally Funded Research on Blood Tests The U.S. Government supports a variety of research studies relating to blood tests. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to blood tests. 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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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 blood tests. The following is typical of the type of information found when searching the CRISP database for blood tests: •

Project Title: A NEW MARKER FOR COLON CANCER SCREENING Principal Investigator & Institution: Kinders, Robert J.; Bion Diagnostic Sciences 12277 134Th Crt Ne Redmond, Wa 98052 Timing: Fiscal Year 2001; Project Start 20-SEP-2001; Project End 31-AUG-2002 Summary: (provided by applicant): Replace the current FOBT (fecal occult-blood tests) used in CRC screening for colorectal cancer in individuals over age 50. We have shown upregulation of TAA mRNA expression in colon tumors. We have produced monoclonal antibodies and affinity purified antisera to the TAA and have used these to formulate a prototype sandwich enzyme immunoassay in a microplate format. We have used this assay to test 70 stool specimens and a number of colonic washes from patients in which a tumor was subsequently found. In a head-to-head comparison with two different fecal occult blood tests (FOBT), the prototype sandwich assay has demonstrated superior clinical diagnostic performance to both. Work has begun on assembling two, 500 specimen panels to demonstrate utility of the marker in relevant populations. Additional Phase I objectives are to 1) generate additional monoclonal antibodies to the TAA; 2) complete cloning and sequencing of the TAA from human tumor specimens. The product we visualize is a low cost, one-step immunoassay device suitable for use in a screening mode in which patients with a positive test result would be worked up by sigmoidoscopy or colonoscopy. PROPOSED COMMERCIAL APPLICATIONS: Replace the current FOBT ( fecal occult-blood tests) used in CRC screening with an immunoassay for a TAA found in stool. A successful product will more than double the number of cancers detected, detect pre-cancerous lesions not currently detected, and cut the number of false-positives by 3 to 5 fold or more. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AV SHUNT IMPLANTATION IN HEMODIALYSIS PATIENTS Principal Investigator & Institution: Harker, Laurence A.; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2001 Summary: This is a placebo-controlled, safety and efficacy dose-finding study assessing the effects of dosing FFR-rFVIIa vs placebo in 4 cohorts of patients each (4:1 randomization favoring active therapy) on AVG 111In-platelet deposition at the time of AVG surgical placement or replacement (primary outcome). Imaging of 111In-platelets accumulating at the sites of AVG anastomoses, and an escalating bolus FFR-rFVIIa in subsequent cohorts will establish safety, tolerance and an effective antithrombotic dose regimen for FFR-rFVIIa administration in dialysis patients undergoing surgical AVG placement or replacement. This dose will subsequently be used in a controlled clinical trial of AVG failure. We also propose to compare the dose-response effects of FFRrFVIIa vs placebo on post-operative changes in blood tests of thrombosis, tests of hemostasis and measured surgical blood loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COLORECTAL CANCER SCREENING--FECAL BLOOD VS DNA Principal Investigator & Institution: Ahlquist, David A.; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2001; Project Start 15-JUN-2001; Project End 31-MAY-2004 Summary: APPLICANT?S Colorectal cancer remains the second leading cause of malignant death, and better preventive strategies are needed. Stool testing, unlike other conventional screening approaches, is noninvasive and requires no cathartic preparation. However, widely-used fecal blood tests yield frequent false-negative and false-positive results that lower the screening effectiveness and raise program costs. There is a compelling biological rationale to target altered DNA exfoliated from neoplasms into stool, and multiple DNA markers would need to be targeted due to the genetic heterogeneity of colorectal neoplasia. Preliminary data suggest that a prototype multi-target DNA-based assay system has potential to detect screen-relevant colorectal neoplasia (early-stage cancer and advanced adenomas) with substantially higher sensitivity and specificity than that of fecal blood tests. The overall objective of this application is to prospectively assess the fecal DNA-based test as a promising new approach to the general screen-detection of colorectal neoplasia. A 3-year cross-sectional multicenter study is planned to compare the validity of the DNA-based test and the most commonly used fecal blood test (Hemoccult) for identification of screen-relevant colorectal neoplasia in 2900 demographically representative average-risk persons using colonoscopy as a gold standard. The performance of the DNA-based test will also be compared to a surrogate for flexible sigmoidoscopy (distal 60 cm of colonoscopy) and to the combination of sigmoidoscopy + Hemoccult. The design will further allow an assessment of the impact of dietary, medication, demographic, and other covariates on test outcomes. Assays will be performed blindly at central laboratories. A specimen bank will be maintained as an important resource for the economical evaluation of additional markers. A state-of-the-art web-based data management system will be employed to efficiently enter and transfer data across the six participating centers with the highest quality control. If the DNA-based test proves to have greater screening accuracy than fecal blood testing, this could translate into more effective cancer control and more efficient use of our limited health care resources. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETIC VARIABILITY IN COLORECTAL NEOPLASIA Principal Investigator & Institution: Gerner, Eugene W.; Professor; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 05-SEP-2002; Project End 31-MAR-2007 Summary: (provided by applicant): The translational goal of this project is to develop simple blood tests to predict colon cancer risk and to tailor therapy for colorectal intraepithelial neoplasia (IEN). Diagnosis of colon cancer at an early stage continues to be problematic, and response to treatment is limited in late stage colon cancer. Better measures of risk will contribute to colon IEN prevention or earlier detection. Earlier detection combined with methodologies to predict response to therapy will decrease colon cancer incidence and mortality. The hypothesis to be tested in this proposal is that the risk of colorectal cancer is influenced by genetic variability affecting the expression/function of the adenomatous polyposis coli (APC) tumor suppressor gene and/or APC modifier genes, such as ornithine decarboxylase (ODC). Measures of this genetic variability may be prognostic and/or predictive factors for colorectal IEN. To test this hypothesis, four specific aims are proposed. First, we will measure specific

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mutations in the APC tumor suppressor gene in colorectal adenomas from participants in colon cancer prevention trials. Second, we will measure germline polymorphism frequencies in codon 1822 of APC. We will determine associations between genetic variability in APC with dietary factors and adenoma recurrence in this patient group. Third, we will measure the genetic variability in the c-myc-dependent region of the ODC promoter in groups at risk for colorectal IEN, and determine whether polymorphisms are associated with adenoma recurrence. Finally, we will ascertain the functional significance of these polymorphisms in intestinal carcinogenesis. Future studies will measure variability in other downstream mediators of APC. These other mediators include networks regulating polyamine and arachidonic acid metabolism. Since these pathways are targets for IEN therapy (e.g., DFMO, NSAIDs), genetic variability in these pathways may be predictive factors for therapeutic response to treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HOE901 VERSUS NPH HUMAN INSULIN WITH TYPE I DIABETES MELLITUS Principal Investigator & Institution: Feinglos, Mark N.; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001 Summary: PURPOSE: The purpose of this study is to compare the effects of HOE 901 and NPH on glycated hemoglobin and to compare the safety of HOE 901 with NPH in subjects with type I diabetes mellitus. A comparison between the two treatments will also be made in terms of blood glucose variability, hypoglycemia, other indicators of metabolic control, quality-of-life, and pharmacoeconomics. METHODS: This is a phase III, randomized, multicenter, open, NPH human insulin controlled, randomized (1:1), 28-week parallel-group study with two treatment groups (HOE901 and NPH human insulin). A total of 520 patients ( a total for all sites) will be evaluated in this study. The study consists of a 1 to 4-week screening phase and a 28-week treatment phase which includes an initial active dose titration phase. Subjects randomized to the NPH insulin group will continue their previous regimen of injections per day. Subjects randomized to HOE901 will receive a single injection of HOE 901 at bedtime. Both treatment groups will also receive regular insulin in addition to either HOE901 or NPH human insulin. The subjects will be stratified by whether they were being treated with a basal insulin once versus twice daily. This study will involve 5 outpatient visits and 3 inpatient visits. During the screen visit, subjects will undergo a history and physical examination, blood tests, pregnancy screen, dilated eye exam, and fundus photography. Subjects will be instructed in home blood glucose monitoring, issued a glucose meter and supplies, and will be asked to monitor their blood glucose 4x/day. At the following visit, patients who qualify will be admitted to the GCRC for approximately 36 hours, during which 24 hr blood glucose samples will be taken. Patients will also have an EKG and blood tests. Patients are randomized at this visit. Outpatient follow-up visits including blood tests will occur at Weeks 1 & 4. Patients will be readmitted for an inpatient stay, including 24 hr sampling, at Week 8. Outpatient follow-up visits including blood tests will occur at Weeks 12 & 20, with optional eye exam and fundus photos at Week 12. The final admission will occur at Week 28. In addition to 24 hr sampling, an EKG, eye exam, fundus photos, and blood tests will be performed. Patients will restart their prestudy insulin regimen at this visit. RESULTS AND CONCLUSIONS: The study was completed in June 1998. This is a pharmaceutical-sponsored, multicenter study, and results have not been provided to date. SIGNIFICANCE: Type I diabetes mellitus is characterized by

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general insulin deficiency due islet beta-cell loss and requires insulin replacement therapy. Normal pancreatic beta-cells secrete approximately 50% of insulin as boluses in response to food and the rest as a continuous basal secretion. Longer-acting insulins such as NPH or Ultralente are often used to simulate endogenous basal insulin in the treatment of type I diabetes. However, neither NPH nor Ultralente provides a stable 24 hr basal insulin supply because either the duration of action is too short (NPH) or absorption from the site is erratic (Ultralente). NPH also often results in nocturnal hypoglycemia due to plasma insulin peaks during the night. Consequently, the bedtime NPH dose cannot be safely increased as appropriate, resulting in elevated blood glucose in the morning, a major obstacle to overall euglycemia. The Diabetes Control and Complications Trial has shown that tight blood glucose control greatly reduces the risk of diabetic complications such as retinopathy, neuropathy, and nephropathy. Human insulin analogue HOE901 is a long-acting insulin that, if proven safe and effective, can be given as a single daily injection to provide near normal blood glucose control and a smoother 24 hr basal insulin profile than previously possible with available medications. FUTURE PLANS:The results of this study will provide the basis for future investigation of HOE901. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SCREENING

INTERVENTIONS

TO

INCREASE

COLORECTAL

CANCER

Principal Investigator & Institution: Menon, Usha; None; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2003 Summary: Colorectal cancer (CRC) is the third leading cause of cancer death in the United States with the majority of CRC diagnosed in those aged 50 or older. Prospective data indicate that annual fecal occult blood tests (FOBT) can decease mortality from CRC. The American Cancer Society recommends an annual FOBT and a flexible sigmoidoscopy every 5 years. Utilization of these tests is very low, ranging from 19% to 39%, especially among those who are 50 or older and most at risk for developing the disease. Tailored interventions have demonstrated significant increases in mammography use, and may be effective in the area of CRC screening as well. The purpose of this study is to compare the effectiveness of a tailored versus a non-tailored intervention designed to increase the use of FOBT and sigmoidoscopy, and to determine its effect on cognitive stage of behavior. The theoretical framework for this study was derived from the Health Belief and Transtheoretical Models. Institutional review board approval will be obtained before data collection. All instruments proposed in this study were previously tested for reliability and validity. Trained research assistants will contact members of a Midwest-based health maintenance organization (HMO), aged 56 or older and who have not had an FOBT in the last 15 months. Once eligibility criteria is verified, those who agree to participate with be randomized to one of three groups; 1) control, 2) tailored print communication, and 3) non- tailored print communication. Baseline data will be collected by telephone from a sample of 600 HMO members. Interventions will be mailed 2 weeks from the baseline interview, and post intervention interviews conducted 2 months from the intervention. Logistic regression will be conducted modeling the odds of having an FORT or sigmoidoscopy by intervention group. Those independent variables significant in bivariate analyses at p equal to or <.20 will be entered in to a separate logistic regression model to identify predictors of FOBT and sigmoidoscopy use. Results will be useful in testing tailored interventions to increase FOBT and sigmoidoscopy in managed care settings.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LAB-IN-A TUBE BLOOD TEST SYSTEM Principal Investigator & Institution: Chen, Shuqi; Iquum, Inc. 214 Lincoln St, Ste 300 Allston, Ma 02134 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-JUL-2004 Summary: (provided by applicant): The objective of this project proposal is the development of a commercially viable diagnostic blood testing product that will meet the growing demand for practical near-patient testing. The product will be built on the lab-in-a-tube platform, which uses novel sample handling, microfluidic, and imaging technology to achieve system miniaturization, low cost, high flexibility, and improved safety. The successful commercialization of this product will improve public health by enabling caregivers to easily collect more information about a patient's condition. They will accomplish this by directly conducting blood tests on-site, during the patient's visit.lQuum proposes to continue the development of the lab-in-a-tube platform by designing and building prototypes of the three major components of the system: the desktop analyzer; the integrated sample collection and processing container, and the multiple-use, disposable reagent cartridge. The company will concurrently develop platelet function and coagulation assays as the first applications for the lab-in-a-tube system. The flexible detection and processing technology of the product enable the platform to conduct numerous types of tests, including blood typing, cell counting, and immunoassay. These assays will be developed separately and will showcase the full multifunction capability of the lab-in-a-tube system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR DIAGNOSIS OF SARCOMAS Principal Investigator & Institution: Baker, Laurence H.; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2003 Summary: (provided by applicant): We will elaborate serum quantitative-PCR (QPCR) and peripheral blood RT-QPCR tests to diagnose the presence of sarcomas. We aim to construct simple blood tests to screen people at increased risk for sarcoma, to evaluate the initial tumor, to assess therapy of patients with sarcoma and/or to follow people who have been treated for sarcoma. Sarcomas were chosen initially because we found appreciable amounts of lysed tumor cell DNA in the serum. This enabled us to propose a generic test based on quantitative differences of tumor suppressors and oncogenes in sarcoma. Subsequently, more specific tests have become available involving aberration of the c-kit gene in GI stromal tumors and specific translocations that characterize defined sarcoma types. We add these more specific tests to our previous application that was based on the generic tests only. 1. Test the primary sarcoma to assay the QPCR markers that show quantitative changes and the RT-QPCR markers that show specific translocations. 2. Monitor the serum simultaneously to determine the QPCR anomalies therein and/or the peripheral blood to screen for specific RT-QPCR markers of translocation. The usefulness of these determinations is supported by our preliminary results demonstrating the presence of QPCR serum anomalies in untreated sarcoma patients. 3. Monitor the serum and peripheral blood longitudinally to screen for these molecular anomalies and (if necessary) new anomalies to detect metastases and/or recurrence that might not be apparent clinically. If we detect useful serum QPCR anomalies and/or peripheral blood anomalies in particular situations in phase I, we will

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expand the studies in phase II to perform longitudinal QPCR assays useful in a given situation. We will use the test to perform diagnosis of at-risk and treated populations, to monitor cancer cell lysis before and during treatment, to monitor the efficacy of cancer treatments and to detect recurrences. This is proposed as an R21 (one year)/R33 (three year) grant to determine the feasibility of these studies for sarcomas in the R21 phase. If more studies are indicated, the R33 phase would support the longer-term longitudinal studies required to demonstrate how best to use this test to follow the course of sarcomas. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR GENETICS OF COLOR VISION Principal Investigator & Institution: Deeb, Samir; Research Professor; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-DEC-1989; Project End 30-NOV-2003 Summary: The central objective of this proposal is to define the molecular genetics of red/green color vision by relating the molecular genetics of the X- linked photopigment genes to their expression in the retina and to the color vision phenotype. The red and green pigment genes are arranged in an array on the X-chromosome consisting of a single red and one or more green pigment genes. Deletion of genes or formation of hybrid genes (red-green and green-red) due to illegitimate recombination at this locus causes color vision defects. However, not all other gens of the red/green array are expressed in the retina, creating uncertainties in predicting color vision phenotype from genotype. Understanding the mechanism by which selective expression of these genes is accomplished is fundamental to defining genotype-phenotype relationships. We have delineated critical regulatory regions of the red-green gene locus and detected proteins that bind to them. A major aim of this proposal is to clone and character the transcription factors that play major roles in regulating expression of the visual pigment genes. We will map the genes encoding these factors on human and mouse chromosomes. Map positions will be correlated with known loci associated with retinal diseases. We developed a rapid method for determining gene order in males who have up to three pigment genes in their arrays and found evidence for a role of gene order in gene expression and color vision. We propose to advance their method in order to determine gene order in the majority of individuals. Knowing the sequence and gene order will allow more precise prediction of the spectral sensitivities of clones and the color vision phenotype. The ratio of red to green cones was determined indirectly by measuring relative levels of mRNA in postmortem human retinae. We propose to determine the ratio and distribution of cones in the retina directly by in situ molecular techniques. The findings will be of fundamental importance for the visual sciences. We observed a very high frequency of green-red hybrid genes among Africans. We will investigate the sequence of these hybrids and determine their position in the array. Elucidation of the molecular mechanism of expression of this locus affecting sensory perception is a model for expression of genes in other complex loci. These studies may lead to rapid and accurate blood tests for color vision defects. The novel photoreceptorspecific genes we propose to clone may be good candidates for some of the inherited retinal diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: N3 FATTY ACIDS EFFECT ON SICKLE CELL PAIN EPISODES Principal Investigator & Institution: Eckman, James R.; Professor; Medicine; Emory University 1784 North Decatur Road Atlanta, Ga 30322

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Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 31-MAY-2003 Summary: Our studies show that sickle cell disease (SCD) patients have platelet activation, increased thrombin formation and fibrinolysis, in vivo, and that activation of thrombosis increases significantly during pain episodes. Moreover, in a small controlled pilot trial evaluating dietary n-3 fatty acids (n-3 Fas) in SCD patients with frequent pain episodes, the frequency of pain episodes was significantly decreased in dietary n-3 FAtreated patients compared to olive oil treated controls. Moreover, markers of thrombosis decreased to near those observed in the control subjects. In addition, the Multicenter Study of Hydroxyurea in Sickle Cell Anemia reports that reduction in pain frequency with hydroxyurea was directly correlated to reduction in neutrophil and monocyte counts. We hypothesize that pain episodes in SCD patients are caused by local microcirculatory occlusion mediated by sickle cells that cause microvascular damage inducing expression of adhesion molecules and counter-receptors by monocytes and endothelial cells. This stimulates TF expression by vascular cells and blood monocytes causing TF induced thrombin production and thrombosis. TF expression provides feedback amplification via thrombin-mediated monocyte activation, accumulation, expression of TF that increases thrombosis enhancing microvascular occlusion and ischemic damage. Because preliminary findings indicate that dietary n-3 FAs are safe and down-regulate multiple membrane-activation pathways of circulating blood and vascular wall cells, we propose to test the therapeutic efficacy of dietary n-3 FAs by conducting a double-blind, olive oil- controlled clinical trial of dietary n-3 FAs in 60 SCD patients with frequent pain episodes, randomly allocated to dietary n-3 FAs or control olive oil. The primary outcome is the frequency of pain episodes. Based on the pilot study, this trial has a 90 percent probability of demonstrating a 50 percent decrease in frequency of pain episodes. Our hypothesis will be tested in secondary analysis of the effects of dietary n-3 FAs on blood markers of thrombosis and inflammation. Blood tests of thrombosis will include flow cytometric assessment of platelet activation and microparticle formation, thrombin:antithrombin complex (TAT) levels, activation fragment of prothrombin (F1.2), thrombin's fibrinogen cleavage product (FPA), plateletspecific secretion proteins platelet factor 4 (PF4) and beta-thromboglobulin (betaTG), and products of fibrinolysis including plasmin-antiplasmin complex (PAP) and Ddimer. Blood tests of inflammation to be measured include flow cytometric assessment of monocyte activation and expression of tissue factor and plasma levels of soluble vascular cell adhesion molecules (sVCAM) and monocyte chemotactic protein-1 (MCP1). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NANOLITER GLUCOSE ASSAY FOR DIABETICS Principal Investigator & Institution: Subramanian, Kumar; Phoenix Bioscience, Inc. 24470 Camino Ramon, Ste 310 San Ramon, Ca 94583 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2004 Summary: (Revised) Phoenix Bioscience is developing enabling technologies for pointof-care diagnostic applications. The MEMS-based technology provides for a cost effective, one step, ease-of-use testing procedure. The product automates what traditionally has been a multi-step process of lancing, blood droplet formation, and sample collection. The system can be adapted to accommodate a variety of sensor types covering a wide range of diagnostic tests. The automation, increased speed, and higher sampling accuracy will dramatically improve the ease and reliability of "finger prick" blood tests. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NIDDM SUSCEPTIBILITY GENES IN A BIRACIAL COHORT Principal Investigator & Institution: Brancati, Frederick L.; Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-JUL-2004 Summary: (Adapted from the Investigator's Abstract) Type 2 diabetes mellitus and its atherosclerotic complications impose a substantial burden on health of Americans in general and on African Americans in particular. Recent discoveries in molecular genetics have lead to the identification of functional variations in several candidate genes for susceptibility to obesity, insulin resistance, and/or diabetes. These include genes which code for beta-2and beta-3 adrenergic receptors, insulin receptor substrate 1, fatty acid binding protein 2, frataxin, and leptin receptor. If their role as novel susceptibility factors is confirmed, these variants promise to illuminate the pathophysiologic basis of diabetes and diabetes related cardiovascular diseases, accelerate the development of chemopreventive agents, and facilitate the conduct of prevention trials by marking individuals at high risk. Unfortunately many previous association studies of these mutations in human populations have been limited by small, selected study samples; by limited cross-sectional data on behavioral factors and on cardiovascular risk phenotype; and by paucity of data on African Americans. The investigators, therefore, propose to conduct an epidemiologic study of functional variants in 10 candidate genes for susceptibility to type 2 diabetes, obesity, and insulin resistance. The main objective will be to detect modest effects consistent with polygenic nature of diabetes but with better sensitivity and precision than previous association and linkage studies. The study sample will a community based cohort of 3,250 African Americans and 3,250 Whites aged 45 to 64 who are participants in the ongoing Atherosclerosis Risk in Communities (ARIC) study. Supported by NHLBI the ARIC study has assembled an extensive data base including behavioral assessment (e.g. diet and physical activity), anthropometry, laboratory blood tests (e.g. oral glucose tolerance test and serum lipids), and carotid ultrasonography as well as clinical events and mortality. Using race specific case-control, cross-sectional, and longitudinal analyses the investigators will determine if these putative diabetes alleles are associated with incident and prevalent diabetes, with obesity and weight gain, with hyperinsulinemia in non-diabetic individuals with the presence of an adverse cardiovascular risk factor profile, and with atherosclerosis progression and cardiovascular disease incidence over 12 years of follow up. The investigators will assess how behavioral and environmental factors such as obesity, diet, and physical activity, influence the expression of genetically conferred risk. Strength of this proposal include the close collaboration between clinical, epidemiologic, and laboratory researchers, a wealth of prospectively collected data from an NIH sponsored study, and a sample size large enough to detect modest gene effects and to investigate gene-gene and gene-environmental interactions. Most important, this study will provide unique information on the expression of diabetes susceptibility genes in the general population and possibly suggest genetic explanations for the excess prevalence of type 2 diabetes and obesity in African Americans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RAPID ON-SITE CYANIDE ASSAY FOR BLOOD AND SALIVA SAMPLES Principal Investigator & Institution: Goodridge, Carolyn F.; Cc Technology, Inc. Box 3136, 813 S 2Nd St Laramie, Wy 82071 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2004

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Summary: (provided by applicant): The specific aim of this project is to develop a rapid test for the detection of cyanide in blood and saliva. Poisoning due to cyanide can occur vary rapidly in less than a few minutes, but current tests require at least 2 -3 hours for results to be reported. In rural communities, blood tests for cyanide are sent out for analysis and often several days pass before levels are reported. The current method is a head-space GC technique that uses a strong acid to liberate hydrogen cyanide from cyanomethemoglobin. This results in the administration of antidotal therapy without conformation of poisoning. The antidote, intravenous sodium nitrite, can in itself cause severe poisoning due to hypotension and complications can be exacerbated by anemia. Our technology centers on the strong affinity of cyanide for gold nanoparticles. We have demonstrated that gold nanoparticles can bind free cyanide in aqueous solutions at levels of less than 10 ppb. Most of our prior work has been with aqueous cyanide and gold nanoparticle suspensions, however, some work with HCN detection has been performed with gold nanoparticle impregnated test strips. For this project, we will examine a test for cyanide in blood or saliva using a test strip and a releasing agent to create free cyanide from a biological sample. An example of a potential releasing agent is a strong such as sulfuric acid. Gas permeable membrane technology will also be tested to prevent mixing of releasing agents with the gold nanoparticles. In addition to the chemistry of gold nanoparticles and release of cyanide from cyanomethemoglobin we will show the feasibility of a low cost spectroscopic measurement system. We will eliminate the large and costly portion of Raman spectrometers that is associated with dispersion of the spectrum and replace it with a very small inexpensive filter system. This new system will be designed for handheld use by first response personnel for onsite analysis. The long-term objective of this project will be to provide emergency personnel with small handheld device to measure concentrations of cyanide in blood or saliva. We are working with a local fire department to ensure that the design and specifications match the needs of first response personnel. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ROLE OF ADIPOSE TISSUE IN VITAMIN D METABOLISM Principal Investigator & Institution: Blum, Miriam; None; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Vitamin D has important effects upon calcium and bone metabolism and may be involved in the functioning of many other systems. Vitamin D insufficiency contributes to bone loss in the elderly and has recently been found to be quite prevalent in the northeast US. In both rodents and humans, adipose tissue is a major repository for vitamin D, however the function of adipose tissue in vitamin D metabolism is uncertain and factors affecting the assimilation and release of vitamin D from adipose tissue need to be elucidated. The overall purpose of this research project is to begin to define the role of adipose tissue in vitamin D metabolism. In this regard, we hypothesize that: 1. Vitamin D intake influences the level of vitamin D in adipose tissue 2. The vitamin D content of adipose tissue varies with season 3. Higher fat stores of vitamin D at the end of the summer will reduce the wintertime decline in blood 25-hydroxy vitamin D levels. To test these hypotheses, detailed investigations of vitamin D content in adipose tissue, body composition measurements, blood tests and dietary intake will be conducted in adult men and women participating in a longitudinal study. The proposed study consists of a seasonal observational period followed by a randomized placebo control trial of varying doses of oral vitamin D. In preparation for this study, I will train in vitamin D assay techniques and help refine the

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method for extracting and measuring vitamin D content in adipose tissue. Studying the role of adipose tissue in vitamin D metabolism will help increase our understanding of vitamin D physiology. It may also enable us to better understand the mechanisms involved in vitamin D insufficiency and give us greater insight into the management of this prevalent condition. In addition, the proposed study sets the groundwork for future studies that are essential to my development as an independent investigator. The proposed study as well as the other components of the K23 Award will enable me to broaden my skills in clinical research and increase my depth of knowledge and technical skills. The supportive environment and distinguished collaborators that are part of this proposal will provide me with the guidance that I need to pursue my research plans as I make the transition to independent clinical investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SMOKING CESSATION IN THE CHEST PAIN OBSERVATION UNIT Principal Investigator & Institution: Bock, Beth C.; Assistant Professor; Miriam Hospital Providence, Ri 02906 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2003 Summary: Approximately 4.5 million Americans visit the emergency department each year with symptoms of chest pain. Over 90% are eventually ruled out for myocardial infarction and other acute cardiovascular events. Three serial blood tests taken at 8 hour intervals are needed to rule out MI, requiring a 24-hour stay in the emergency department Observation Unit (OU). During most of this time patients are at bed rest. While approximately 25% of these patients are smokers, nothing is currently being done to address smoking cessation with these patients. The experience of hospitalization for chest pain is intense, but transient. The long term impact of this experience on smoking cessation and motivation to quit is unknown. The effects of this experience on the individual's perception of risk from smoking, and how personal coping style may interact with the OU experience are also unknown. We will recruit 722 smokers and randomly assign them to either (a) Usual Treatment, or (b) Enhanced Treatment for smoking cessation. Enhanced Treatment consists of a brief intervention by the attending physician, a 30 minute motivationally tailored cognitive behavioral interview with a trained health educator, nicotine replacement when appropriate, and scheduled followup phone contacts. Data will be collected on smoking attitudes, motivation and behaviors, nicotine dependence, risk perception, psychological coping style. Follow- up assessments will be conducted at l, 3, and 6 months after recruitment. An implementation index of the amount and duration of all smoking interventions delivered in both conditions will be created statistically, and analyzed for effects on smoking outcomes and interactions with coping style and risk perception, and determination of optimal cost-benefit ratios. Primary outcome analyses will examine 7day point prevalence abstinence at each follow-up and survival analysis (time to 1st relapse). We hypothesize that; (1)smokers given the Enhanced Treatment will show significantly higher abstinence rates at 6 months post-tx, and (2) greater improvement variables mediating readiness to quit (ie., decision making, self-efficacy), compared to Usual Care and, (3) coping style and risk perception will moderate the efficacy of the intervention for all subjects. Information provided by this study is needed to develop specific smoking interventions targeted to this population. Broad application of these findings should reach over l million smokers per year. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SPECIALIZED RESEARCH CENTER--SLE Principal Investigator & Institution: Langford, Janice S.; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: SLE is an unpredictable disease characterized by flare-ups, usually requiring an increase in lupus medications. The current laboratory tests available to doctors are unsatisfactory, because they miss over 50% of flare-ups, and because they are sometimes abnormal in patients who are doing well. This is a research effort to find better blood tests to predict disease flare-ups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: VIRAL AND HOST FACTORS IN THE TRANSMISSION & PATHOGENESIS OF HIV Principal Investigator & Institution: Kost, Rhonda; Rockefeller University New York, Ny 100216399 Timing: Fiscal Year 2001 Summary: Subjects are recruited through local physician networks and are interviewed over the telephone to be sure they meet the appropriate disease definition (multiplyexposed, acute seroconvertor, or long-term survivor). If the history matches the disease definition to be studied, they are scheduled for a visit at which time more extensive history is obtained, informed consent is signed, and screening blood tests are drawn. The blood tests vary based upon the disease state that is being studied. For instance, in acute seroconvertors, we look for evidence of falling viral load and an increasing immune response; in long-term survivors we look for low viral load and normal CD4 cell counts in someone with documented infection for >10 years; in exposed-uninfected subjects we look for evidence of sero-negativity in someone with a documented history of multiple high risk exposures. Once a subject meets the specific disease definition, he or she is asked to return for further phlebotomy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: WARFARIN VS ASPIRIN FOR INTRACRANIAL ARTERIAL STENOSIS Principal Investigator & Institution: Chimowitz, Marc I.; Neurology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2001; Project Start 25-SEP-1998; Project End 31-JUL-2003 Summary: Background and Relevance. Atherosclerotic stenosis of the major intracranial arteries causes 40,000 strokes per year in the USA, costing the country at least 600,000,000 dollars annually. There have been no prospective trials evaluating optimal medical therapy for this disease. The main objective of this clinical trial is to compare warfarin (INR 2-3) with aspirin (1300 mg/day) for preventing stroke (ischemic and hemorrhagic) and vascular death in patients with symptomatic stenosis of a major intracranial artery. Study Design. Prospective, randomized, double-blind, multi-center trial. The sample size required will be 403 patients per group (based on stroke and vascular death rates of 33 percent/3 years in the aspirin group vs 22 percent/3 years in the warfarin group, an alpha of 0.05, beta of 0.80, a 24 percent withdrawal of therapy rate, and a 1 percent drop out rate). Conduct of Trial. Patients with transient ischemic attack (TIA) or stroke caused by angiographically proven stenosis (greater than or equal to 50 percent) of a major intracranial artery will be randomized to warfarin or aspirin.

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The dose of warfarin will be adjusted to maintain the INR between 2-3 based on monthly blood tests. Patients will be contacted monthly by phone and examined every four months (mean follow-up of 3 years) to determine whether any endpoints have occurred. The primary analysis will compare the rates of stroke (ischemic and hemorrhagic) and vascular death in the two treatment groups. Secondary analyses will compare the two treatment groups with respect to rates of i) all vascular deaths and disabling stroke, ii) all stroke (ischemic and hemorrhagic), iii) fatal and nonfatal ischemic stroke, iv) all ischemic stroke, myocardial infarction and vascular death, v) all major systemic and any intracranial hemorrhage, vi) all ischemic stroke in the territory of the stenotic intracranial artery. Conclusion. This study will 1) define optimal medical therapy for patients with symptomatic intracranial arterial stenosis, and 2) identify patients whose rate of ischemic stroke in the territory of the stenotic intracranial artery on best medical therapy is sufficiently high (i.e., greater than or equal to 6 percent per year) to justify a subsequent trial comparing intracranial angioplasty with best medical therapy in these patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: YOUNG ADULT VERY LOW BIRTHWEIGHT--NEONATAL BLOOD TRANSFU Principal Investigator & Institution: Hack, Maureen; Professor of Pediatrics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2001 Summary: Prior to 1986 risk factors for hepatitis C, or non A, non B hepatitis as it was then called, included transfusions of blood and blood products, needle sharing and intravenous drug abuse, health care employment with frequent exposure to blood, sexual contact with, or household exposure to a person who had hepatitis C, and possibly sexual contact. The overall prevalence of hepatitis C infection ranges from 0.5% for low risk blood donors to 60%-90% for drug users and hemophiliacs who have received multiple blood transfusions. Five to 15% of persons transfused prior to 1986 contracted hepatitis C. In examining these results, it is important to take into account that the majority of reports between 1990 and 1992 pertain to results obtained using first generation type radioimmunoassay tests, which, as noted above, have a poor sensitivity and predictive value. There is very little known of the natural history of HCV infections in childhood. High risk groups include children requiring multiple blood transfusions and/or pooled blood products, as well as those born to Hepatitis C positive mothers. It is postulated that the natural history and risk of progression to liver disease in children will vary depending on the underlying condition for which the blood products were received, but that it is likely that 40% of infected children will develop chronic hepatitis with progression at some time to cirrhosis, and that they will be at increased risk of developing hepatocellular carcinoma. This progression may extend over 30 to 40 years. The Specific Aims are: 1) to examine the prevalence of Hepatitis C infection in a cohort of very low birthweight young adults. 2) to estimate the risk of hepatitis C infection according to the total volume of blood received, and the number of different donors. 3) among Hepatitis C positive VLBW subjects, to identify the neonatal risk factors and childhood and adolescent health and behavioral risk factors associated with both the development of Hepatitis C liver disease and its severity. 4) to refer the Hepatitis C positive VLBW subjects for the best possible treatment currently available, to prevent the development of disease and/or deterioration of the liver associated with viral infection. 5) to inform the Hepatitis C positive VLBW subjects of the results of their tests, and to counsel them concerning health risk behaviors (such as drinking alcohol) and

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hepatotoxic medications, and precautions they might need to take to prevent transmission to close intimate partners. Hypotheses: 1) That 10-15% of the very low birthweight subjects who received neonatal blood transfusions will be Hepatitis C positive at 20 years of age. 2) That the probability of testing Hepatitis C positive will depend on the number of transfusions from different donors and the total volume of blood received during the neonatal and behavioral risk factors. We propose, initially, a pilot study to examine the prevalence of Hepatitis C infection among the 20 year-old subjects in our main study born in 1977 who received blood (n=87). If the hypothesized Hepatitis C infection rate of 10-15% is found, we plan to extend the study to examine the prevalence of Hepatitis C infection among the total cohort of 20 year-old very low birthweight subjects who received blood (n=198/156 seen at age 20). All subjects will be screened with the anti-HCV 3.0 enzyme immunoassay. We also plan to test for ALT as an indicator of ongoing hepatitis associated with HCV infection and for other transfusion-transmitted disease associated markers including HbsAg, anti-HBc and HIV. The pilot project will be implemented by initially sending a letter to the subjects who received neonatal blood transfusions informing them that they received blood as infants, that prior to 1986 blood was not screened for Hepatitis C, and that the Center for Disease Control suggests screening all persons who received blood transfusions prior to this time. Blood tests will be free of charge. Since the subjects were seen a year ago, the only additional information which will be required is an update on health and a question as to whether they ever received blood transfusions after the neonatal period. The subjects will be informed of the results, and if positive for Hepatitis C they will be referred for counseling and further testing for potential liver disease. " Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “blood tests” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for blood tests in the PubMed Central database: •

A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, Hemoccult. by Towler B, Irwig L, Glasziou P, Kewenter J, Weller D, Silagy C.; 1998 Aug 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28648

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Analysis of the Practice Guidelines of the Dutch College of General Practitioners with Respect to the Use of Blood Tests. by VAN Wijk MA, Bohnen AM, VAN DER Lei J.; 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=61373

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Comparison of Two Rapid Whole-Blood Tests for Helicobacter pylori Infection in Chinese Patients. by Leung WK, Chan FK, Falk MS, Suen R, Sung JJ.; 1998 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105355

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with blood tests, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “blood tests” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for blood tests (hyperlinks lead to article summaries): •

A comparative study of eight fecal occult blood tests and HemoQuant in patients in whom colonoscopy is indicated. Author(s): Gopalswamy N, Stelling HP, Markert RJ, Maimon HN, Wahlen SD, Haddy RI. Source: Archives of Family Medicine. 1994 December; 3(12): 1043-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7804488&dopt=Abstract

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A comparative study of fecal occult blood tests for early detection of gastrointestinal pathology. Author(s): Stelling HP, Maimon HN, Smith RA, Haddy RI, Markert RJ. Source: Archives of Internal Medicine. 1990 May; 150(5): 1001-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2331181&dopt=Abstract

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A comparison of fecal occult-blood tests for colorectal-cancer screening. Author(s): Allison JE, Tekawa IS, Ransom LJ, Adrain AL. Source: The New England Journal of Medicine. 1996 January 18; 334(3): 155-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8531970&dopt=Abstract

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A comparison of three blood tests for cancer. Author(s): DeYoung NJ, Ashman LK, Ludbrook J, Marshall VR. Source: Surg Gynecol Obstet. 1980 January; 150(1): 12-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7350696&dopt=Abstract

6

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

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A comparison of two rapid whole-blood tests and laboratory serology, in the diagnosis of Helicobacter pylori infection. Author(s): Hawthorne AB, Morgan S, Westmoreland D, Stenson R, Thomas GA, Newcombe RG. Source: European Journal of Gastroenterology & Hepatology. 1999 August; 11(8): 863-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10514118&dopt=Abstract

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A proposed set of new guidelines for routine blood tests during isotretinoin therapy for acne vulgaris. Author(s): Altman RS, Altman LJ, Altman JS. Source: Dermatology (Basel, Switzerland). 2002; 204(3): 232-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037453&dopt=Abstract

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A prospective multicenter evaluation of new fecal occult blood tests in patients undergoing colonoscopy. Author(s): Greenberg PD, Bertario L, Gnauck R, Kronborg O, Hardcastle JD, Epstein MS, Sadowski D, Sudduth R, Zuckerman GR, Rockey DC. Source: The American Journal of Gastroenterology. 2000 May; 95(5): 1331-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10811348&dopt=Abstract

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A prospective survey of reactions to blood tests by children and adolescents. Author(s): Fradet C, McGrath PJ, Kay J, Adams S, Luke B. Source: Pain. 1990 January; 40(1): 53-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2339016&dopt=Abstract

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A special cuvette for capillary blood tests. Author(s): Muller HA. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1984 January 31; 136(2-3): 241-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6692577&dopt=Abstract

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Accuracy of near-patient blood tests for Helicobacter pylori. Author(s): Wilcox MH. Source: Lancet. 1996 November 16; 348(9038): 1390. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8918308&dopt=Abstract

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Accuracy of near-patient blood tests for Helicobacter pylori. Author(s): Duggan A, Logan R, Knifton A, Logan R. Source: Lancet. 1996 August 31; 348(9027): 617. Erratum In: Lancet 1996 November 9; 348(9037): 1322. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8774595&dopt=Abstract

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Accuracy of occult blood tests over a six-day period. Author(s): St John DJ, Macrae FA. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 1985 June; 11(2): 200-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4007179&dopt=Abstract

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Accuracy of occult blood tests over a six-day period. Author(s): Farrands PA, Hardcastle JD. Source: Clin Oncol. 1983 September; 9(3): 217-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6616996&dopt=Abstract

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All patients should undergo routine blood tests before undergoing implant surgery. Author(s): Dhanrajani PJ. Source: Implant Dentistry. 2003; 12(2): 107. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12861876&dopt=Abstract

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Alterations of routine blood tests in adult patients with soft tissue sarcomas: relationships to cytokine serum levels and prognostic significance. Author(s): Ruka W, Rutkowski P, Kaminska J, Rysinska A, Steffen J. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2001 October; 12(10): 1423-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11762815&dopt=Abstract

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Analysis of blood tests in the emergency department of a tertiary care hospital. Author(s): Rehmani R, Amanullah S. Source: Postgraduate Medical Journal. 1999 November; 75(889): 662-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10621876&dopt=Abstract

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Analysis of the practice guidelines of the Dutch College of General Practitioners with respect to the use of blood tests. Author(s): van Wijk MA, Bohnen AM, van der Lei J. Source: Journal of the American Medical Informatics Association : Jamia. 1999 JulyAugust; 6(4): 322-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10428005&dopt=Abstract

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Are annual blood tests in preschool cystic fibrosis patients worthwhile? Author(s): Jaffe A, Buchdahl R, Bush A, Balfour-Lynn IM. Source: Archives of Disease in Childhood. 2002 December; 87(6): 518-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12456552&dopt=Abstract

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Are blood tests of value in the primary assessment and resuscitation of patients in the A&E department? Author(s): Tormey WP. Source: Postgraduate Medical Journal. 1995 September; 71(839): 575. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7479481&dopt=Abstract

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Are blood tests of value in the primary assessment and resuscitation of patients in the A&E department? Author(s): Pennycook A. Source: Postgraduate Medical Journal. 1995 February; 71(832): 81-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7536918&dopt=Abstract

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Ask the doctor. I know that high triglyceride levels probably increase my risk for heart disease. My last blood tests showed that my cholesterol numbers were pretty good, but my triglycerides were 256 mg/dL. What should I do to bring that number down? Author(s): Lee TH. Source: Harvard Heart Letter : from Harvard Medical School. 2000 September; 11(1): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10966655&dopt=Abstract

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Biochemical and blood tests in midwifery practice (1). Pre-eclampsia. Author(s): McKay K. Source: Pract Midwife. 1999 September; 2(8): 28-31. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10723399&dopt=Abstract

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Blood tests and Doppler flowmeter examination. Compared with phlebograms in venous thrombosis. Author(s): Hume M, Glancy JJ, Chan YK. Source: Archives of Surgery (Chicago, Ill. : 1960). 1968 December; 97(6): 894-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5727690&dopt=Abstract

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Blood tests and fair competition: the biathlon experience. Author(s): Manfredini F, Carrabre JE, Litmanen H, Zhukovskaja L, Malagoni AM, Dal Follo D, Haberstroh J. Source: International Journal of Sports Medicine. 2003 July; 24(5): 352-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868046&dopt=Abstract

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Blood tests and oral contraception. Author(s): Dujardin B, Buekens P, Vekemans M, Wollast E. Source: World Health Forum. 1990; 11(2): 205-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2271103&dopt=Abstract

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Blood tests and prognosis in bladder carcinomas treated with definitive radiotherapy. Author(s): Hannisdal E, Fossa SD, Host H. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 1993 May; 27(2): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8356221&dopt=Abstract

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Blood tests and the law. Author(s): Lanham D. Source: Med Sci Law. 1966 October; 6(4): 190-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5977102&dopt=Abstract

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Blood tests and what they mean. Author(s): McCormick P, Sax P. Source: Aids Clin Care. 1995 July; 7(7): 57-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11362553&dopt=Abstract

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Blood tests before elective surgery on patients who cannot communicate. Author(s): Brahams D. Source: Lancet. 1990 June 9; 335(8702): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1971673&dopt=Abstract

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Blood tests before elective surgery. Author(s): Jacobsen J, Bach AB, Dalsgaard PF. Source: Anaesthesia. 1987 January; 42(1): 78-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3826581&dopt=Abstract

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Blood tests for allergies. Author(s): Li TM. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2002 August; 89(2): 218; Author Reply 2189. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197583&dopt=Abstract

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Blood tests for cognitive decline? Author(s): Soinne L, Roine RO. Source: Acta Anaesthesiologica Scandinavica. 1999 May; 43(5): 491-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10341994&dopt=Abstract

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Blood tests for detection of alcoholic cause of acute pancreatitis. Author(s): Jaakkola M, Sillanaukee P, Lof K, Koivula T, Nordback I. Source: Lancet. 1994 May 28; 343(8909): 1328-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7910327&dopt=Abstract

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Blood tests for the detection of thrombosis. Effects of blood flow and location of the sampling site. Author(s): Owen J, Kaplan KL. Source: Annals of the New York Academy of Sciences. 1987; 516: 621-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3439748&dopt=Abstract

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Blood tests for the diagnosis of venous and arterial thrombosis. Author(s): Hirsh J. Source: Blood. 1981 January; 57(1): 1-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7004530&dopt=Abstract

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Blood tests in pregnancy (2). Iron deficiency anaemia. Author(s): McKay K. Source: Pract Midwife. 2000 April; 3(4): 25-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11146934&dopt=Abstract

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Blood tests in pregnancy. Author(s): Zavell PM. Source: Mich Med. 1972 March; 71(9): 210. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4622594&dopt=Abstract

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Blood tests in the diagnosis of connective tissue diseases. Author(s): Handwerger BS. Source: Md Med J. 1991 February; 40(2): 97-105. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1997799&dopt=Abstract

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Blood tests in the establishment of paternity. Author(s): Tunkel V. Source: Med Sci Law. 1969 January; 9(1): 53-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5385268&dopt=Abstract

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Blood tests in the management of Helicobacter pylori infection. Italian Helicobacter pylori Study Group. Author(s): Vaira D, Holton J, Menegatti M, Landi F, Ricci C, Ali A, Gatta L, Farinelli S, Acciardi C, Massardi B, Miglioli M. Source: Gut. 1998 July; 43 Suppl 1: S39-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9764039&dopt=Abstract

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Blood tests or urine tests in diabetes management? Author(s): Smith RB. Source: N Z Med J. 1982 June 9; 95(709): 383. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6955657&dopt=Abstract

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Blood tests showing nonpaternity-conclusive or rebuttable evidence? The Chaplin case revisited. Author(s): Benson F. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1981 September; 2(3): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7034526&dopt=Abstract

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By the way, doctor. For years, I've been taking the same dose of Synthroid for hypothyroidism, and recent tests place me in the normal range. However, I still have several symptoms of low thyroid--fatigue, difficulty losing weight, sensitivity to cold, and constipation. My doctor doesn't seem concerned with the symptoms, as long as my blood tests are normal. But I'm frustrated. Is there anything I can do? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2001 January; 8(5): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137975&dopt=Abstract

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Can transcutaneous bilirubinometry reduce the need for blood tests in jaundiced full term babies? Author(s): Briscoe L, Clark S, Yoxall CW. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2002 May; 86(3): F190-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11978751&dopt=Abstract

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Carbon monoxide poisoning. Carboxyhaemoglobin can be measured with standard blood tests. Author(s): Turner M. Source: Bmj (Clinical Research Ed.). 2000 March 18; 320(7237): 804. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10720383&dopt=Abstract

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Changes in physician behavior and cost savings associated with organizational recommendations on the use of “routine” chest X rays and multichannel blood tests. Author(s): Thompson RS, Kirz HL, Gold RA. Source: Preventive Medicine. 1983 May; 12(3): 385-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6410370&dopt=Abstract

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Characteristics of subjects with chronic pain, in relation to local and widespread pain report. A prospective study of symptoms, clinical findings and blood tests in subgroups of a geographically defined population. Author(s): Andersson HI, Ejlertsson G, Leden I, Rosenberg C. Source: Scandinavian Journal of Rheumatology. 1996; 25(3): 146-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8668957&dopt=Abstract

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Children's reactions to blood tests. Author(s): Fradet C. Source: Nurs Times. 1990 June 13-19; 86(24): 55. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2362863&dopt=Abstract

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Choice of fecal occult blood tests for colorectal cancer screening: recommendations based on performance characteristics in population studies: a WHO (World Health Organization) and OMED (World Organization for Digestive Endoscopy) report. Author(s): Young GP, St John DJ, Winawer SJ, Rozen P; WHO (World Health Organization) and OMED (World Organization for Digestive Endoscopy). Source: The American Journal of Gastroenterology. 2002 October; 97(10): 2499-507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12385430&dopt=Abstract

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Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: influence of age, gender, and family history. Author(s): Rex DK, Lehman GA, Ulbright TM, Smith JJ, Pound DC, Hawes RH, Helper DJ, Wiersema MJ, Langefeld CD, Li W. Source: The American Journal of Gastroenterology. 1993 June; 88(6): 825-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8503374&dopt=Abstract

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Colorectal cancer screening in asymptomaic adults: comparison of colonoscopy, sigmoidoscopy and fecal occult blood tests. Author(s): Cheng TI, Wong JM, Hong CF, Cheng SH, Cheng TJ, Shieh MJ, Lin YM, Tso CY, Huang AT. Source: J Formos Med Assoc. 2002 October; 101(10): 685-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517041&dopt=Abstract

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Colorectal cancer screening. Faecal occult blood tests. Author(s): McDonald C. Source: Aust Fam Physician. 1985 April; 14(4): 273, 276-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4015528&dopt=Abstract

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Comments on: Should there be mass screening using faecal occult blood tests for colorectal cancer? Pro: Faivre, et al. Eur J Cancer 1998, 34(6), 773-780. Author(s): Zappa M, Castiglione G, Grazzini G. Source: European Journal of Cancer (Oxford, England : 1990). 1999 February; 35(2): 326. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10448280&dopt=Abstract

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Common blood tests for liver disease. Which ones are most useful? Author(s): Neuschwander-Tetri BA. Source: Postgraduate Medicine. 1995 July; 98(1): 49-56, 59, 63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7603947&dopt=Abstract

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Comparative studies on the “in vivo”-sensitivity of four commercial pseudoperoxidase-based faecal occult blood tests in relation to actual blood losses as calculated from measured whole body-59Fe-elimination rates. Author(s): Heinrich HC, Icagic F. Source: Klin Wochenschr. 1980 December 1; 58(23): 1283-97. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6970298&dopt=Abstract

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Comparative value of self-report and blood tests in assessing outcome amongst alcoholics. Author(s): Keso L, Salaspuro M. Source: British Journal of Addiction. 1990 February; 85(2): 209-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1969294&dopt=Abstract

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Comparison of a urine spot test and blood tests as indicators of patient compliance. Author(s): Yoder LJ, Guitrau M, Jacobson R. Source: Indian J Lepr. 1991 April-June; 63(2): 195-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1783788&dopt=Abstract

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Comparison of Coloscreen Self-Test and Haemoccult faecal occult blood tests in the detection of colorectal cancer in symptomatic patients. Author(s): Pye G, Jackson J, Thomas WM, Hardcastle JD. Source: The British Journal of Surgery. 1990 June; 77(6): 630-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2200550&dopt=Abstract

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Comparison of fecal occult blood tests for detection of gastrointestinal bleeding in pediatric patients. Author(s): Rosenthal P, Jennings MT. Source: The American Journal of Gastroenterology. 1992 November; 87(11): 1575-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1442676&dopt=Abstract

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Comparison of home occult blood tests and interaction of tests with ibuprofen. Author(s): Collins CL, DeTullio PL, Berardi RR, Elta GH, Patterson RW. Source: Clin Pharm. 1989 July; 8(7): 501-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2752699&dopt=Abstract

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Comparison of three faecal occult blood tests in the detection of colorectal neoplasia. Author(s): Hope RL, Chu G, Hope AH, Newcombe RG, Gillespie PE, Williams SJ. Source: Gut. 1996 November; 39(5): 722-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9014773&dopt=Abstract

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Comparison of two rapid whole-blood tests for Helicobacter pylori infection in Chinese patients. Author(s): Leung WK, Chan FK, Falk MS, Suen R, Sung JJ. Source: Journal of Clinical Microbiology. 1998 November; 36(11): 3441-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9774619&dopt=Abstract

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Compliance of general practitioners with a guideline-based decision support system for ordering blood tests. Author(s): van Wijk MA, van der Lei J, Mosseveld M, Bohnen AM, van Bemmel JH. Source: Clinical Chemistry. 2002 January; 48(1): 55-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751538&dopt=Abstract

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Correlation between qualitative and quantitative faecal occult blood tests. Author(s): Robertson JD, Maughan RJ, Davidson RJ. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1987 December; 170(2-3): 339-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3436067&dopt=Abstract

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Current thinking on blood tests in pregnancy. Author(s): Gaffney G. Source: The Practitioner. 1995 August; 239(1553): 488-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7659675&dopt=Abstract

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Delayed cutaneous hypersensitivity, lymphocyte count, and blood tests in patients with breast carcinoma. Author(s): Lee YT. Source: Journal of Surgical Oncology. 1984 November; 27(3): 135-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6492808&dopt=Abstract

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Demystifying diagnostic procedures: Part I. Hospital admission--basic blood tests. Author(s): Carlson M. Source: J Pract Nurs. 1979 May; 29(5): 16-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=255154&dopt=Abstract

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Detection of colorectal adenomas by fecal occult blood tests. Author(s): Gschwantler M, Weiss W. Source: Gastroenterology. 1994 January; 106(1): 279-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8276201&dopt=Abstract

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Detection of occult upper gastrointestinal tract bleeding: performance differences in fecal occult blood tests. Author(s): Harewood GC, McConnell JP, Harrington JJ, Mahoney DW, Ahlquist DA. Source: Mayo Clinic Proceedings. 2002 January; 77(1): 23-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11794453&dopt=Abstract

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Detection of upper gastrointestinal blood with fecal occult blood tests. Author(s): Rockey DC, Auslander A, Greenberg PD. Source: The American Journal of Gastroenterology. 1999 February; 94(2): 344-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10022627&dopt=Abstract

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Diagnosing fibrosis in hepatitis C: is the pendulum swinging from biopsy to blood tests? Author(s): Afdhal NH. Source: Hepatology (Baltimore, Md.). 2003 May; 37(5): 972-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12717376&dopt=Abstract

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Diagnosis of thrombosis. Evaluation of 125I-fibrinogen scanning and blood tests. Author(s): Hirsh J, Gallus AS, Cade JF. Source: Thromb Diath Haemorrh. 1974 September 30; 32(1): 11-20. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4616422&dopt=Abstract

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Diagnostic validity of fecal occult blood tests for detecting gastroenterological cancers. Author(s): Murakami R, Otani T, Nakanishi K, Fudemoto Y, Ishikawa H, Hiyama T, Tsukuma H, Fujimoto I, Miki N, Oshima A. Source: Japanese Journal of Cancer Research : Gann. 1992 February; 83(2): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1555995&dopt=Abstract

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Do children need routine preoperative blood tests and blood cross matching in orthopaedic practice? Author(s): Jones MW, Harvey IA, Owen R. Source: Annals of the Royal College of Surgeons of England. 1989 January; 71(1): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2923412&dopt=Abstract

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Early detection of colorectal cancer using faecal occult blood tests. Author(s): Elliot MS, Levenstein JH, Wright JP, Kottler RE. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1984 August 11; 66(6): 219-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6463799&dopt=Abstract

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Emerging technologies in screening for colorectal cancer: CT colonography, immunochemical fecal occult blood tests, and stool screening using molecular markers. Author(s): Levin B, Brooks D, Smith RA, Stone A. Source: Ca: a Cancer Journal for Clinicians. 2003 January-February; 53(1): 44-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568443&dopt=Abstract

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Evaluation of AMHTS for the early detection of gastric cancer--with special reference to blood tests. Author(s): Hinohara S, Takahashi T, Suzuki S, Niwa M. Source: Med Inform (Lond). 1983 April-June; 8(2): 89-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6865568&dopt=Abstract

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Evaluation of blood tests to predict normal gastric mucosa. Author(s): Oksanen A, Sipponen P, Miettinen A, Sarna S, Rautelin H. Source: Scandinavian Journal of Gastroenterology. 2000 August; 35(8): 791-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10994615&dopt=Abstract

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Evaluation of new occult blood tests for detection of colorectal neoplasia. Author(s): St John DJ, Young GP, Alexeyeff MA, Deacon MC, Cuthbertson AM, Macrae FA, Penfold JC. Source: Gastroenterology. 1993 June; 104(6): 1661-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8500724&dopt=Abstract

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Evaluation of preoperative blood tests for predicting deep vein thrombosis after total hip replacement. Author(s): Mindner K, Bergmann I, Sturm G, Liedloff H, Hindersin P, Gleiser W, Till U, Vogel G. Source: Haematologia. 1988; 21(1): 47-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3396975&dopt=Abstract

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Faecal calprotectin and faecal occult blood tests in the diagnosis of colorectal carcinoma and adenoma. Author(s): Tibble J, Sigthorsson G, Foster R, Sherwood R, Fagerhol M, Bjarnason I. Source: Gut. 2001 September; 49(3): 402-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11511563&dopt=Abstract

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Faecal occult blood tests in adenoma detection. Author(s): Kronborg O. Source: European Journal of Cancer Prevention : the Official Journal of the European Cancer Prevention Organisation (Ecp). 1993 June; 2 Suppl 2: 107-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8364366&dopt=Abstract

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Failure of health care professionals to interpret fecal occult blood tests accurately. Author(s): Selinger RR, Norman S, Dominitz JA. Source: The American Journal of Medicine. 2003 January; 114(1): 64-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543293&dopt=Abstract

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False-negative stool occult blood tests caused by ingestion of ascorbic acid (vitamin C). Author(s): Jaffe RM, Kasten B, Young DS, MacLowry JD. Source: Annals of Internal Medicine. 1975 December; 83(6): 824-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1200528&dopt=Abstract

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False-positive stool occult blood tests caused by iron preparations. A controlled study and review of literature. Author(s): Lifton LJ, Kreiser J. Source: Gastroenterology. 1982 October; 83(4): 860-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7106516&dopt=Abstract

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Familial hypo-beta-lipoproteinemia: a family detected by cord blood tests. Author(s): Stein EA. Source: Am J Dis Child. 1977 December; 131(12): 1363-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=201167&dopt=Abstract

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Fecal occult blood testing in a general medical clinic: comparison between guaiacbased and immunochemical-based tests. Author(s): Ko CW, Dominitz JA, Nguyen TD. Source: The American Journal of Medicine. 2003 August 1; 115(2): 111-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893396&dopt=Abstract

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Fecal occult blood tests for colorectal cancer. Author(s): Singh P, Gallo SH. Source: Annals of Internal Medicine. 1993 March 15; 118(6): 472. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8439124&dopt=Abstract

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Fecal occult blood tests in occult gastrointestinal bleeding. Author(s): Bond JH. Source: Semin Gastrointest Dis. 1999 April; 10(2): 48-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10361895&dopt=Abstract

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Fecal occult blood tests often misinterpreted by providers. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2003 March 7; 14(5): 5-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12817576&dopt=Abstract

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Fecal occult blood tests. A cost-effectiveness analysis. Author(s): Gyrd-Hansen D. Source: International Journal of Technology Assessment in Health Care. 1998 Spring; 14(2): 290-301. Erratum In: Int J Technol Assess Halth Care 1998 Summer; 14(3): 602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9611904&dopt=Abstract

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Fecal occult blood tests: what's new? Author(s): Lance P. Source: Gastroenterology. 1993 June; 104(6): 1852-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8500745&dopt=Abstract

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Flexible sigmoidoscopy in asymptomatic patients with negative fecal occult blood tests. Author(s): Cauffman JG, Hara JH, Rasgon IM, Clark VA. Source: The Journal of Family Practice. 1992 March; 34(3): 281-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1541954&dopt=Abstract

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Further developments in the law relating to blood tests. Author(s): Lanham D. Source: Med Sci Law. 1968 April; 8(2): 80-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5665689&dopt=Abstract

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Gaining patient consent for blood tests following sharps injuries. Author(s): Dimond B. Source: Nurs Times. 2003 September 16-22; 99(37): 48-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14533328&dopt=Abstract

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How long to abstain from eating red meat before fecal occult blood tests. Author(s): Feinberg EJ, Steinberg WM, Banks BL, Henry JP. Source: Annals of Internal Medicine. 1990 September 1; 113(5): 403-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2200323&dopt=Abstract

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How useful are combinations of blood tests in “rheumatic panels” in diagnosis of rheumatic diseases? Author(s): Lichtenstein MJ, Pincus T. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1988 September-October; 3(5): 435-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3262732&dopt=Abstract

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I have heard that buspirone regularly affects various blood tests. Is this so? Author(s): Shader RI. Source: Journal of Clinical Psychopharmacology. 1996 April; 16(2): 194. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8690840&dopt=Abstract

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Images of children appeal to seniors. Stratis Health lures mature market for blood tests. Author(s): Herreria J. Source: Profiles Healthc Mark. 1998 November-December; 14(6): 35-8, 3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10387287&dopt=Abstract

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Immunochemical vs guaiac faecal occult blood tests in a population-based screening programme for colorectal cancer. Author(s): Castiglione G, Zappa M, Grazzini G, Mazzotta A, Biagini M, Salvadori P, Ciatto S. Source: British Journal of Cancer. 1996 July; 74(1): 141-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8679448&dopt=Abstract

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Immuno-cytological blood tests in cases of sarcoidosis. Author(s): Wurm K, Lohr G. Source: Sarcoidosis. 1986 March; 3(1): 52-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3033787&dopt=Abstract

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Immunological determination of fecal hemoglobin and transferrin levels: a comparison with other fecal occult blood tests. Author(s): Miyoshi H, Ohshiba S, Asada S, Hirata I, Uchida K. Source: The American Journal of Gastroenterology. 1992 January; 87(1): 67-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1728128&dopt=Abstract

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In vivo acoustic attenuation in liver: correlations with blood tests and histology. Author(s): Duerinckx A, Rosenberg K, Hoefs J, Aufrichtig D, Cole-Beuglet C, Kanel G, Lottenberg S, Ferrari LA. Source: Ultrasound in Medicine & Biology. 1988; 14(5): 405-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3051614&dopt=Abstract

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Influence of diet on occult blood tests. Author(s): Illingworth DG. Source: Gut. 1965 December; 6(6): 595-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5857896&dopt=Abstract

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Influence of non-steroidal anti-inflammatory drugs in faecal occult blood tests. Author(s): Niv Y. Source: British Medical Journal (Clinical Research Ed.). 1987 August 15; 295(6595): 446. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3115493&dopt=Abstract

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Influence of non-steroidal anti-inflammatory drugs on the outcome of faecal occult blood tests in screening for colorectal cancer. Author(s): Pye G, Ballantyne KC, Armitage NC, Hardcastle JD. Source: British Medical Journal (Clinical Research Ed.). 1987 June 13; 294(6586): 1510-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3111616&dopt=Abstract

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Interference of plant peroxidases with guaiac-based fecal occult blood tests is avoidable. Author(s): Sinatra MA, St John DJ, Young GP. Source: Clinical Chemistry. 1999 January; 45(1): 123-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9895348&dopt=Abstract

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Interpretation of routine blood tests. Author(s): Bratt-Wyton R. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1998 December 9-15; 13(12): 42-6; Quiz 47-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10036480&dopt=Abstract

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Is there a preference for different ways of performing faecal occult blood tests? Author(s): Kettner JD, Whatrup C, Verne JE, Young K, Williams CB, Northover JM. Source: International Journal of Colorectal Disease. 1990 May; 5(2): 82-6. Erratum In: Int J Colorectal Dis 1990 August; 5(3): 176. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2242119&dopt=Abstract

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Letter: Red fruits causing false-positive occult blood tests in stool. Author(s): Wiener SL, Wiener J. Source: The New England Journal of Medicine. 1975 August 21; 293(8): 408. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1152946&dopt=Abstract

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Liability for police-ordered, unconsented blood tests. Author(s): Davis CD. Source: Tex Hosp. 1982 November; 38(6): 41-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10257742&dopt=Abstract

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Management of dyspepsia in primary care. Breath test is better than near patient blood tests. Author(s): Churchill RD, Hill PG, Holmes GK. Source: Bmj (Clinical Research Ed.). 1998 May 2; 316(7141): 1389. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9616004&dopt=Abstract

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Management of thyroid nodules. I: History and physical examination, blood tests, Xray tests, and ultrasonography. Author(s): Ashcraft MW, Van Herle AJ. Source: Head Neck Surg. 1981 January-February; 3(3): 216-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7007286&dopt=Abstract

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Managing patients with an absent or dysfunctional spleen. Uncertainty exists over frequency of blood tests to test antipneumococcal immunity. Author(s): Kassianos GC. Source: Bmj (Clinical Research Ed.). 1996 May 25; 312(7042): 1360; Author Reply 1361. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8646068&dopt=Abstract

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Maryland law, disputed paternity, and blood tests. Author(s): Wenk RE, Houtz T, Brooks M. Source: Md State Med J. 1983 June; 32(6): 448-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6876893&dopt=Abstract

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Midwifery basics. Antenatal care--blood tests in pregnancy. Author(s): Baston H. Source: Pract Midwife. 2002 December; 5(11): 28-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520815&dopt=Abstract

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Neonatal blood tests to exclude caesarean section as a cause of maternal-fetal transmission of hepatitis C. Author(s): Giorlandino C, Gambuzza G, D'alessio P, Morgani AR. Source: Lancet. 1995 September 30; 346(8979): 908. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7564703&dopt=Abstract

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Occult blood tests and colorectal tumours. Author(s): Ribet A, Frexinos J, Escourrou J, Delpu J. Source: Lancet. 1980 February 23; 1(8165): 417. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6101861&dopt=Abstract

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Occult blood tests and general practitioners. Author(s): Scally G. Source: Lancet. 1983 August 13; 2(8346): 401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6135897&dopt=Abstract

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Occult blood tests. Author(s): Hardcastle JD, Thomas WM. Source: Lancet. 1989 September 16; 2(8664): 672. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2570915&dopt=Abstract

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Occult blood tests. Author(s): Heinrich HC. Source: Lancet. 1980 April 12; 1(8172): 822-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6102701&dopt=Abstract

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Occult blood tests. Author(s): Gnauck R. Source: Lancet. 1980 April 12; 1(8172): 822. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6102700&dopt=Abstract

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Occult-blood tests. Author(s): Simpson RG. Source: Lancet. 1970 May 9; 1(7654): 1001. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4191916&dopt=Abstract

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On the application of blood tests to legal cases of disputed paternity. Author(s): Henningsen K. Source: Rev Fr Transfus. 1969 March; 12(1): 137-58. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4975541&dopt=Abstract

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Optimal use of blood tests for assessment of thyroid function. Author(s): Becker DV, Bigos ST, Gaitan E, Morris JC 3rd, Rallison ML, Spencer CA, Sugawara M, Van Middlesworth L, Wartofsky L. Source: Jama : the Journal of the American Medical Association. 1993 June 2; 269(21): 2736-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8492395&dopt=Abstract

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Peripheral blood findings of young females through the result of blood tests of students of a women's college. (Part 2) Calorie intake during camp training and athlete's anemia. Author(s): Horiguchi S. Source: Osaka City Med J. 1975; 21(2): 79-83. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1230723&dopt=Abstract

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Peripheral blood findings of young females through the result of blood tests on students of a women's college. Author(s): Horiguchi S, Miyashita K, Ideta S, Aaska K. Source: Osaka City Med J. 1975; 21(1): 15-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1226311&dopt=Abstract

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Population screening for colorectal cancer: comparison between guaiac and immunological faecal occult blood tests. Author(s): Robinson MH, Marks CG, Farrands PA, Thomas WM, Hardcastle JD. Source: The British Journal of Surgery. 1994 March; 81(3): 448-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8173928&dopt=Abstract

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Postmortem blood tests for HIV, HBV, and HCV in a body donation program. Author(s): Watkins BP, Haushalter RE, Bolender DL, Kaplan S, Kolesari GL. Source: Clinical Anatomy (New York, N.Y.). 1998; 11(4): 250-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9652540&dopt=Abstract

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Post-operative blood tests and multicentric recurrence of hepatocellular carcinoma. Author(s): Shuto T, Hirohashi K, Kubo S, Tanaka H, Hamba H, Mikami S, Ikebe T, Kinoshita H. Source: Hepatogastroenterology. 1999 July-August; 46(28): 2545-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10522037&dopt=Abstract

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Posture and blood tests. Author(s): Dimmitt SB. Source: Lancet. 1990 December 1; 336(8727): 1381-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1978189&dopt=Abstract

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Practical approach to patient with abnormal blood tests. Author(s): DeMarco LI, Eirinberg ID. Source: S D J Med. 1970 January; 23(1): 11-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5262401&dopt=Abstract

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Prediction of postoperative survival by preoperative serum concentrations of anti-p53 compared to CEA, CA 50, CA 242 and conventional blood tests in patients with colorectal carcinoma. Author(s): Forslund A, Engaras B, Lonnroth C, Lundholm K. Source: International Journal of Oncology. 2002 May; 20(5): 1013-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11956598&dopt=Abstract

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Prediction of the severity of ABO haemolytic disease of the newborn by cord blood tests. Author(s): Whyte J, Graham H. Source: Acta Paediatr Scand. 1981 March; 70(2): 217-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7195139&dopt=Abstract

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Pre-operative blood tests in children undergoing plastic surgery. Author(s): Ansermino JM, Than M, Swallow PD. Source: Annals of the Royal College of Surgeons of England. 1999 May; 81(3): 175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10364949&dopt=Abstract

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Preoperative blood tests in prediction of postoperative deep vein thrombosis. Author(s): Dhall TZ, Shah GA, Ferguson IA, Ardlie NG, Dhall DP. Source: Thrombosis Research. 1982 July 15; 27(2): 143-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7135351&dopt=Abstract

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Prevalence of proximal colonic polyps in average-risk asymptomatic patients with negative fecal occult blood tests and flexible sigmoidoscopy. Author(s): Kadakia SC, Wrobleski CS, Kadakia AS, Meier NJ. Source: Gastrointestinal Endoscopy. 1996 August; 44(2): 112-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8858314&dopt=Abstract

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Rehydration of guaiac-based faecal occult blood tests in mass screening for colorectal cancer. An economic perspective. Author(s): Walker AR, Whynes DK, Hardcastle JD. Source: Scandinavian Journal of Gastroenterology. 1991 February; 26(2): 215-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2011707&dopt=Abstract

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Relationship between fecal sampling times and sensitivity and specificity of immunochemical fecal occult blood tests for colorectal cancer: a comparative study. Author(s): Nakama H, Kamijo N, Fujimori K, Fattah AS, Zhang B. Source: Diseases of the Colon and Rectum. 1997 July; 40(7): 781-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9221852&dopt=Abstract

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Relative frequency of upper gastrointestinal and colonic lesions in patients with positive fecal occult-blood tests. Author(s): Rockey DC, Koch J, Cello JP, Sanders LL, McQuaid K. Source: The New England Journal of Medicine. 1998 July 16; 339(3): 153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664091&dopt=Abstract

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Relevance of preoperative and postoperative blood tests to postoperative leg-vein thrombosis. Author(s): Gallus AS, Hirsh J, Gent M. Source: Lancet. 1973 October 13; 2(7833): 805-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4126613&dopt=Abstract

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Results of a repeat television-advertised mass screening program for colorectal cancer using fecal occult blood tests. Author(s): McGarrity TJ, Long PA, Peiffer LP. Source: The American Journal of Gastroenterology. 1990 March; 85(3): 266-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2309678&dopt=Abstract

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Screening blood tests in members of the Israeli National Olympic team. Author(s): Eliakim A, Nemet D, Constantini N. Source: The Journal of Sports Medicine and Physical Fitness. 2002 June; 42(2): 250-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032424&dopt=Abstract

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Screening colonoscopy in asymptomatic average-risk persons with negative fecal occult blood tests. Author(s): Rex DK, Lehman GA, Hawes RH, Ulbright TM, Smith JJ. Source: Gastroenterology. 1991 January; 100(1): 64-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1796931&dopt=Abstract

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Screening colorectal cancer: fecal occult blood tests. Author(s): Boone WT. Source: J Miss State Med Assoc. 1985 April; 26(4): 95-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3989861&dopt=Abstract

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Screening for colorectal cancer. A comparison of 3 fecal occult blood tests. Author(s): Levin B, Hess K, Johnson C. Source: Archives of Internal Medicine. 1997 May 12; 157(9): 970-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9140267&dopt=Abstract

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Screening for colorectal cancer: alternative faecal occult blood tests. Author(s): Young GP. Source: European Journal of Gastroenterology & Hepatology. 1998 March; 10(3): 205-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9585022&dopt=Abstract

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Screening for primary hyperparathyroidism (PHPT) in clinic patients: differential diagnosis between PHPT and malignancy-associated hypercalcemia by routine blood tests. Author(s): Kim SJ, Shiba E, Maeda I, Yoshioka T, Amino N, Noguchi S. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2001 March; 305(1-2): 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249920&dopt=Abstract

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Second-generation blood tests to detect erythropoietin abuse by athletes. Author(s): Gore CJ, Parisotto R, Ashenden MJ, Stray-Gundersen J, Sharpe K, Hopkins W, Emslie KR, Howe C, Trout GJ, Kazlauskas R, Hahn AG. Source: Haematologica. 2003 March; 88(3): 333-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651273&dopt=Abstract

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Self-administered faecal occult blood tests do not increase compliance with screening for colorectal cancer: results of a randomized controlled trial. Author(s): Verne J, Kettner J, Mant D, Farmer A, Mortenson N, Northover J. Source: European Journal of Cancer Prevention : the Official Journal of the European Cancer Prevention Organisation (Ecp). 1993 July; 2(4): 301-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8358281&dopt=Abstract

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Serum enzymes and other blood tests used to detect alcohol abuse. Author(s): Kaplan MM. Source: Trans Am Acad Insur Med. 1993; 76: 96-114. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8101672&dopt=Abstract

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Should all people over the age of 50 have regular fecal occult-blood tests? If it works, why not do it? Author(s): Fletcher RH. Source: The New England Journal of Medicine. 1998 April 16; 338(16): 1153-4; Discussion 1154-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9547141&dopt=Abstract

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Should all people over the age of 50 have regular fecal occult-blood tests? Postpone population screening until problems are solved. Author(s): Simon JB. Source: The New England Journal of Medicine. 1998 April 16; 338(16): 1151-2; Discussion 1154-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9545367&dopt=Abstract

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Should there be mass screening using faecal occult blood tests for colorectal cancer? Author(s): Faivre J, Tazi MA, Autier P, Bleiberg H. Source: European Journal of Cancer (Oxford, England : 1990). 1998 May; 34(6): 773-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797686&dopt=Abstract

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Simple blood tests can predict compensated liver cirrhosis in patients with chronic hepatitis C. Author(s): Luo JC, Hwang SJ, Chang FY, Chu CW, Lai CR, Wang YJ, Lee PC, Tsay SH, Lee SD. Source: Hepatogastroenterology. 2002 March-April; 49(44): 478-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11995477&dopt=Abstract

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The contribution of resting heart rate and routine blood tests to the clinical assessment of disease activity in systemic lupus erythematosus. Author(s): Guzman J, Cardiel MH, Arce-Salinas A, Alarcon-Segovia D. Source: The Journal of Rheumatology. 1994 October; 21(10): 1845-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7837148&dopt=Abstract

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The correlation of symptoms, occult blood tests, and neoplasms in patients referred for double-contrast barium enema. Author(s): Jensen J, Kewenter J, Swedenborg J. Source: Scandinavian Journal of Gastroenterology. 1993 October; 28(10): 911-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8266021&dopt=Abstract

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The diagnosis of adult pneumonia in general practice. The diagnostic value of history, physical examination and some blood tests. Author(s): Melbye H, Straume B, Aasebo U, Brox J. Source: Scandinavian Journal of Primary Health Care. 1988 May; 6(2): 111-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3387706&dopt=Abstract

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The early detection of alcohol consumption (EDAC) score in the identification of Heavy and at-risk drinkers from routine blood tests. Author(s): Harasymiw JW, Vinson DC, Bean P. Source: Journal of Addictive Diseases : the Official Journal of the Asam, American Society of Addiction Medicine. 2000; 19(3): 43-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11076119&dopt=Abstract

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The effect of self-administered faecal occult blood tests on compliance with screening for colorectal cancer: results of a survey of those invited. Author(s): Hunter W, Farmer A, Mant D, Verne J, Northover J, Fitzpatrick R. Source: Family Practice. 1991 December; 8(4): 367-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1800202&dopt=Abstract

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The effect of toilet sanitizers and detergents on immunological occult blood tests. Author(s): Imafuku Y, Nagai T, Yoshida H. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1996 September 30; 253(1-2): 51-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8879838&dopt=Abstract

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The effectiveness of blood tests in detecting secondary osteoporosis or mimicking conditions in postmenopausal women. Author(s): Cooper A, Brew S, de Lusignan S. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2002 April; 52(477): 311-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11942449&dopt=Abstract

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The erythrocyte sedimentation rate and other blood tests in terminal cancer. Author(s): Mead J, Larson DL. Source: Journal of the American Geriatrics Society. 1970 June; 18(6): 489-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5446058&dopt=Abstract

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The nurse and bedside blood tests. Author(s): Smith JH. Source: Nurs Times. 1982 July 28-August 3; 78(30): 1285. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6921671&dopt=Abstract

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The relative value of fecal occult blood tests and flexible sigmoidoscopy in screening for large bowel neoplasia. Author(s): Rozen P, Ron E, Fireman Z, Hallak A, Grossman A, Baratz M, Rattan J, Gilat T. Source: Cancer. 1987 November 15; 60(10): 2553-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3664435&dopt=Abstract

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The reliability of blood tests drawn from intravenous lines. Author(s): Jackson EF Jr. Source: Ohio State Med J. 1972 January; 68(1): 32-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5009134&dopt=Abstract

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The role of screening blood tests in patients with arterial disease attending vascular outpatients. Author(s): Pararajasingam R, Nasim A, Sutton C, Dennis MJ, Bell PR, Sayers RD. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 1998 December; 16(6): 513-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9894492&dopt=Abstract

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The use of blood tests to detect alcohol as a cause of pancreatitis. Author(s): Nordback I. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1998 April; 14(4): 405-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9591317&dopt=Abstract

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To Dr. H. J. Nord, regarding discussion of the workup of a patient with positive fecal occult blood tests. Author(s): Van Ness MM. Source: The American Journal of Gastroenterology. 1991 November; 86(11): 1687. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1951254&dopt=Abstract

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Two British blood tests launched. Author(s): Clarke M. Source: Nature. 1985 August 8-14; 316(6028): 474. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2993894&dopt=Abstract

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Two new HIV blood tests. Author(s): Highleyman L. Source: Beta. 1999 April; 12(2): 4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11366696&dopt=Abstract

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Understanding the usefulness of specific IgE blood tests in allergy. Author(s): Ahlstedt S. Source: Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology. 2002 January; 32(1): 11-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12002727&dopt=Abstract

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Use of blood tests in general practice: a collaborative study in eight European countries. Eurosentinel Study Group. Author(s): Leurquin P, Van Casteren V, De Maeseneer J. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 1995 January; 45(390): 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7779470&dopt=Abstract

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Use of symptoms, signs, and blood tests to diagnose acute sinus infections in primary care: comparison with computed tomography. Author(s): Lindbaek M, Hjortdahl P, Johnsen UL. Source: Family Medicine. 1996 March; 28(3): 183-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8900550&dopt=Abstract

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Useful blood tests in the diagnosis and management of cancer: a review. Author(s): Hartman HA Jr, Foley JF. Source: Nebr Med J. 1977 April; 62(4): 111-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=846611&dopt=Abstract

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Useful blood tests in the diagnosis and management of cancer: a review. Part II. Author(s): Hartman HA, Foley JF. Source: Nebr Med J. 1977 May; 62(5): 151-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=854126&dopt=Abstract

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Useful blood tests in the diagnosis and management of cancer: a review. Part III Antigens and Antibodies. Author(s): Hartman HA Jr, Foley JF. Source: Nebr Med J. 1977 June; 62(6): 184-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=69997&dopt=Abstract

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Usefulness of blood tests carried out during screening of the elderly population in one practice. Author(s): Edwards Y, Davies TR. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 1991 December; 41(353): 496-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1807325&dopt=Abstract

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Value of routine multiple blood tests in patients attending the general practitioner. Author(s): Carmalt MH, Freeman P, Stephens AJ, Whitehead TP. Source: British Medical Journal. 1970 March 7; 1(696): 620-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5440241&dopt=Abstract

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Venipuncture is more effective and less painful than heel lancing for blood tests in neonates. Author(s): Larsson BA, Tannfeldt G, Lagercrantz H, Olsson GL. Source: Pediatrics. 1998 May; 101(5): 882-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9565419&dopt=Abstract

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Vitamin C and guaiac occult blood tests. Author(s): Nagengast FM. Source: Lancet. 1981 March 14; 1(8220 Pt 1): 614. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6110846&dopt=Abstract

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Voluntary blood tests for Canadian doctors? Author(s): Kondro W. Source: Lancet. 1998 October 10; 352(9135): 1205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9777852&dopt=Abstract

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What is measured when we identify alcoholics by means of blood tests? Author(s): Evenson RC, Frankel MF, Freedland KE. Source: Int J Addict. 1988 April; 23(4): 433-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3164307&dopt=Abstract

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What the doctor says--blood tests. Author(s): Fleetwood J. Source: Caritas. 1988 Autumn; 54(67): 15. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3203227&dopt=Abstract

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CHAPTER 2. NUTRITION AND BLOOD TESTS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and blood tests.

Finding Nutrition Studies on Blood Tests The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “blood tests” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

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

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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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

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Healthnotes: http://www.healthnotes.com/

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

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

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

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to blood tests; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation:

Nutrition

•

Vitamins Niacin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Vitamin B12 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B3 Source: Prima Communications, Inc.www.personalhealthzone.com

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Minerals Gabapentin Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. DISSERTATIONS ON BLOOD TESTS Overview In this chapter, we will give you a bibliography on recent dissertations relating to blood tests. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “blood tests” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on blood tests, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Blood Tests ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to blood tests. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

The Role of Counseling in Discovery, Analysis and Amelioration of the Effects of Alleged Fathers of Compelled Participation in a Paternity Blood Test Program by Ward, Jane L., Phd from University of Pittsburgh, 1985, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8517998

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 4. PATENTS ON BLOOD TESTS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “blood tests” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on blood tests, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Blood Tests By performing a patent search focusing on blood tests, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on blood tests: •

Blood bank cuvette cassette and label therefor Inventor(s): Levy; Didya D. (Brooklyn, NY), Scordato; Richard E. (Scarsdale, NY) Assignee(s): Medical Laboratory Automation, Inc. (Mount Vernon, NY) Patent Number: 4,472,357 Date filed: November 18, 1981 Abstract: A plurality of cuvettes joined together by breakable links between each cuvette for use in testing blood for its ABO classification and the presence of a typical antibodies, and for crossmatching blood for compatibility, together with label means for indicating the reagents used in each cuvette and the identity of the person whose blood is being tested. The cuvettes may be adapted to accept a closure means which permits the cuvettes to be pre-packaged with reagents required to carry out blood tests. The cuvettes have a hydrophilic polymer coating thereon that is non-destructive of red blood cells. Excerpt(s): This invention relates to cuvettes used in a blood processing center for typing blood according to the ABO classification system, for screening the blood to identify atypical antibodies, and for crossmatching the blood for compatibility with that of potential donors. The invention also relates to an indicia means for positively identifying the cuvettes both as to the reagents used therein for carrying out the aforesaid procedures and the person whose blood is being classified. The importance of error free classification of a patient's blood and a donor's blood when the latter is to be transfused to the patient is so well understood by those working in the field of blood banking that it need not be reiterated here other than to say that transfusion of incompatible blood to a patient can lead to severe hemolytic reactions and even to the death of the patient. This incompatibility arises from the fact that red blood cells vary in their structure by what are called antigens so that one person's blood cells may have certain antigens that differ from those carried by the red blood cells of another person. If foreign antigens are introduced into a person's blood stream, his immunological system immediately produces antibodies that destroy the foreign material, i.e., the introduced blood cells carrying the foreign antigen. The incompatibility may also arise from the donor's serum which may contain antibodies that would destroy the patient's red blood cells because of the antigens carried thereon. Therefore, every effort must be made to facilitate the proper classification of blood and to properly and positively identify the classified blood so that incompatible blood transfusions are avoided. The principal blood cell antigens are designated A and B, with some cells having A antigens, some having B antigens, some having both A and B antigens, and some having neither A nor B antigens. Thus, blood having red cells carrying A antigens is referred to as Type A blood, that having cells carrying B antigens as Type B blood, that having cells carrying both A and B antigens as Type AB blood, and that having cells which do not carry either antigen as Type O blood. Other antigens are important, such as the D and other Rh antigens. The ABO blood group is generally determined by a forward typing protocol in which a person's red cells are mixed with antiserum reagents containing known antibodies to see if agglutination takes place. Thus, red cells are mixed with anti-A serum, anti-B serum, anti-AB serum, and anti-D serum. If the mixture of anti-A serum and the patient's red cells agglutinate and the mixture of anti-B serum and red cells does not, the patient's blood group is Type A. That is, the patient's red cells carry the A

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antigen. If the reverse result obtains, then the patient' s blood group is Type B. In both of these instances, the anti-AB mixture would agglutinate. If agglutination occurs in both mixtures, and in the anti-AB mixture, the blood group is Type AB, and if agglutination is absent in all mixtures, the blood group is Type O. If the D antigen is present, i.e., the anti-D serum-cell mixture agglutinates, the blood group is positive, e.g., Type A+, and if the D antigen is absent (when the mixture does not agglutinate) the blood group is negative, e.g., Type B-. Web site: http://www.delphion.com/details?pn=US04472357__ •

Blood test for assessing hepatic function Inventor(s): Wagner; David A. (Nashua, NH), Woolf; Graham M. (Los Angeles, CA) Assignee(s): Metabolic Solutions, Inc. (Merrimack, NH) Patent Number: 5,928,167 Date filed: October 20, 1997 Abstract: Provided herein is a novel blood test for assessing hepatic function. The test involves administration of a labeled methionine or methionine metabolite to a subject and measurement of the expired label in blood. Excerpt(s): The present invention relates to a method for monitoring hepatic disease or dysfunction. More specifically, the invention relates to administering labeled methionine or methionine metabolites to an individual and assessing labeled carbon dioxide in blood. Standard serologic and biochemical serum liver tests have been used to determine the presence of liver disease. However, these tests do not provide an accurate assessment of hepatic functional capacity nor do they detect changes in hepatic disease severity (Gitnick, G. Surg. Clin. N. Am. 61:197-207 ›1981!). Increasing prothrombin time and decreasing serum albumin concentrations have been used as prognostic indicators of progressive liver disease (Rydning, A., et al. Scand. J. Gastroenterol. 25:119-126 ›1990!). Significant changes in prothrombin time and albumin may occur in patients for reasons other than liver dysfunction and, at times, only after severe liver decompensation. Further, radiological testing and histological examination of liver biopsies are poor indicators of decreasing hepatic function. The Child-Pugh (CP) classification is used to determine the degree of liver disease severity. The CP classification reflects the sum of scores derived from clinical and laboratory parameters. Disadvantages of the CP classification include subjective measures (degree of ascites and encephalopathy) and dependence on serum tests (bilirubin, albumin, and prothrombin time) that may be influenced by extrahepatic factors. As a result, the CP classification is a poor measure of patient status and is insensitive to small changes in the patient's condition. Web site: http://www.delphion.com/details?pn=US05928167__

•

Blood test strip Inventor(s): Kloepfer; Mary A. (10930 Braewick Dr., Carmel, IN 46032) Assignee(s): none reported Patent Number: 4,883,764 Date filed: July 20, 1987

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Abstract: A blood test strip includes a support member having an upper surface and lower surface. A separating member is disposed on the upper surface of the support member, and includes an upstream end and a downstream end. A recipient member is disposed on the upper surface of the support member in a side by side relation to the separating member. The recipient member includes an upstream end disposed in an adjacent, non-interwoven relation to the downstream end of the separating member to define an incision therebetween. Excerpt(s): The present invention relates to methods and devices for the testing of blood constituents, and more particularly to a blood test strip, and a method of using a blood test strip to prepare a blood sample for analysis. In recent years, there has been a marked increase in the awareness of health issues. One manifestation of this awareness is that an increased importance is being placed on the use of preventive medicine to maintain good health. The widespread adoption of preventative medicine has resulted in an increase in the frequency of the testing for certain conditions, such as abnormal glucose and cholesterol levels, which indicate the existence of a disease, or the propensity to acquire a disease or disorder. The monitoring and detection of these conditions often is performed by analyzing a patient's blood to determine whether a particular substance exists in the patient's blood, or to determine the amount of that substance in a patient's blood. As a consequence of this increased monitoring, blood tests are being performed on a more frequent basis. Formerly, these tests were usually performed in large hospital or independent laboratories, for only large laboratories performed a sufficient volume of tests to justify the large expenditures often required for sophisticated laboratory equipment. Web site: http://www.delphion.com/details?pn=US04883764__ •

Blood test ware and matrixes Inventor(s): Anraku; Hideo (Shinnanyou, JP), Isogawa; Hironobu (Shinnanyou, JP) Assignee(s): Sekisui Kagaku Kogyo Kabushiki Kaisha (Osaka, JP) Patent Number: 5,888,824 Date filed: July 5, 1996 Abstract: This invention has for its object to provide a blood component depositionpreventing agent and a blood coagulation accelerator, which are substantially indifferent to blood coagulation activity and serum chemistry parameters and a plastic blood test ware and a blood test matrix which do not confound measured values. The invention relates to a blood component deposition-preventing agent comprising a random copolymer of a monomer component (a) giving a water-soluble homopolymer and a monomer component (b) giving a water-insoluble homopolymer, a blood coagulation accelerator comprising a substantially blood-insoluble antimicrobial composition comprising a carrier and, as supported thereon, an antimicrobial metal, and a blood test ware or matrix carrying them on its inside wall or surface. Excerpt(s): The present invention relates to a blood component deposition-preventing agent and a blood coagulation accelerator for use in the laboratory examination of a blood sample, particularly in hematology, serum biochemistry, and immunoserology, methods using them, and blood examination ware and matrixes. With recent advances in testing techniques, the chemical, immunoserological and hematological examinations of blood have witnessed a remarkable mechanization so that it is by now certain that only if properly prepared samples were provided, such examinations could be carried

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through in short periods of time. For example, even in the outpatient setting, the doctor would be able to make a diagnosis based on blood examination data, thus contributing much to the diagnosis and therapy of diseases. As to the pretreatment for hematological examinations using whole blood as a sample, mere admixing of the blood with an anticoagulant, which is not time-consuming, is sufficient so that the sample can be almost immediately set in an analyzer. Web site: http://www.delphion.com/details?pn=US05888824__ •

Capillary tube holder for test instruments especially blood tests and particularly for platelet counters, with two coaxial chambers Inventor(s): Pierotti; Romano (Aiezzo, IT) Assignee(s): S.E.A.C.s.r.l. (IT) Patent Number: 4,738,827 Date filed: May 6, 1986 Abstract: The phial or vial holding for a capillary tube is internally subdivided into an external chamber having annular cross-section and an internal chamber having circular cross-section. The outer wall of the chamber of annular cross-section carries a capillary hole and the inner tubular wall separating the two chambers has a hole in alignment with that of the outer wall and of larger diameter. In the hollow space of annular crosssection, a slight entrained flow through the hole of the inner wall and consequently a fast removal of the sample liquid which has passed through the capillary hole takes place. This is without backward flow in the direction of the capillary hole. Excerpt(s): This invention relates, in general, to holders and, in particular, to a new and useful holder for capillary tubes and phial holders. The invention refers particularly to a phial or vial for holding capillary tubes that are intended for use with biomedical test instruments and in particular for certain blood tests requiring the counting of cells present in suitably diluted blood. This is particularly but not exclusively, for the counting of thrombocytes or platelets. The basic concept of the present capillary tube holder involves the evaluation of the difference of electrical characteristics which occur within the capillary port or hole upon the passage of a body contained in the sample that is to be counted. The main problem is that of avoiding or at least limiting the error which may occur upon a possible passage of an already counted body--and which has therefore already passed through the capillary tube--in the vicinity of the same capillary tube, which event may cause an electrical signal corresponding to that taking place upon a passage of a body and, hence, may lead to a mistaken count of a further particle. According to the invention, the phial for holding capillary tubes, or capillary tube holder, is internally subdivided into an external chamber having an annular crosssection and an internal chamber having a circular cross-section most coaxial therewith. The outer wall of the chamber, which has an annular cross-section, carries the capillary port or hole and the inner tubular wall separating the two chambers has a hole disposed in alignment with that of the external capillary hole. The inner hole has a larger diameter than the outer capillary hole. Through suction, the sample liquid is made to enter inside the test tube of the platelet counter through the capillary hole. Soon after its transit into the capillary hole, the sample liquid goes through the annular hollow space and passes through the hole of large diameter, into the tubular inner wall to reach the internal chamber. Inside the hollow space having the annular cross-section, a slight call flow is thus generated through the hole of the tubular inner wall, said flow causing a fast removal of the sample liquid that has gone through the capillary hole with no

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backward flows in the direction of the outer capillary hole but with relatively very fast transit within the internal chamber defined by the tubular wall and having circular cross-section. Web site: http://www.delphion.com/details?pn=US04738827__ •

Device for testing fluids Inventor(s): Rayman; Gerard A. (10 Sternes Way, Stapleford, Cambridge, GB) Assignee(s): none reported Patent Number: 5,004,584 Date filed: June 23, 1988 Abstract: Blood tests are made using a diagnostic stick which has a testing chamber at one end of the stick. The chamber has an open end and is dimensioned so that blood can be drawn in to fill the chamber by capillary action. A testing surface is either mounted in the chamber or is on a separate probe which can be immersed in blood in the chamber. The invention can be used with fluids other than blood. Excerpt(s): This invention relates to a device for testing fluids. The device is particularly useful for testing body fluids, especially blood, and it allows blood testing to be carried out simply, quickly, and hygienically. Certain blood tests are conventionally carried out using a diagnostic stick which carries a testing surface having a culture medium or chemical reagent on it. Sticks with an electrochemical testing surface are also known. Blood to be tested is brought into contact with the testing surface and it is important that precise coverage of the testing surface is achieved, i.e. that the whole of the surface is evenly brought into contact with the blood to be tested. According to the present invention, there is provided a fluid testing device which has a chamber having an opening at one end, the chamber being adapted to be filled through capillary action when the opening is placed in a fluid, and a testing surface associated with the chamber and adapted to react to fluid in the chamber to produce an indication of properties of the fluid. Web site: http://www.delphion.com/details?pn=US05004584__

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Electronic instrument for the control and treatment of infertility in women Inventor(s): Crausaz; Jacques (Fribourg, CH), Nessi; Pierre (Geneva, CH) Assignee(s): Ares N.V. Amsterdam NL, Swiss Branch (Geneva, CH) Patent Number: 4,530,366 Date filed: November 23, 1982 Abstract: A micro-computer-based instrument for characterizing a woman's menstrual cycle by measuring her temperature (BBT) each day and storing and analyzing those temperatures. The instrument defines, with user interaction, a time window each day during which it will accept a temperature measurement within a predetermined acceptable temperature range taken with the aid of a thermistor temperature probe than can be placed under the woman's tongue. The analysis carried out on the collected temperature data includes comparing, from the eighth day of a cycle, two average temperatures: M.sub.F (average of a presumed follicular phase) and M.sub.L (average of a presumed luteal phase). Comparison continues until the difference between M.sub.L

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and M.sub.F exceeds a predetermined level thereby defining a second phase of the cycle indicating that ovulation has occured. After characterizing the cycle, the instrument indicates the most appropriate days for hormone treatment, blood tests and physician visits so that fertility treatment can be optimized. Excerpt(s): This invention relates to an electronic instrument for measuring and analyzing a woman's basal bodily temperature (BBT) in connection with the treatment of infertility. A normal menstrual cycle of a fertile woman is characterized by basal body temperature (BBT) curve that is biphasic, i.e., there is a rise in temperature a few hours after ovulation, a rise which generally occurs at about the middle of the menstrual cycle. In cases of infertility the BBT curve is frequently abnormal. For this reason a gynecologist usually begins the investigation of an infertile patient by analyzing 2 or 3 cycles of the BBT. Web site: http://www.delphion.com/details?pn=US04530366__ •

Fecal occult blood test Inventor(s): Lawrence; Paul J. (2082 Abbey La., Campbell, CA 95008) Assignee(s): none reported Patent Number: 4,615,982 Date filed: December 11, 1984 Abstract: Fecal occult blood tests of enhanced sensitivity and specificity are provided by employing (1) a developer composition comprising a solution of a hydroperoxide in a solvent comprising at least about 50% by volume of a solvent for iron protoporphyrins such as dimethyl sulfoxide and/or (2) a solid test matrix comprising a solid support impregnated with a leuco dye and a hemoprotein solubilizing agent. Test results may be further improved by incorporating plant peroxidase inhibitors, iron/copper chelating agents and buffers in the developer and/or test matrix. Excerpt(s): This invention is in the field of fecal occult blood tests (FOBT). More particularly it relates to improved FOBT that provide a reduced incidence of false results and/or greater sensitivity and specificity. U.S. Pat. No. 3,996,006 describes a FOBT technique that popularized the guaiac-based test for occult blood in feces. It employs a slide having a sheet of guaiac-impregnated paper between a front panel and a rear panel with openings in the panels and pivotal flaps to cover the openings. A fecal specimen is placed on the paper through the opening in the front panel and that panel is closed. The rear panel is then opened and a hydrogen peroxide developer is placed on the paper via the opening in the rear panel. If blood is present in the specimen, the paper will turn blue. A commercial embodiment of this test, called the HEMOCCULT.RTM. test, is widely used in hospitals and physicians' offices. Despite the widespread popularity of the HEMOCCULT.RTM. test recent studies have pointed out serious limitations in its sensitivity and specificity. Applicant believes that the sensitivity limitation is due partly to (1) the fact that hemoglobin in many specimens is degraded to hemoproteins that exhibit little or no peroxidative activity, (2) degradation of peroxidatively active hemoproteins by the hydroperoxide reagent used in the test and (3) relative insolubility of the degraded products (i.e., iron protoporphyrins such as heme and hemin) in the reagents used in the test. Sensitivity limitations, of course, may cause false negative results. The specificity limitation is probably due to the response of the test to plant peroxidases and/or iron or copper in the specimens or the environment in which the test is run. Specificity limitations lead to false positive results. U.S. Pat. No. 4,333,734

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describes a variation in the guaiac-based FOBT that is intended to reduce the incidence of false positive results due to the presence of plant peroxidases in the specimen. It includes a peroxidase denaturing agent such as urea or guanidine hydrochloride together with a metal chelating agent to sequester calcium and magnesium ions that are essential to peroxidase activity. The denaturant and the chelating agent are formulated with the guaiac. Web site: http://www.delphion.com/details?pn=US04615982__ •

Fecal occult blood test product with positive and negative controls Inventor(s): Burrows; Janine P. (Orange, TX), Guadagno; Philip A. (Vidor, TX) Assignee(s): Helena Laboratories Corporation (Beaumont, TX) Patent Number: 5,196,167 Date filed: May 9, 1991 Abstract: A test sheet for the determination of the presence of a substance having peroxidase-like activity in a throw-in-the-bowl fecal occult blood test, includes a specimen test area and a positive control area. The test area has deposited thereon a test ink having at least one oxygen donor reagent and a chromogen reagent capable of being oxidized by the oxygen donor in the presence of blood or a substance having peroxidase-like activity, to provide a visually observable change of color. The test ink also includes a water soluble polymer for immobilizing the chromogen and oxygen donor. The positive control area has deposited thereon the test ink and a substance having the peroxidase-like activity. Excerpt(s): The present invention relates generally to an occult blood test product, of the type to be physically placed into a toilet bowl containing a fecal specimen, for detecting the presence of fecal occult blood in an aqueous solution. More particularly, the present invention relates to an improved, reliable fecal occult blood test product which may be utilized with a minimum of human intervention. The principles of the present invention may be employed in the testing for occult blood, ferritin and myoglobin in various biological fluids. In general terms, the testing of a fecal specimen for occult blood is based on the well-known principle that blood (more particularly hemoglobin) will function as a catalyst and cause oxygen to be liberated from an oxygen donor, with the liberated oxygen thus causing a color change in a chromogenic substance. As such, the test for fecal occult blood is not only well-known, but numerous oxygen donors, numerous chromogens and numerous donor-chromogen pairs have been suggested in the prior literature. In considering the chromogens and oxygen donors which may be used, it should be appreciated that the fecal occult blood test is frequently referred to as a test for the presence of a substance having a peroxidase-like activity. In addition, there are several principle styles of fecal occult blood test products which have been marketed or described in the literatures. These include slides, tape, wipe and throw-inthe-bowl products. Slide products require the patient to retrieve part of the stool specimen and, using a spatula or equivalent device, place part of the specimen on a paper which paper is thereafter submitted to a laboratory where a developing solution is applied to the slide. Tape products are typically utilized by a physician after a rectal examination in which instance the physician smears a stool sample on a thin, narrow tape and then a developing solution is applied to the tape. In both of these types of products, the chromogen is guaiac, and the oxygen donor or developing solution is hydrogen peroxide.

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Web site: http://www.delphion.com/details?pn=US05196167__ •

Glucose monitor calibration methods Inventor(s): Gross; Todd M. (Saugus, CA), Mastrototaro; John J. (Los Angeles, CA), Shin; John J. (Glendale, CA) Assignee(s): Medtronic Minimed, Inc. (Northridge, CA) Patent Number: 6,424,847 Date filed: February 23, 2000 Abstract: A method of calibrating glucose monitor data includes collecting the glucose monitor data over a period of time at predetermined intervals. It also includes obtaining at least two reference glucose values from a reference source that temporally correspond with the glucose monitor data obtained at the predetermined intervals. Also included is calculating the calibration characteristics using the reference glucose values and the corresponding glucose monitor data to regress the obtained glucose monitor data. And calibrating the obtained glucose monitor data using the calibration characteristics is included. In preferred embodiments, the reference source is a blood glucose meter, and the at least two reference glucose values are obtained from blood tests. In additional embodiments, the calculation of the calibration characteristics is obtained using linear regression and in particular embodiments, least squares linear regression. Alternatively, the calculation of the calibration characteristics is obtained using non-linear regression. Excerpt(s): This invention relates to glucose monitor systems and, in particular embodiments, to calibration methods for glucose monitoring systems. Over the years, body characteristics have been determined by obtaining a sample of bodily fluid. For example, diabetics often test for blood glucose levels. Traditional blood glucose determinations have utilized a painful finger prick using a lancet to withdraw a small blood sample. This results in discomfort from the lancet as it contacts nerves in the subcutaneous tissue. The pain of lancing and the cumulative discomfort from multiple needle pricks is a strong reason why patients fail to comply with a medical testing regimen used to determine a change in a body characteristic over a period of time. Although non-invasive systems have been proposed, or are in development, none to date have been commercialized that are effective and provide accurate results. In addition, all of these systems are designed to provide data at discrete points and do not provide continuous data to show the variations in the characteristic between testing times. A variety of implantable electrochemical sensors have been developed for detecting and/or quantifying specific agents or compositions in a patient's blood. For instance, glucose sensors are being developed for use in obtaining an indication of blood glucose levels in a diabetic patient. Such readings are useful in monitoring and/or adjusting a treatment regimen which typically includes the regular administration of insulin to the patient. Thus, blood glucose readings improve medical therapies with semi-automated medication infusion pumps of the external type, as generally described in U.S. Pat. Nos. 4,562,751; 4,678,408; and 4,685,903; or automated implantable medication infusion pumps, as generally described in U.S. Pat. No. 4,573,994, which are herein incorporated by reference. Typical thin film sensors are described in commonly assigned U.S. Pat. Nos. 5,390,671; 5,391,250; 5,482,473; and 5,586,553 which are incorporated by reference herein. See also U.S. Pat. No. 5,299,571. Web site: http://www.delphion.com/details?pn=US06424847__

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Method and apparatus for non-destructive screening of specimen integrity Inventor(s): Jacobs; Merrit Nyles (Fairport, NY), Samsoondar; James (Cambridge, CA) Assignee(s): CME Telemetrix Inc. (Waterloo, CA) Patent Number: 6,353,471 Date filed: June 9, 1997 Abstract: A method and apparatus for providing a non-destructive pre-test screen of specimen integrity for a blood analyzer by measurement of absorbance or reflectance is provided. The method involves measurement of polychromatic light in the near infrared and adjacent visible region, which is either transmitted or reflected from a specimen as presented for measurement, and correlation of the measurement, on the basis of predetermined algorithms, to the quantity of a known substance contained in the sample. The apparatus employs a spectrophotometer which emits radiation which is split into a beam which passes to a sample and a reference beam, the beam returning from the sample and the reference beam are variably combined and further separated into various components by means of a grating and focused onto a linear array detector. A microprocessor receives output from the array detector and performs calculations of concentration(s) of the known substance(s). The invention provides quality assurance for state-of-the art blood analyzers and automated laboratories by pre-screening serum and plasma integrity, even where labels on the sample container would normally interfere with a quality assurance assessment, identifying samples not suitable for certain blood tests, or, if tests are conducted on specimens with compromised integrity, the pre-screening results will aid in the interpretation of the test results. Excerpt(s): This invention relates to spectrophotometry and the spectrophotometric analysis of blood samples. In particular, this invention relates to a method and apparatus for providing a non-destructive pre-test screen of specimen integrity for a blood analyzer by measurement of absorbance or reflectance. Clinical laboratory tests are routinely performed on the serum or plasma of whole blood. In a routine assay, red blood cells are separated from plasma by centrifugation, or red blood cells and various plasma proteins are separated from serum by clotting prior to centrifugation. Haemoglobin (Hb), bilirubin (Bili) and light-scattering substances like lipid particles are typical substances which will interfere with, and affect spectrophotometric and other blood analytical measurements. Such substances are referred to as interferents. Elevated Bili can be due to disease states, and increased lipid particles in the blood, also known as hyperlipidemia, can be due to disease states and dietary conditions. Elevated Hb in the blood, hemoglobinemia, can be due to disease states and as a result of specimen handling. Clinical laboratories currently emphasize these three potential interferents as being of greatest concern with respect to affecting blood analysis. Biliverdin, (BV), a fourth potential interferent, is rarely mentioned. Web site: http://www.delphion.com/details?pn=US06353471__

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Method for preventing blood denaturation and blood test tool to be used therein Inventor(s): Higashino; Kouji (Kyoto, JP), Nishimura; Satoshi (Kyoto, JP) Assignee(s): Arkray, Inc. (Kyoto, JP) Patent Number: 6,379,318 Date filed: May 11, 2001

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Abstract: A blood test tool with which blood in a dried state can be held without denaturation. In the blood test tool wherein a card made of filter paper is impregnated with the blood and then the blood is held in a dried state, a carboxylic acid such as citric acid is added to the part for holding blood. Thus, the carboxylic acid exerts an effect of preventing the blood in the dried state from denaturation. It is preferable to add a nonreducing sugar (sucrose, etc.), an anticoagulant (EDTA, etc.) and an antioxidant (glutathione, etc.) together with the carboxylic acid. This blood test tool can be produced by impregnating a filter paper card with a solution containing citric acid, etc. dissolved therein and then air-drying. Excerpt(s): The present invention relates to a method for preventing the denaturation of blood, particularly hemoglobin, and a blood test tool to be used therein. Hemoglobin Alc (HbAlc) in which hemoglobin (Hb) is bonded to glucose reflects the average glucose level of the body one or two months earlier. Therefore, it is widely used in physical examinations for geriatric diseases or treatment and consultation therefor. However, since it takes a long time to measure HbAlc, for example, even if the blood is collected from outpatients when they visits to hospital, the result of the examination of HbAlc is generally evaluated when the patient visits to the hospital the next time. Therefore, although the measurement value of HbAlc is an important factor for diagnosis of diabetes, actually, it has not been used effectively for treatment. To solve this problem, a blood collection card made of filter paper has been proposed ("Diabetes" Vol. 38, No. 10 (1995), JP10-104226A, etc.). The patients collect blood onto the collection card by themselves and allow the collection card to be impregnated with the collected blood, dried, and then mail the card to the hospital. In the hospital where this card is received, the part impregnated with the blood of the card is cut out or punched out (punch-out), and then blood is eluted therefrom. The eluted blood is examined for the predetermined items including HbAlc, etc. When the patient visits to the hospital, the treatment or diagnosis is performed based on the examination results. Web site: http://www.delphion.com/details?pn=US06379318__ •

Method of carrying out blood tests Inventor(s): Melber; Karl (Duesseldorf, DE), Menssen; Hans Dietrich (Berlin, DE), Strasser; Alexander W. M. (Duesseldorf, DE), Thiel; Eckard (Berlin, DE) Assignee(s): Rhein Biotech Gesellschaft fur Neue Biotechnologische Prozesse und Produkte (DE) Patent Number: 6,521,460 Date filed: February 8, 1999 Abstract: The present invention relates to a method of carrying out blood tests. The invention is based on the finding that clinico-chemical blood parameters can be determined using not only blood serum but also blood plasma. Therefore, freshly taken blood samples, which are mixed with at least one thrombin inhibitor, can be used for determining both clinico-chemical parameters and hematological parameters. The clinico-chemical parameters can thus be determined using blood plasma, a separation of coagulable components being not required any more. Excerpt(s): The present invention relates to a method of carrying out blood tests. Many diverse blood tests are required for diagnosing, in particular, internal diseases and for controlling the course thereof. These blood tests can be divided into tests regarding the cellular blood components (blood count, differential blood count, blood group,

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immunophenotyping of blood cells) and into serum tests and also into antibody screening tests, Coombs tests and cross-matching tests. Serum tests are concerned with the determination of enzymes, metabolic products (e.g. creatinine, urea, blood sugar) and coagulation parameters. In addition, special tests, such as hormone analyses or drug level analyses, are carried out on the basis of serum. With seriously ill and hospitalized grown-up patients, enlarged blood tests have to be carried out over a prolonged period of time every day and sometimes even twice a day to detect critical changes in the physical condition of the patient at an early stage. Blood is taken under sterile conditions normally using a closed blood taking system by puncturing a vein in the bend of the elbow (e.g. V. cubita mediana). Blood is optionally taken through already laid central indwelling catheters. Depending on the clinical requirements and the desired laboratory tests, types and numbers of the tubes to be filled with blood are defined. Specific laboratory tests can only be carried out with specific substances specifically prepared for such tests (e.g. specific anticoagulants (heparin, EDTA, citrate, etc.)) or with glucosidase inhibitor ("blood sugar tubes") or blood withdrawing tubes containing coagulation-promoting substances ("serum tubes"). Heparin and EDTA are unspecific, indirect inhibitors. They do not act directly or specifically on a specific element of the blood coagulation cascade, but their effect is of an indirect nature in that they intercept, for example, Ca.sup.2+ ions which, in turn, are essential for the activation of different proteins of the coagulation system. A uniform pretreatment of the blood to be tested ("standard tube"), on the basis of which all or at least the majority of important blood tests could then be carried out, does not exist. Furthermore, it follows from the standard logistic sequence in clinico-chemical or hematological laboratories that a plurality of blood withdrawal tubes that have been pretreated in the same way are often needed. After withdrawal from the patient, and depending on the laboratory values to be determined, the blood tubes are transferred into laboratories that are most of the time separated spatially (most of the time a clinico-chemical laboratory and a hematological laboratory and optionally laboratories for special tests, such as immunophenotyping, drug level in the serum, etc. (material dispatch by mail or courier might here be necessary). The blood tubes received in the laboratory must first be sorted, and the tubes to be centrifuged are then centrifuged at about 3,500 r.p.m. for five minutes. The blood taking tubes are then forwarded to the different work places (coagulation tubes to the coagulation place, serum tubes for electrolyte determination on the flame photometer, etc). The respective automatic analyzing devices are then loaded with the samples, with the sample volume of about 10.mu.l to 100.mu.l, which is needed for one measurement, being very small in most measuring operations. The actual measuring operation lasts from a few seconds to a few minutes (five minutes at the most, depending on the method and the device). The measured values are finally printed out and, depending on the origin, are communicated in writing to the dispatching stations. Web site: http://www.delphion.com/details?pn=US06521460__ •

Occult blood test monitor Inventor(s): Oksman; Norman H. (Mountain Lakes, NJ), Talmage; Joseph M. (Landing, NJ) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 4,675,160 Date filed: January 28, 1986

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Abstract: An in-the-bowl occult blood test is provided with a flushable matrix having a separate testing site which will indicate the presence of residual oxidizing compounds in the toilet. Excerpt(s): This invention relates to a testing monitor useful for detection of peroxidaselike activity and, in particular, a test kit for detection of such activity in stool samples containing a testing monitor. The detection of peroxidase-like activity was found to be indicative of the presence of hemoglobin in a specimen and, reported to be correlated to the heightened fertility period in females during the estrous cycle. The detection of peroxidase-like activity has, therefore, become an invaluable aid to the medical practitioner. Over 100,000 persons in the United States are affected by cancer of the colon and rectum each year. When the number of colorectal cancers occurring each year is combined with the number of cancers occurring in other digestive organs, including the esophagus and stomach, such cancers of the digestive system account for more occurrences of cancer than any other single form of the disease. Web site: http://www.delphion.com/details?pn=US04675160__ •

Reminder device for blood self-testing Inventor(s): Cota; Joseph A. (Apt #1, No. Andover, MA 01845) Assignee(s): none reported Patent Number: 6,024,723 Date filed: March 4, 1999 Abstract: A device is described for reminding a patient suffering from ailments such as diabetes and high cholesterol levels, who performs daily blood tests, of the site of the last blood extraction, in the case where blood is drawn from one or more sites of each finger of the hands. The invention includes two disks, each having an inner face and an outer face, the inner face containing a representation of the opposite hand from the other. On each disk finger holes are punched in the vicinity of the fingers to represent the sites where blood is drawn. On the inner face of each disk is a red marker area which may be displayed under the finger hole on the opposite disk, corresponding to the last site where blood was drawn. When the user progresses from one hand to the other in his testing regime, the device is flipped over, and the outside face of the other disk is used to display the status of the site where blood has been drawn on a representation of the hand currently used. Excerpt(s): The present invention relates to medical reminder devices, and more specifically to reminders used in connection with the drawing of blood for self-testing by patients suffering from ailments such as diabetes and high cholesterol levels. Millions of people suffer from diabetes in the United States alone. Many of these patients are required to draw blood on a daily basis, and do test the blood themselves in order to assure the chemical balance of their systems, which is essential to their well-being. Drawing of the blood involves puncturing the skin in the region where blood will flow freely and profusely. The fingers of the hands are generally chosen as appropriate for the sites of blood extraction. Web site: http://www.delphion.com/details?pn=US06024723__

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Test tube for biological analyses, provided with a device for checking efficiency and position, for photometric readings Inventor(s): Pratellesi; Tiziano (Pontassieve, IT), Ricci; Antonio (Monteriggioni, IT) Assignee(s): Diesse Diagnostica Senese S.r.l. (Milan, IT) Patent Number: 5,244,637 Date filed: January 8, 1992 Abstract: Test tube for biological analyses, and in particular for blood tests such as erythrocyte sedimentation rate, provided with a device making it possible to perform a photometric inspection of the test tube with a relative movement between the optical system and the test tube (1), the latter being between the emitter (E) and the receiver (R) of said system; the test tube possesses--externally on the base--a device in the form of an optical prism (5) that induces a sudden change in the direction of the light beam emitted by the emitter so that it briefly is unable to reach the receiver. Excerpt(s): The invention relates to a test tube for biological analyses and in particular for blood tests, for example measuring the erythrocyte sedimentation rate (or E.S.R.) and other tests and analyses that can be performed with optical measuring instruments. With equipment of this kind, use is generally made of test tubes that may be of various shapes and sizes. To achieve a good level of automation and eliminate all sources of error, it is advisable to carry out a number of checks, especially checking that test tubes are present and that they have been correctly positioned in the instrument. In addition, it is always advisable to check the efficiency of the optical systems (emitter+receiver), so that errors of insertion and position of the test tubes are not inadvertently made. In the present invention, the check for the presence of the test tube can in fact be made directly by the instrument's optical reading system and suitably controlled by a computer. The device of the invention also serves to check on the exact position of the test tube inside the instrument, since a test tube that is not fully inserted in its seat can--if the fault is not reported--give rise to bad data readings which may then cause sometimes very serious problems and errors. Another useful aspect of the invention is that it can automatically carry out a continuous and repeated check on the speed and inertia of response of the optical sensor, so as to avoid errors in the readings and in the results obtained from these. Web site: http://www.delphion.com/details?pn=US05244637__

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Treatment of human plasma with brown recluse spider toxin to emulate a lupus anticoagulant Inventor(s): Babcock; James L. (San Antonio, TX), McGlasson; David L. (San Antonio, TX) Assignee(s): The United States of America as represented by the Secretary of the Air (Washington, DC) Patent Number: 4,877,741 Date filed: October 24, 1988 Abstract: A new method for improving the accuracy of blood tests for the presence of lupus anticoagulants and for blood factor deficiencies is disclosed. Brown recluse spiders are collected, their venon glands removed by microdissection and the active toxin extracted. The toxin is mixed with normal donor plasma in concentrations of about

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3.5.mu.l/ml of toxin to plasma. The treated plasma successfully mimics human plasma having lupus anticoagulants. By using the treated plasma in blood tests and assays as a standardized control to which the results from tests on questioned blood plasma samples may be compared, the equipment and procedures for those tests may be calibrated and test results made more sensitive and reliable. Excerpt(s): The present invention relates generally to medical testing methods, and more specifically to the use of a brown recluse spider (Loxosceles reclusa) toxin treated human plasma as a positive control, or standardized reference, for lupus anticoagulant blood tests. Lupus anticoagulants are antibodies that interfere with blood coagulation, or clotting. Curiously, they are anticoagulants only in vitro, or outside the human body. In vivo, or inside the body, they act to increase the risk of thrombosis, or detrimental blood coagulation inside the heart, arteries, veins or capillaries. Lupus anticoagulants are found in the blood of many persons, and not merely in the blood of persons suffering from systemic lupus erythematosus, an inflammatory autoimmune disorder from which lupus anticoagulants derive their name. While persons having lupus anticoagulants present in their blood often show no adverse symptoms, a significant percentage of such persons will suffer from such complications as thrombosis, seizure disorders and, in women, spontaneous abortions. Unfortunately, testing blood for the presence of lupus anticoagulants is very inexact. Present tests or assays used for detecting lupus anticoagulants, which generally test in vitro for various impaired coagulation indicators, can give misleading results from, for example, the presence of mild blood factor deficiencies. Blood factors are contributors to beneficial blood clotting and a deficiency in any one of many such factors will reduce clotting both in vivo and in in vitro tests so that they can produce, in vitro, the same test results as lupus anticoagulants. Vice versa, a mild blood factor deficiency may be misdiagnosed as the presence of a mild lupus anticoagulant. To most accurately test blood plasma samples for lupus anticoagulants, a standardized positive control is required for calibration and comparison of both testing equipment and technique. Because blood plasma with a lupus anticoagulant is not easily stored, and because patients with a lupus anticoagulant for obtaining blood samples are not always convenient, there is a need for a commercially available control plasma that accurately mimics the effects of a lupus anticoagulant in human plasma for laboratory testing. Without such a positive control, laboratory technicians cannot be certain that their testing for the presence of lupus anticoagulants is indeed performed in a manner consistent with expected results. Web site: http://www.delphion.com/details?pn=US04877741__ •

Urine occult blood test apparatus Inventor(s): Watanabe; Hiroki (30-20, Hieidaira 3-chome, Ootsu-shi, Shiga-ken, JP) Assignee(s): none reported Patent Number: 5,665,308 Date filed: October 12, 1995 Abstract: A urine occult blood test apparatus includes an insert member insertable in a working channel of a cystoscope and a urine occult blood test member provided at a tip portion of the insert member. The urine occult blood test member is covered during insertion of the insert member and exposed after the insertion. The urine occult blood test apparatus is inserted and advanced to just before the ureteral opening by using the cystoscope. It is directly observed that urine coming out from the ureteral opening is received by the tip portion of the insert member having the urine occult blood test

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member. Therefore, such a urine occult blood test enables to confirm which is bleeding, the right or left kidney or the right or left ureter. Excerpt(s): The present invention relates to a urine occult blood test apparatus for detecting bleeding from a urinary tract, especially bleeding from an upper urinary tract. Reaction paper for inspecting presence or absence of urine occult blood has been available on the market. This reaction paper is directly immersed in a urine sample to ascertain presence or absence of urine occult blood in the sample. In the conventional method of dipping the known reaction paper directly in the sampled urine, it is detectable whether or not occult blood exists in the urine discharged from a bladder. However, it is impossible to ascertain which is responsible for bleeding, the right kidney, the left kidney, the right ureter or the left ureter which supply urine into the bladder. Web site: http://www.delphion.com/details?pn=US05665308__

Patent Applications on Blood Tests As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to blood tests: •

Blood test container and blood test method Inventor(s): Isogawa, Hironobu; (Tokuyama-shi, JP), Matsumoto, Mie; (Osaka, JP), Shibata, Junzou; (Kameoka-shi, JP), Shimmura, Kazuo; (Osaka, JP), Shinoda, Jun-Ichiro; (Kyoto-shi, JP), Yokoi, Masayuki; (Kusatsu-shi, JP) Correspondence: Rader Fishman & Grauer Pllc; Lion Building; 1233 20th Street N.W., Suite 501; Washington; DC; 20036; US Patent Application Number: 20030108447 Date filed: January 9, 2003 Abstract: A blood test container and a blood test method are provided which facilitate the procedures starting from blood collection and ending with measurement of various componens present in the blood while eliminating a risk for a tester to come into contact with the blood.A blood test container 1 having a closed-bottom tubular container 2, a closed-bottom second tubular container having a diameter smaller than that of the tubular container 2 for accommodation therein, and a blood test reagent 3 secured onto at least one of an inner face of the tubular container and an outer face of the second tubular container. A blood test method comprising, in sequence, introducing blood into any one of the aforementioned blood test containers 1 and allowing the blood or its component to contact the blood test reagent 3. Excerpt(s): The present invention relates to a blood test container for use in clinical examinations or testing of human and animals, and more particularly to a blood test container by which a whole procedure starting from blood collection and ending with measurement of blood components can be carried out with the use of a single container. The blood component testing as heretofore practiced in clinical examinations and the like is accomplished according to the following procedure. First, blood is collected by

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This has been a common practice outside the United States prior to December 2000.

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using an injector or a vacuum blood-collecting tube. Next, the blood either transferred into a test tube or introduced into the blood-collecting tube is centrifuged to separate int serum or plasma and solid matter. Subsequently, the serum or plasma separated is distributed into separately-prepared test containers for measurements. An equipment for carrying out such measurements is commercially available, for example, under the product name "ORTHO HCV.multidot.Ab QUICKPACK" from Orthoclinical Diagnostics Co., Ltd. With the use of this testing equipment, HCV antigen screening test can be performed, for example, after serum or plasma is dripped on a reagent of the testing equipment such as by a dropping pipet. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Cardiovascular imaging and functional analysis system Inventor(s): Bishop, Harry; (Bridgeport, WV), Majewski, Stanislaw; (Yorktown, VA), Umeno, Marc M.; (Cleveland Heights, OH) Correspondence: Supervisor, Patent Prosecution Services; Piper Marbury Rudnick & Wolfe Llp; 1200 Nineteenth Street, N.W.; Washington; DC; 20036-2412; US Patent Application Number: 20020188197 Date filed: December 1, 2000 Abstract: A Cardiovascular imaging and functional analysis system and method employing a dedicated fast, sensitive, compact and economical imaging gamma camera system that is especially suited for heart imaging and functional analysis. The system uses a dedicated nuclear cardiology small field of view imaging camera, allowing image physiology, while offering inexpensive and portable hardware. In some variations, a basic modular design suitable for cardiac imaging with one of several radionucleide tracers is used. The detector is positioned in close proximity to the chest and heart from several different projections, allowing rapid accumulation of data for first-pass analysis, positron imaging, quantitative stress perfusion, and multi-gated equilibrium pooled blood tests. In one variation, a Cardiovascular Non-Invasive Screening Probe system provides rapid, inexpensive preliminary indication of coronary occlusive disease by measuring the activity of emitted particles from an injected bolus of radioactive tracer. Excerpt(s): The present invention relates to medical diagnostic and screening apparatuses and methods. Particularly, the present invention relates to non-invasive medical diagnostic and screening systems. Still more particularly, the present invention relates to non-invasive imaging and functional analysis systems for evaluating cardiac and cardiovascular health. Cardiac imaging and functional analysis is the largest single nuclear medical imaging application and represents the area of greatest unmet need in the prior art. This need is exemplified by the fact that historically, for 30%-50% of those stricken with coronary occlusive (artery) disease, the first symptom of the disease is death. This outcome has motivated considerable interest in developing diagnostic methods and apparatuses to detect the condition of coronary occlusive disease prior to the onset of fatal symptoms, and further to assist in the development and implementation of preventive measures. First-Pass Radionucleide Angiography (RNA) provides the clinician with patient information for improved patient management that is either difficult and/or costly to obtain using other technologies. The First-Pass RNA can provide unique qualitative and quantitative information about cardiac function such as regional ventricular wall motion just at the peak of maximum exercise stress, left and right ventricular ejection fraction, regional contractivity, and left to right shunt quantitation. Concurrently, improvements in software analysis of the diagnostic tests

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are being developed and implemented on a regular basis. However, medical instrument improvements have not kept pace with detector hardware enhancements such as pixellated scintillation crystals, and position-sensitive photomultipliers. Presently, the nuclear medicine health care sector can perform a first-pass RNA diagnostic protocol using the commercially available dedicated cardiac imager multicrystal scanner model SIM400 from Picker International of Cleveland, Ohio, or a single crystal Anger gamma camera. The single crystal Anger camera has numerous disadvantages when used for first-pass RNA related to its low count rate capability including pulse-pileup and low count density. A low-count density image limits the ability to define changes in wall motion. Improvements in defining wall motion are attained using the multicrystal high rate camera. Other factors influencing the image quality are the intrinsic system resolution, count density, and the target-to-nontarget ratio. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Devices and methods for reading and interpreting guaiac-based occult blood tests Inventor(s): Matusewicz, Richard Sergei; (San Jose, CA), Schoengold, Ronald Joseph; (Saratoga, CA), Schrier, Wayne H.; (Half Moon Bay, CA), Silzel, John Warwick; (Yorba Linda, CA) Correspondence: Beckman Coulter Inc; 4300 North Harbor Boulevard; P O Box 3100; Fullerton; CA; 928343100 Patent Application Number: 20020136436 Date filed: February 23, 2001 Abstract: A medical analysis system for reading and interpreting an occult blood test (OBT) device is provided. The instant system comprises an image sensor for capturing an image of the entire test area of the FOBT device and for converting the image into a digital data. The system further comprises a data processor conventionally coupled to the image sensor. The data processor compares the digital data with pre-determined threshold conditions of a positive FOBT by utilizing a spectrographic and morphologic image analysis algorithm and determines a presence of the occult blood in the sample. A hue angle analysis for data processing may be used. A method of performing a FOBT on a sample is also provided. Excerpt(s): The present invention relates to determining the presence of occult blood in fecal matter, and more particularly to a system for reading and interpreting guaiacbased occult blood tests. Each year, more than 130,000 Americans are diagnosed with colorectal cancer. Of those afflicted, an estimated 56,000 die--a death toll that ranks this cancer as the second highest, for women and men, among all types of cancers. Scientific evidence suggests that the majority of colon cancers arise from the evolution of normal mucosa progressing into adenomas and finally to adenocarcinomas. Adenoma removal correlates with a reduced risk of rectal carcinomas; analogously, the removal of adenomatous polyps, reduces the likelihood of colon cancer (U.S. Pat. No. 5,790,761). Unlike other forms of cancer, early diagnosis and treatment of colorectal cancer results in a high cure rate of more than 90%. If, however, the disease is not detected until the later stages, the cure rate drops drastically to 25% or less (U.S. Pat. No. 5,264,181). Thus, early detection of the disease is critical to successful treatment of colorectal cancer. Occult (hidden) blood in feces is an early sign of colorectal cancer, adenomas and polyps. It is undetectable to the naked eye, because the blood is present in minute amounts. Tests and procedures for detecting occult blood in fecal matter are wellknown. One of the most successful tests is offered by Beckman Coulter, Inc. (Fullerton,

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Calif.) under the trademark HEMOCCULT.RTM. and disclosed in U.S. Pat. No. 3,996,006 issued to J. F. Pagano. Briefly, a thin smear of fecal matter is applied to one side of the guaiac paper. Then, a developing solution, such as hydrogen peroxide, is applied to the opposite side of the guaiac paper. If blood is present in the fecal matter, the guaiac reaction will color the paper blue. Recently, a similar but more sensitive test has been introduced under trademark HEMOCCULT.RTM. SENSA.RTM. by Beckman Coulter, Inc. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Home doctor system, blood capsule and injection appliance Inventor(s): Kisakibaru, Toshiro; (Tokyo, JP) Correspondence: Rader Fishman & Grauer Pllc; Lion Building; 1233 20th Street N.W., Suite 501; Washington; DC; 20036; US Patent Application Number: 20010005772 Date filed: December 21, 2000 Abstract: A subscriber of a home doctor center carries a physical condition-monitoring device. Physical condition data measured by the device is transmitted to a personal computer in the subscriber's residence, and then transmitted therefrom to the center via a contact path. Blood collected to the subscriber is sent to the center. The center analyzes the physical condition data and tests the received blood with an automatic test system. Based on analytic results of the physical condition data and results of blood tests, initial diagnosis of the subscriber is performed, and the subscriber is informed of the result of the initial diagnosis together with a corresponding advise. By close tie-up with a medial institute and an insurance institute, the center can early find diseases of subscribers, and by calculating premiums imposed to subscribers with reference to results of initial diagnosis, premiums can be reduced. Excerpt(s): This invention relates to a home doctor system, blood capsule and injection appliance. People's interests in healthcare are getting larger and larger. As a result, market of dietary facilities, healthcare food and healthcare appliances has recently expanded rapidly. In regard to dietary conjunction, there are tonometers, pedometers, body fat measuring devices, and so forth, available for private use. Regarding healthcare food, a huge variety of preparations are commercially available. However, these dietary facilities, healthcare food and healthcare appliances often have only weak medical support about their efficacies, and consumers cannot get valuable effects for expenses. Additionally, most of dietary facilities, healthcare food and healthcare appliances were sold as products, individually, and were far from the concept of systematic, continuous healthcare. On the other hand, along with developments of genetic engineering, some genetic diseases are now being specified by DNA decoding, but such data is not yet used for systematic healthcare. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and device to treat vulnerable plaque Inventor(s): Daum, Wolfgang; (Groton, MA), Doscher, Claas; (Hamburg, DE) Correspondence: Dorsey & Whitney Llp; Intellectual Property Department; 50 South Sixth Street; Minneapolis; MN; 55402-1498; US Patent Application Number: 20030139739 Date filed: January 10, 2002 Abstract: A method and device to treat cardiovascular vulnerable plaque is provided by heating an implanted structure placed adjacent to a vulnerable plaque tissue to conduct heat into the vulnerable plaque tissue for a period of time. In a preferred embodiment, the implanted structure is a stent-like structure (SLS), and the heating of the implanted structure is a non-invasive inductive heating. The detecting of the vulnerable plaque tissue can be accomplished by techniques, such as Magnetic Resonance Imaging (MRI), infrared spectroscopy, thermography, blood tests, ultrasound, and X-ray, etc. Excerpt(s): The present invention generally relates to cardiovascular medicine. More particularly, the present invention relates to a cardiovascular heat delivery device and a method to treat a vulnerable plaque tissue. Coronary artery disease (CAD) is the most important cause of morbidity and mortality in today's society. Atherosclerosis (the most common form of arteriosclerosis, marked by cholesterol-lipid-calcium deposits in arterial linings), "hardening" of the arteries caused by plaques and plaque lesions, is the cause of myocardial infarction (MI). Some plaques are "hard and solid", and the others are "soft and squishy". It's the soft variety that is to worry about. Recently, this soft plaque has been called "vulnerable plaque" because of its tendency to burst or rupture. Ischemic heart disease represents a continuum from stable angina to unstable angina to non-Q-wave MI to Q-wave MI. Patients whose angina becomes unstable are classified as having acute coronary syndrome (ACS). It was formerly believed that thrombosis leading to critical occlusion of coronary arteries at the site of atherosclerotic plaque rupture was the common cause of ischemic heart disease. It is now thought, that even plaque lesions that do not critically occlude coronary arteries can cause MI. ACS can be caused by the rupture of an unstable atherosclerotic plaque. Vulnerable plaques are usually those causing only mild to moderate stenosis and having a lipid-rich core and a thin, macrophage-dense, collagen-poor fibrous cap. Factors affecting plaque rupture include mechanical injury, circadian rhythm, inflammation, and infection. Progressive thrombosis and vasospasm may follow plaque rupture. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method for analyzing blood test sample and dry analytical element and analytical kit utilizing the method Inventor(s): Saitoh, Hitomi; (Saitama, JP) Correspondence: Jules E. Goldberg, ESQ.; Reed Smith Llp; 559 Lexington Avenue, 29th Floor; New York; NY; 10022; US Patent Application Number: 20030202904 Date filed: April 24, 2003 Abstract: Objects of the present invention are to provide a method for analyzing a blood test sample containing blood platelet collected from a human body to detect presence of an analyte in the test sample, wherein fluctuations of measured results due to difference

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of processing mode of the test sample is eliminated, a dry analytical element and an analytical kit utilizing the method. The objects are achieved by a blood analytical method in which surfactant added to the blood test sample is at least one selected from surfactants that do not destroy blood platelet, a dry analytical element and an analytical kit utilizing the method. Excerpt(s): This invention relates to a method for analyzing a blood test sample containing blood platelet collected from a human body, a dry analytical element and an analytical kit utilizing the method. An analytical method, in which blood collected from a human body is analyzed as a test sample to diagnose human diseases, has conventionally been performed. The method is generally classified into two types, that is, a wet analytical method in which a reagent(s) necessary for designed analysis and a test sample are added into water to prepare a solution to allow some detectable reaction to take place; and a dry analytical method in which a test sample is supplied onto a layer (gelatin layer, for example) containing reagents previously in dry state to allow some detectable reaction to take place in the layer. In the case where enzyme activity is measured by utilizing a dry analytical method, for example, such an analytical element is utilized that has one or more layers containing reagents in dry state on an undercoated transparent polyethylene terephthalate (PET) base and a spreading layer of tricot knitted cloth made of polyester spun yarn laminated on the layer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Rapid multiple panel of biomarkers in laboratory blood tests for TIA/stroke Inventor(s): Dambinova, Svetlana A.; (Atlanta, GA) Correspondence: King & Spalding; 191 Peachtree Street, N.E.; Atlanta; GA; 30303-1763; US Patent Application Number: 20030096331 Date filed: August 2, 2001 Abstract: A methods, kits and compositions for diagnosing a central nervous system disorder, particularly transient ischemic attack or stroke, comprising measuring the level of NR2A and/or NR2B NMDA receptor or fragment thereof, in a biological sample from a human subject, and optionally measuring other biomarkers such as homocysteine and glutamate. The method is particularly useful for identifying individuals that are at risk for stroke, and for diagnosing stroke in an emergency room setting. Excerpt(s): This application claims priority under 35 U.S.C.sctn.119(e) to U.S. Provisional Application No. 60/301,297, filed Jun. 27, 2001, and under 35 U.S.C.sctn.120 to U.S. Utility application Ser. No. 09/632,749, filed Aug. 4, 2000 (currently pending), of which this application is a continuation-in-part. The present invention relates generally to the diagnosis, management and therapy of central nervous system disorders such as stroke, transient ishemic attack, and traumatic brain injury. In particular, the invention relates to methods and kits for evaluating these central nervous system disorders, in order to better respond to episodes of focal cerebral ishemia, and to best manage the risk associated with future acute incidences. Stroke or "brain attack" is clinically defined as a rapidly developing syndrome of vascular origin that manifests itself in focal loss of cerebral function. In more severe situations, the loss of cerebral function is global. A stroke occurs when the blood supply to the part of the brain is suddenly interrupted (ischemic) or when a blood vessel in the brain bursts, spilling blood into the spaces

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surrounding the brain cells (hemorrhagic). The symptoms of stroke are easy to spot: sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking; dizziness; or loss of balance or coordination. (National Institute of Neurological Disorders and Stroke, 2001). Stroke is the most common devastating neurologic disease in the world, and the third leading cause of death in world after heart disease and cancer. Despite recent progress understanding stroke mechanisms, stroke management is still not optimal for a number of reasons. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Real time self-adjusting calibration algorithm Inventor(s): Dangui, Nandita D.; (Los Angeles, CA), Holtzclaw, Kris R.; (Valencia, CA), Hong, Peter I.; (Santa Clarita, CA), Kanderian, Sami JR.; (Northridge, CA), Mastrototaro, John J.; (Los Angeles, CA), Shin, John J.; (Glendale, CA) Correspondence: Medtronic Minimed, INC.; 18000 Devonshire Street; Northridge; CA; 91325-1219; US Patent Application Number: 20020161288 Date filed: May 8, 2002 Abstract: A method of calibrating glucose monitor data includes collecting the glucose monitor data over a period of time at predetermined intervals. It also includes obtaining at least two reference glucose values from a reference source that temporally correspond with the glucose monitor data obtained at the predetermined intervals. Also included is calculating the calibration characteristics using the reference glucose values and the corresponding glucose monitor data to regress the obtained glucose monitor data. And calibrating the obtained glucose monitor data using the calibration characteristics is included. In preferred embodiments, the reference source is a blood glucose meter, and the at least two reference glucose values are obtained from blood tests. In additional embodiments, the calculation of the calibration characteristics is obtained using linear regression and in particular embodiments, least squares linear regression. Alternatively, the calculation of the calibration characteristics is obtained using non-linear regression. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/511,580, filed Feb. 23, 2000 and entitled "Glucose Monitor Calibration Methods", which is herein incorporated by reference in its entirety. This invention relates to glucose monitor systems and, in particular embodiments, to calibration methods for glucose monitoring systems. Over the years, body characteristics have been determined by obtaining a sample of bodily fluid. For example, diabetics often test for blood glucose levels. Traditional blood glucose determinations have utilized a painful finger prick using a lancet to withdraw a small blood sample. This results in discomfort from the lancet as it contacts nerves in the subcutaneous tissue. The pain of lancing and the cumulative discomfort from multiple needle pricks is a strong reason why patients fail to comply with a medical testing regimen used to determine a change in a body characteristic over a period of time. Although non-invasive systems have been proposed, or are in development, none to date have been commercialized that are effective and provide accurate results. In addition, all of these systems are designed to provide data at discrete points and do not provide continuous data to show the variations in the characteristic between testing times. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Keeping Current In order to stay informed about patents and patent applications dealing with blood tests, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “blood tests” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on blood tests. You can also use this procedure to view pending patent applications concerning blood tests. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON BLOOD TESTS Overview This chapter provides bibliographic book references relating to blood tests. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on blood tests 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 “blood tests” (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 blood tests: •

Dinosaur Tamer and Other Stories for Children with Diabetes Source: Alexandria, VA: American Diabetes Association. 1995. 186 p. Contact: Available from American Diabetes Association, Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (404) 442-9742. PRICE: $7.95 (members) or $9.95 (nonmembers). ISBN: 0945448589. Summary: This book presents 25 fictional stories about children with diabetes, in family life, at school, and at play. They are designed to help children learn about and sustain their interest in diabetes. The stories are interwoven with ideas about positive ways to cope with concerns and adjustment issues common to children everywhere. Each tale reduces the fear of insulin shots, blood tests, being 'different,' and all the other not-sofun parts of having diabetes. The collection also emphasizes the strengths and potential for growth within each child and family. (AA-M).

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Meeting the Challenge: Living with Chronic Illness Source: West Bloomfield, MI: Audrey Kron. 1996. 199 p. Contact: Available from Audrey Kron, M.A., CGP. Center for Coping with Chronic Illness, 7466 Pebble Lane, West Bloomfield, MI 48322-3521. (248) 626-6960. Fax (248) 6261379. PRICE: $16.00 plus $3.00 for shipping. ISBN: 0963387715. Summary: This book provides strategies for coping with chronic illness. Written by a woman who has lived with inflammatory bowel disease (IBD) for many years and is a medical psychotherapist and licensed marriage counselor, the book provides ideas for living well with serious health problems. After two introductory chapters that update readers on the author's situation since her first book, 'Ask Audrey', was published, the next five chapters cover dealing with chronic illness, relationships, chronic illness from a family member's perspective, emotions, and coping techniques. The author gives practical suggestions concerning finding a doctor, preparing for outpatient procedures, going to the hospital, taking medication, controlling pain, taking blood tests, managing diarrhea and incontinence, improving doctor-patient relationships, coping with multiple illnesses, getting out of bed on difficult mornings, having fun despite weakness, traveling, finding work, maintaining a professional life, managing time, and handling recurrences. The book includes appendices about support groups and additional resource materials.

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Ask Audrey: The Author's Personal and Professional Experience in the Day-to-Day Living with Inflammatory Bowel Disease Source: Detroit, MI: Audrey Kron. 1992. 156 p. Contact: Available from Center for Coping with Chronic Illness. 7466 Pebble Lane, West Bloomfield, MI 48322. (810) 626-6960. Also available from CCFA Michigan Chapter. 31313 Northwestern Highway, Suite 209, Farmington Hills, MI 48334. (810) 737-0900. Fax (810) 737-0904. PRICE: $15 including shipping and handling. ISBN: 0963387707. Summary: This book, written by a medical psychotherapist with inflammatory bowel disease (IBD), presents practical guidelines for coping with IBD. After an introduction in which the author shares her life story, she provides chapters on general information about chronic illness; practical suggestions; relationships; emotions and IBD; and coping techniques. Practical suggestions are provided on dealing with diarrhea; choosing a doctor; going to the hospital; controlling pain; taking blood tests; travelling; total parenteral nutrition (TPN); living with TPN; deciding on an ostomy; getting out of bed; having fun despite weakness; and enjoying the holidays. Much of the information in the book is based on the Ask Audrey columns that originally appeared in the Crohn's and Colitis Foundation of America's Michigan Chapter CCFA Newsletter.

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AIDS in the Workplace Source: AIDS and the Law; A Guide for the Public. Contact: Yale University Press, PO Box 209040, New Haven, CT, 06520-9040, (203) 4320940. Summary: This chapter provides a summary of legal principles potentially applicable to Acquired immunodeficiency syndrome (AIDS) in the workplace and their implications for employees and employers. Traditionally, employers had complete discretion to refuse to employ people under the "Employment at Will Rule." A relatively new body of law aimed at preventing discrimination against the disabled partially limits this

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discretion. If AIDS and AIDS-related complex (ARC) are defined as handicaps, as seems likely, Federal, State, and local laws are in effect that limit employer discretion in hiring, firing, and setting conditions of employment. Several States and cities also have passed laws directly prohibiting either AIDS-related discrimination or the use of blood tests to screen employees for AIDS. Other laws governing unemployment, health, and pension benefits also limit discretion, and there are labor laws governing the treatment of employees afraid to work due to fear of AIDS. It is concluded that for reasons of law, public policy, compassion, and common sense, employers should educate themselves and their employees to avoid AIDS-related discrimination. •

Lupus: A Patient Care Guide for Nurses and Other Health Professionals Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1998. 146 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail: [email protected]. Website: www.niams.nih.gov. PRICE: 1 to 25 copies free. Order Number: AR-204. Summary: This guide provides health professionals with an overview of lupus and what is involved in caring for patients who have it. Chapter one focuses on the features of discoid lupus erythematosus, systemic lupus erythematosus (SLE), and drug-induced SLE; the symptoms, diagnosis, and treatment of SLE; medications; and psychosocial aspects. The implications of these aspects for the way nurses or other health professionals work with a patient who has lupus are discussed as well. Chapter two highlights some recent research advances in terms of the role of immune system dysfunction, genetics, environmental influences, and hormones in the etiology of Systemic Lupus Erythematosus. It also reviews ongoing research in treatment and health maintenance and discusses the role of the National Institute of Arthritis and Musculoskeletal and Skin Diseases in lupus research. Chapter three describes the major tests used to diagnose and evaluate SLE, including blood tests, autoimmunity measurements, and tests for kidney disease. It also provides information on the rationale for using these tests and their clinical usefulness. Chapter four provides an overview of general and system specific lupus manifestations, as well as potential problems and nursing interventions for each. Among the general manifestations are fatigue, fever, and psychological and emotional effects. Specific manifestations include dermatologic, musculoskeletal, hematologic, cardiopulmonary, renal, central nervous system, gastrointestinal, and ophthalmologic abnormalities. Several key issues, including pregnancy, infection, and nutrition, are also discussed. Chapter five reviews the major categories of medications used to treat lupus, including nonsteroidal antiinflammatory drugs, antimalarials, corticosteroids, and immunosuppressives. Chapter six examines the psychosocial aspects of lupus, including helping a patient cope with the emotional needs associated with seeking a diagnosis; handling the reactions of family members and oneself; and gaining control over feelings, emotions, and new physical limitations. Chapter seven presents 16 short fact sheets covering a broad range of issues related to living with lupus and using medications to manage it. The final chapter identifies organizations and written materials that may be useful as sources of further information about lupus and patient care. The guidebook concludes with an index. 54 references.

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Getting Help: A Patient's Guide for Men With Impotence Source: Lenexa, KS: Integrated Medical Resources, Inc. 1995. 48 p. Contact: Available from Integrated Medical Resources, Inc. 8326 Melrose Drive, Lenexa, KS 66214. (913) 894-0591. PRICE: $6.95. Summary: This handbook provides basic information about the diagnosis and treatment of male erectile dysfunction, or impotence. After introductory chapters defining impotence and discussing its causes, the author considers diagnostic issues, including the patient history and physical, specialized blood tests, erection monitoring during sleep, in-office impotence testing, and other specialized tests. The next chapter outlines treatment options, including sexual counseling, oral medications, testosterone hormone replacement, penile injections, vacuum constriction devices, penile implant surgery, and corrective surgeries. Also included is a chapter on penile curvature and Peyronie's disease. The handbook concludes with two brief sections to help readers determine if they really have a problem and to encourage them to consult a health care provider. A brief index concludes the book. Simple line drawings illustrate many of the concepts.

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Ciara's Story Contact: Irish Association of Social Workers, 114 Pearse St, Dublin 2, http://iasw.eire.org. Summary: This illustrated children's book tells the story of Ciara, an elementary-schoolaged girl residing in Ireland who has HIV. The book explains that, although Ciara is HIV-positive and must undergo regular medical checkups, she leads a relatively normal lifestyle. The book depicts the blood tests and other procedures that are part of Ciara's regular medical care and explains what happens during an HIV-related hospitalization.

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When Your Kidneys Fail: A Handbook for Patients and Their Families. 3rd ed Source: Los Angeles, CA: National Kidney Foundation of Southern California. 1994. 228 p. Contact: Available from National Kidney Foundation of Southern California. 5777 West Century Boulevard, Suite 1450, Los Angeles, CA 90045-7404. (310) 641-8152. (800) 7473527. Fax (310) 641-5246. PRICE: $14.95 plus shipping and handling. Free to Southern California dialysis patients. Summary: This informational handbook is intended for kidney disease patients and their families. Written in an accessible question and answer format, the book provides 12 chapters covering topics including kidney function and dysfunction; methods of treatment; hemodialysis; peritoneal dialysis; treatment for anemia; kidney transplantation; diet and medication; adjustment and rehabilitation; financial information and other resources; research and kidney failure; other considerations, including parenthood, genetics, employment, and legal rights; and advance directives. The book also includes a detailed glossary of terms; bibliography; subject index; and five appendices, including information on blood tests, food lists, a list of cookbooks, weights and measurements, and a list of medications. 35 references.

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Hepatitis C: A Personal Guide to Good Health Contact: Publishers Group West Incorporated, 1700 4th St, Berkeley, CA, 94710-1711, (510) 528-1444, http://www.pgw.com.

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Summary: This monograph summarizes and updates existing knowledge about hepatitis C virus (HCV) infection. Part one provides information on the discovery of HCV, the features of HCV and other types of hepatitis, the effect of HCV on the liver, modes of transmission, and symptoms. Part two describes the ways HCV is diagnosed, confirmed, and monitored, focusing on blood tests, genotype testing, liver function tests, imaging studies, and liver biopsies. Other topics include the medical and surgical therapies available to treat HCV, including interferon/ribavirin therapy and liver transplantation; alternative and complementary therapies used to treat HCV such as herbs, massage, acupuncture, and other stress-reduction techniques; and the role of diet and exercise in HCV treatment. Part three describes steps individuals can take to assume responsibility for their health. Topics include reaching out for support from physicians, family and friends, coworkers, support groups, professional counselors, and substance abuse specialists as well as stopping the spread of HCV by protecting oneself and others from HCV, supporting efforts to educate others about the dangers of HCV, and advocating for more research. •

Living With Hepatitis C: A Survivor's Guide Contact: Hatherleigh Press, 5-22 46 Ave Ste 200, Long Island City, NY, 11101, (800) 3672550, http://www.hatherleigh.com. Summary: This monograph, for individuals with hepatitis C, offers guidance and answers for individuals infected with hepatitis C. It provides guidance and answers to individuals infected with hepatitis C, their friends and family. It discusses the nature of the disease and how it affects the body; how to understand blood tests and biopsies; how to avoid infecting others; healthy nutrition; what to expect if a liver transplant is needed; how to deal with emotions and grief; children with Hepatitis C; how an individual can protect him/herself from enormous medical costs; and what to expect in the future regarding new research and new drugs.

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AIDS Ministries. National Association of Evangelicals, Washington AIDS Conference; Washington, D.C Contact: National Association of Evangelicals, PO Box 28, Wheaton, IL, 60187. Summary: This sound recording of proceedings from the National Association of Evangelicals Washington AIDS Conference deals with church policies on Acquired immunodeficiency syndrome (AIDS). The first speaker explains that he feels AIDS should be treated as a public health issue rather than as a civil rights issue. National compulsory blood tests should be initiated. Education about the methods of Human immunodeficiency virus (HIV) transmission should be widespread and the fact that HIV is not spread by casual contact should be stressed. The group, Americans for a Sound AIDS Policy (ASAP), wishes to serve as a resource center for AIDS and HIV information for churches. The second speaker is from Love in Action and he discusses their work as caregivers for Persons with AIDS (PWA's).

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

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NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “blood tests” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “blood tests” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “blood tests” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

A Parent's Guide to the Screening Test for Spina Bifida and Down's Syndrome: A Blood Test You Can Choose to Have During Your Pregnancy (2002); ISBN: 1902030737; http://www.amazon.com/exec/obidos/ASIN/1902030737/icongroupinterna

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Blood Test by Jonathan Kellerman (Author); ISBN: 0553569635; http://www.amazon.com/exec/obidos/ASIN/0553569635/icongroupinterna

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Blood tests and the proof of paternity in civil proceedings; ISBN: 010200269X; http://www.amazon.com/exec/obidos/ASIN/010200269X/icongroupinterna

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Common blood tests : getting acquainted with your lab results; ISBN: 1881818063; http://www.amazon.com/exec/obidos/ASIN/1881818063/icongroupinterna

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Common Blood Tests: What Every Patient Must Know About Lab Tests by N. L. Gifford (Editor) (1999); ISBN: 1881818098; http://www.amazon.com/exec/obidos/ASIN/1881818098/icongroupinterna

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Disputed paternity : the value and application of blood tests by Neville J. Bryant; ISBN: 0913258741; http://www.amazon.com/exec/obidos/ASIN/0913258741/icongroupinterna

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Jonathan Kellerman: Blood Test, When the Bough Breaks, over the Edge by Jonathan Kellerman; ISBN: 0451924169; http://www.amazon.com/exec/obidos/ASIN/0451924169/icongroupinterna

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Normal Blood Test Scores Aren't Good Enough! by Ellie Cullen, et al; ISBN: 0971628300; http://www.amazon.com/exec/obidos/ASIN/0971628300/icongroupinterna

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Oxidology : the study of reactive oxygen toxic species (ROTS) and their metabolism in health and disease : the ROTS theory of degenerative disease and the HLB blood test by Robert W. Bradford; ISBN: 0934740046; http://www.amazon.com/exec/obidos/ASIN/0934740046/icongroupinterna

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Psa: How a Simple Blood Test Can Save Your Life by Don Kaltenbach (1998); ISBN: 0965182754; http://www.amazon.com/exec/obidos/ASIN/0965182754/icongroupinterna

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Robbie Has a Blood Test by Paula J. Girard; ISBN: 0533073006; http://www.amazon.com/exec/obidos/ASIN/0533073006/icongroupinterna

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The Blood Handbook: A Comprehensive Guide to Blood Tests in Health & Illness by Georg, Md Hoffmann, et al; ISBN: 0881790842; http://www.amazon.com/exec/obidos/ASIN/0881790842/icongroupinterna

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The Blood Tests (Evidence of Paternity) (Amendment) Regulations (Northern Ireland) 1992: Evidence (Statutory Rule: 1992: 225) (1992); ISBN: 0337108250; http://www.amazon.com/exec/obidos/ASIN/0337108250/icongroupinterna

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The use of blood test in determining paternity: a handbook for solicitors, doctors and court officials by Brian Harris; ISBN: 090050059X; http://www.amazon.com/exec/obidos/ASIN/090050059X/icongroupinterna

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

When You Have Hepatitis B: Understanding the Diagnosis: Blood Tests and Biopsies Source: in Everson, G.T.; Weinberg, H. Living with Hepatitis B: A Survivor's Guide. Long Island, NY: Hatherleigh Press. 2002. p.18-37. Contact: Available from Hatherleigh Press. 5-22 46th Avenue Suite 200, Long Island City, NY 11101. (800) 528-2550. E-mail: [email protected]. Website: http://store.yahoo.com/hatherleighpress/index.html. PRICE: $15.95 plus shipping and handling. ISBN: 1578260841. Summary: Chronic hepatitis B can lead to cirrhosis (liver scarring), liver cancer, and the need for liver transplantation. This chapter on diagnostic tests is from a book that helps readers diagnosed with hepatitis B virus (HBV) infection educate themselves about the disease and its treatment. The authors answer questions about the testing process for hepatitis B, from diagnosis through monitoring during the years of ongoing care. The chapter covers hepatitis B virus tests, including proteins, antigens, and antibodies; liver imaging tests, including ultrasound, computed tomography, and magnetic resonance imaging (MRI); liver biopsy, including the procedure used and how to interpret the results obtained; liver blood tests, including liver enzymes, bilirubin, albumin, clotting factors, alpha-fetoprotein, and complete blood count (CBC); and patterns of hepatitis B tests in patients, including for acute and chronic disease, and for chronic carriers. Throughout the chapter the authors include quotes from real people who are living with hepatitis. 6 figures. 3 tables.

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CHAPTER 6. MULTIMEDIA ON BLOOD TESTS Overview In this chapter, we show you how to keep current on multimedia sources of information on blood tests. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on blood tests is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “blood tests” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “blood tests” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on blood tests: •

ABC News Nightline: National Town Meeting on AIDS, Part 1 and Part 2 Contact: MTI Film and Video, 420 Academy Dr, Northbrook, IL, 60062, (708) 940-1260. Summary: In this videorecording, a panel of 19 guests who include celebrities, artists, physicians, psychologists, insurance representatives, lawyers, sex workers, entertainment figures, politicians, and religious leaders discuss the impact of Acquired immunodeficiency syndrome (AIDS) on society. The program explores the epidemiology of Human immunodeficiency virus (HIV), available treatment programs, the effect of HIV on the immune system, and issues surrounding compulsory blood tests and reporting laws. The panelists provide various perspectives on public opinion on AIDS, moral values, and AIDS and minorities. Other topics include the problems faced by insurance companies and State health authorities, safer sexual conduct and behavior modification as a result of AIDS, youth education programs, euthanasia in relation to the AIDS epidemic, living with AIDS, and coping strategies of hospital personnel who treat Persons with AIDS (PWA's).

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A Positive Influence Contact: Greater Los Angeles Council on Deafness, AIDS Education/Services for the Deaf, 2222 Laverna Ave, Los Angeles, CA, 90041, (323) 550-4250, http://www.gladinc.org. Summary: This videorecording uses a dramatized story line to make points about Human immunodeficiency virus (HIV) infection among the deaf community. It tells the story of Catherine, a young deaf woman who is about to be married; when she and her fiance take blood tests prior to getting their marriage license, they come back HIVpositive. Catherine fails into despair, and her mother, Regina, visits a community clinic to learn more about Acquired immunodeficiency syndrome (AIDS). There, she is called on to interpret when a counselor cannot communicate with a deaf man, Doug; through this encounter, Catherine and Doug begin to support each other, and decide to try joining a support group. They feel excluded by the hearing members of this group, and visit the AIDS Education for the Deaf office seeking a support group for deaf persons. With help from a counselor, Ray, they start the group. The videorecording addresses the issue of confidentiality and presents basic information about taking charge of one's health to check the progress of HIV infection. The videorecording is captioned, with dialogue taking place in a combination of sign language and spoken words.

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Now That You Know: Living Healthy With HIV; Part 2 - Understanding HIV Contact: Kaiser Permanente, National Video Communications, 825 Colorado Blvd Ste 301, Los Angeles, CA, 90041, (323) 259-4776, http://www.kaiserpermanente.org/locations/index.html. Summary: This videorecording, part of a series, advises persons with Human immunodeficiency virus (HIV) infection that education is the best way to take control of their health. Viewers are advised to know their treatment options so they can choose the best program for them. Bob Goen and Susan Campos serve as narrators for the program, which is intercut with short-burst interviews with infected persons. The HIV-positive persons speak of how knowledge quells their fears and makes them feel in control of their health. The videorecording features two embedded segments, one on how HIV affects the immune system, and the other on the importance and meaning of various blood tests, including the HIV-antibody test. Physicians discuss the best time to begin medication, and point out that how a patient feels physically is also important. The narrators emphasize the importance of a strong physician-patient relationship.

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Gestational Diabetes: Your Questions Answered Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1996. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 093096B. Summary: This videotape answers frequently asked questions about gestational diabetes. A moderator asks an obstetrician-gynecologist and a dietitian about various aspects of gestational diabetes. Topics include what gestational diabetes is and what causes it, how it differs from other kinds of diabetes, and how it will affect a baby. Gestational diabetes, which usually develops between 24 to 26 weeks of gestation, is caused when the placenta produces chemicals that interfere with insulin and the

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mother's body cannot compensate for this change. Risk factors for gestational diabetes include being over 30 years old and overweight, having a family history of diabetes, and having had a baby over 9.5 pounds or a stillborn infant. Most women have no symptoms so blood tests are usually performed between 24 and 28 weeks of gestation. Many women who have gestational diabetes can manage the disease with diet and exercise. However, some women may need insulin to manage their diabetes. If a woman needs insulin, she needs to self monitor her blood glucose levels, give herself insulin injections, have her pregnancy monitored more closely, do urine tests to monitor ketones, and have tests to make sure the baby is developing properly. Participants also answer questions about the effect of gestational diabetes on the baby, the impact of gestational diabetes on delivery, and other pregnancy complications. The videotape concludes by identifying sources of additional information. •

It's Time To Learn About Diabetes: A Video on Diabetes for Children Source: Minneapolis, MN: Chronimed Publishing. 1993. Contact: Available from Chronimed Publishing. P.O. Box 59032, Minnetonka, MN 55459-9686. (800) 848-2793 or (612) 541-0239. Fax (800) 395-3344 or (612) 541-0210. PRICE: $24.95 plus shipping and handling. Summary: This videotape program is designed to help children recently diagnosed with diabetes understand their disease and how to manage it. With the help of animated hosts Mike and Cindy, the program shows children about diabetes management, insulin shots, blood tests, and other potentially frightening topics. The video explains that children can continue all of their normal activities with a little bit of planning. The video is based on the book of the same name.

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 “blood tests” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on blood tests: •

Keynote Speaker: 3rd National Forum on AIDS and Hepatitis B, Washington, D.C., November 21-23, 1988 Contact: Sound Solution, PO Box 566074, Dallas, TX, 75356, (214) 258-6144. Summary: In this sound recording, Dr. Ralph Reed, Deputy Assistant Secretary of the U.S. Department of Health and Human Services, delivers the keynote address at the Third National Forum on AIDS and Hepatitis B, presented by the National Foundation for Infectious Diseases, Nov. 23, 1988. He compliments the group on the topic of the conference: Protecting America's health-care system. He says that sometimes it seems that the Public Health Service worries more about the health of doctors and nurses than they do themselves. However, the epidemic of Acquired immunodeficiency syndrome (AIDS), caused by the Human immunodeficiency virus (HIV), is changing many physicians' attitudes. He says that people who were nonchalant about the dangers of Hepatitis B are becoming more cautious about AIDS, although only 12 health-care workers worldwide have ever died of AIDS; while 10,000 to 12,000 health care workers

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each year are infected by Hepatitis B in the United States. Of these, 200 to 300 die. He then describes the program begun by the Indian Health Service to combat Hepatitis B in Alaska. A screening program of blood tests in the Native Alaskan villages identified the geographic hot spots where Hepatitis B was most prevalent. People in these villages were immunized first; then the remainder of the population of 75,000 Native Alaskans, including all newborn babies. Fifteen hundred chronic carriers were identified, and these are now being checked twice a year in their villages. He says that without this program, 40 per cent of male chronic carriers and 20 per cent of female chronic carriers would die of liver cancer. He adds that this is the first Hepatitis B program in the world to screen pregnant females and immunize newborn babies. Dr. Reed says that the success of the program is due to the availability of several good vaccines. This, unfortunately, is not the case with AIDS. There is no vaccine and no cure. The only thing that the PHS can do is to tell people how to avoid AIDS, and a booklet about AIDS was mailed to every family in the United States, 107 million booklets in all. Also, he says, 13 regional centers for AIDS education and training have been set up across the country. These centers provide consultation and training for the primary-care providers who will deal dire.

Bibliography: Multimedia on Blood Tests 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 multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in blood tests (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 blood tests: •

Tube handling for blood tests [videorecording] Source: [presented by] Medcom; Year: 1995; Format: Videorecording; Cypress, CA: Medcom, c1995

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CHAPTER 7. PERIODICALS AND NEWS ON BLOOD TESTS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover blood tests.

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

Newer fecal blood test has no advantage in general clinic setting Source: Reuters Medical News Date: August 25, 2003

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Blood test can predict diabetes during pregnancy Source: Reuters Health eLine Date: August 01, 2003

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Blood test may predict HIV-related dementia Source: Reuters Health eLine Date: June 23, 2003

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Rapid blood test for TB looks promising: report Source: Reuters Health eLine Date: April 04, 2003

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New blood test for TB looks promising Source: Reuters Medical News Date: April 03, 2003

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Blood test may predict colon cancer risk Source: Reuters Health eLine Date: March 13, 2003

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Blood test reportedly effective for monitoring MS Source: Reuters Health eLine Date: December 06, 2002

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Blood test may identify ovarian cancer: study Source: Reuters Health eLine Date: November 19, 2002

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Blood test helps predict heart patient survival Source: Reuters Health eLine Date: November 11, 2002

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FDA pushing for quick development of West Nile blood test Source: Reuters Medical News Date: November 06, 2002

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FDA officials urge West Nile blood test development Source: Reuters Health eLine Date: November 06, 2002

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Blood test catches prostate cancer-report Source: Reuters Health eLine Date: October 16, 2002

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Scientists take new approach in mad-cow blood test Source: Reuters Health eLine Date: October 09, 2002

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Blood test helps catch congestive heart failure Source: Reuters Health eLine Date: July 17, 2002

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Cheaper HIV blood tests a next step for Africa Source: Reuters Health eLine Date: July 08, 2002

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Simple blood test can spot organ transplant recipients prone to rejection Source: Reuters Medical News Date: April 15, 2002

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Blood test might spot pregnancy complication Source: Reuters Health eLine Date: April 05, 2002

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “blood tests” (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 “blood tests” (or synonyms). If you know the name of a company that is relevant to blood tests, 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 “blood tests” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly

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to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “blood tests” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on blood tests: •

Liver Tests: Simple Blood Tests Can Reveal a Lot Source: Mayo Clinic Health Letter. 18(5): 1-3. May 2000. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465. Summary: This article, from a health newsletter, reviews the liver function tests that are used to monitor liver health and disease. The author begins by reviewing the healthy functions of the liver, including regulating the composition of the blood, manufacturing vital nutrients (such as cholesterol, vitamin A, certain proteins, bile), and neutralizing toxic substances. Sometimes there is an obvious sign of a problem, such as jaundice, which is a buildup of bilirubin in the blood, resulting in a yellow appearance of the skin and eyes. The various liver tests basically screen for three types of abnormalities: liver cell damage, reduced protein levels in the blood, and failure to eliminate certain substances from the blood. Information from the blood tests, combined with a thorough physical exam and sometimes diagnostic imaging, may be enough to reach a specific diagnosis; sometimes a liver biopsy is added to the list of diagnostic tests. Some of the more common liver disorders that are detected with these tests are viral hepatitis, alcohol or drug related liver disease, liver cancer, nonalcoholic steatohepatitis (a form of fatty liver), and hemochromatosis (high amounts of iron stored in the body). One sidebar reviews the drugs that can lead to liver toxicity. The author concludes that mild liver test abnormalities are normal; however, significantly abnormal test results should never be ignored. 1 figure.

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What Blood Tests Tell Us Source: Harvard Women's Health Watch. 7(3): 6. November 1999. Contact: Available from Harvard Women's Health Watch. P.O. Box 420068, Palm Coast, FL 32142-0068. (800) 829-5921 or (904) 445-4662. Summary: This brief newsletter article describes the standard blood tests that may be done to diagnose disease or monitor risk factors. The author uses the metaphor of the bloodstream as a river that brings oxygen and other vital nutrients to the body's cells and carries waste away from them. This 'river' also transports the cellular and molecular forces that fight disease, and ferries hormones from the glands to the tissues. By sampling this stream, doctors can identify elevated risk in people who are healthy and pick up clues to the sources of symptoms in those who are sick. The few cubic centimeters of blood contain millions of cells and molecules, each of which can vary in number according to the person's state of health. The lab report resulting from a blood test usually consists of two sections: hematology, which provides information about blood cells, and chemistry, which furnishes data about plasma. The bulk of the article consists of a chart that explains the results of a typical blood test. The chart lists the lab values typically studied, the range of results considered normal, and the significance of values outside the normal range. Lab values included are WBC (white blood cells), HCT (hematocrit), PLT (platelets), CHOL (total cholesterol), HDL ('good' cholesterol), LDL

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('bad' cholesterol), TRIG (triglycerides), BUN (blood urea nitrogen), CREAT (creatinine), GLU (glucose), and TSH (thyroid stimulating hormone). 1 table.

Academic Periodicals covering Blood Tests Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to blood tests. In addition to these sources, you can search for articles covering blood tests 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 8. 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 blood tests. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with blood tests. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to blood tests: Anticoagulants •

Systemic - U.S. Brands: Coumadin; Miradon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202050.html

Antidiabetic Agents, Sulfonylurea •

Systemic - U.S. Brands: Amaryl; DiaBeta; Diabinese; Dymelor; Glucotrol; Glucotrol XL; Glynase PresTab; Micronase; Orinase; Tolinase http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202742.html

Clozapine •

Systemic - U.S. Brands: Clozaril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202157.html

Diazoxide •

Oral - U.S. Brands: Proglycem http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202191.html

Heparin •

Systemic - U.S. Brands: Calciparine; Liquaemin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202280.html

Insulin •

Systemic - U.S. Brands: Humulin 50/50; Humulin 70/30; Humulin 70/30 Pen; Humulin L; Humulin N; Humulin N Pen; Humulin R; Humulin R, Regular U500 (Concentrated); Humulin U; Lente; Lente Iletin II; Novolin 70/30; Novolin 70/30 PenFill; Novolin 70/30 Prefilled; Novolin L; Novoli http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203298.html

Iron Supplements •

Systemic - U.S. Brands: DexFerrum; Femiron; Feosol; Feostat; Feostat Drops; Feratab; Fer-gen-sol; Fergon; Fer-In-Sol Capsules; Fer-In-Sol Drops; Fer-In-Sol Syrup; Fer-Iron Drops; Fero-Gradumet; Ferospace; Ferralet; Ferralet Slow Release; Ferralyn Lanacaps; Ferra-TD; Ferretts; http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202305.html

Isotretinoin •

Systemic - U.S. Brands: Accutane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202309.html

Measles Virus Vaccine Live •

Systemic - U.S. Brands: Attenuvax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202338.html

Strontium Chloride Sr 89 •

Therapeutic - U.S. Brands: Metastron http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202706.html

Researching Medications

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Tacrine •

Systemic - U.S. Brands: Cognex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202722.html

Varicella Virus Vaccine Live •

Systemic - U.S. Brands: Varivax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202998.html

Vitamin B 12 •

Systemic - U.S. Brands: Alphamin; Cobex; Cobolin-M; Crystamine; Crysti-12; Cyanoject; Cyomin; Hydrobexan; Hydro-Cobex; Hydro-Crysti-12; HydroxyCobal; LA-12; Nascobal; Neuroforte-R; Primabalt; Rubramin PC; Shovite; Vibal; Vibal LA; Vitabee 12 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202596.html

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

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

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APPENDICES

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

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/

10

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

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

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

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

•

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

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

•

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

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

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

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

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

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

•

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

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

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

•

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

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

•

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

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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.11 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:12 •

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

•

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

•

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

•

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

•

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

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

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

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

•

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

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

•

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

11

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). 12 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 “blood tests” 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 “blood tests” (or synonyms) into the “For these words:” box. The following is a sample result: •

Diagnosis and Treatment of Chronic Intestinal Pseudo-Obstruction in Children: Report of Consensus Workshop Source: Atlanta, GA: Children's Motility Disorder Foundation. 1997. 37 p. Contact: Available from Children's Motility Disorder Foundation. 225 Peachtree Street, NE, Suite 1430, Atlanta, GA 30303. (800) 809-9492 or (404) 529-9200. Fax (404) 529-9202. E-mail: [email protected]. PRICE: Single copy free. Summary: The diagnostic term 'chronic intestinal pseudo-obstruction' (CIP) is often used without real regard of its meaning. The resultant inconsistency in the use of the term has hampered the clinical investigation and management of children with disorders of gastrointestinal motility. To address these problems, a Consensus Working Group was convened to arrive at a clear definition of CIP and to suggest an approach for the diagnosis and treatment of CIP; this document is the report of that Working Group. The term pseudo-obstruction denotes signs and symptoms resembling a physical obstruction to luminal flow, but without a true mechanical obstruction. CIP is a rare, severe, disabling disorder characterized by repetitive episodes or continuous symptoms and signs of bowel obstruction, including radiographic documentation of dilated bowel with air-fluid levels, in the absence of a fixed, lumen-occluding lesion. Disorders associated with primary CIP are classified as either myopathy or neuropathy depending on histopathology. Disorders causing secondary CIP are classified according to the presumed underlying pathophysiology, which facilitates an organized approach to evaluation. The document describes diagnostic approaches, including motility testing, screening blood tests, measurement of transit, antroduodenal manometry, electrogastrography, and histology. The document concludes with a brief description of treatment options, including optimal nutrition, treatment of bacterial overgrowth, cisapride, bowel decompression, and small intestine transplant. 2 figures. 2 tables. 174 references.

•

Role of Diet in the Treatment of Kidney Disease Source: in Exceptional Parent. End Stage Renal Disease: A Practical Guide for Physicians, Dietitians, Nurses, Patients, Families, and Caregivers. Englewood Cliffs, NJ: Exceptional Parent. 1999. p. 9.

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Contact: Available from Exceptional Parent. P.O. Box 1807, Englewood Cliffs, NJ 07632. (800) 535-1910. Fax (201) 947-9376. E-mail: [email protected]. Website: www.eparent.com. PRICE: $5.95. Summary: This brief article on the role of diet is from a monograph written to soften the blow of receiving the diagnosis of kidney failure by providing patients, caregivers, and their families some practical, easy to read information. The articles are written to be practical enough for patients to use, yet informative enough that professionals can refer to them as well. This article recommends that any individual with kidney disease (either chronic kidney failure or end stage renal disease, ESRD) be referred to a renal dietitian for nutrition consultation. The renal dietitian will perform a complete nutrition assessment that includes a review of the individual's medical, surgical, and diet histories, blood tests, and medications. After the information is collected and reviewed, the dietitian develops a nutritional care plan with objectives and goals. The care plan includes nutrient requirements, such as the amount of protein and calories that the person needs to maintain a good nutritional status. The author notes that the ability to incorporate cultural foods, practices, and preferences in the dietary plan is important for dietary compliance. Whatever the belief and practice, every diet plan needs to be individualized for the person who must follow it. The article includes the toll free number of the National Kidney Foundation (800 622 9010) through which readers can locate a renal dietitian. •

AIDS - Related Knowledge and Attitudes: A Survey of College Students Contact: Virginia Commonwealth University, Center for Public Policy, Survey Research Lab, PO Box 843065, Richmond, VA, 23284-3065, (804) 828-8813, http://www.vcu.edu/srl. Summary: This paper presents results of a survey of Virginia college and university students regarding their Knowledge, Attitudes, Behaviors, and Beliefs (KABB) about Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV). The survey respondents answered questions relating to HIV transmission; HIV prevention; compulsory blood tests; drug abuse; their personal sexual behavior and adherence to safer sexual conduct, particularly condom use; and their attitudes toward taking the HIV-antibody test themselves.

•

Client Satisfaction With Inpatient and Outpatient HIV/AIDS Services in New South Wales Contact: New South Wales Department of Health, AIDS Bureau, 150 Albion St, Surry Hills. Summary: This report of a survey of client satisfaction with inpatient and outpatient HIV/AIDS services in New South Wales (NSW) presents findings from six outpatient and six inpatient clinics. The total number of respondents were 272 patients in an outpatient clinic and 72 patients in an inpatient facility. Both the outpatient and inpatient questionnaires contained 24 assessment questions. Results indicate that the outpatient respondents registered much more satisfaction with services than dissatisfaction, yet there was considerable variation of item scores within, and between, clinics. The inpatient respondents were more satisfied than dissatisfied; however, there was much variation within and among inpatient services. The results suggest that inpatients and outpatients want more information and explanations. Outpatients also want reduced waiting times for seeing the doctor, getting blood tests done, and getting prescriptions.

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AIDS - Related Knowledge, Attitudes, and Behavior of Virginia College Students: The Virginia Statewide AIDS Needs Assessment Contact: Virginia Commonwealth University, Center for Public Policy, Survey Research Lab, PO Box 843065, Richmond, VA, 23284-3065, (804) 828-8813, http://www.vcu.edu/srl. Summary: This report presents the findings of a survey of Virginia college and university students regarding their Knowledge, Attitudes, and Behaviors (KAB) related to Acquired immunodeficiency syndrome (AIDS), caused by Human immunodeficiency virus (HIV). Although public awareness of AIDS among this population was high, there were substantial gaps in knowledge, probably reflecting media emphases and discussions of the disease. The report concludes that there is a need for improved information dissemination about AIDS on college campuses. Virginia undergraduates strongly support compulsory blood tests for health professionals but only a minority believe that employers have a right to test their employees. Other situations produce moderate levels of support for testing. A small minority of respondents have extremely negative attitudes toward Persons with AIDS (PWA's), supporting quarantines and expulsion of children with AIDS from schools. Larger proportions agree they would not like to live near, work with, or go to school with PWA's. The students feel that AIDS and drug abuse pose very serious national problems and, while they agree that the government should set up AIDS clinics, they are more ambiguous about governmental responsibility to pay for treatment costs. There is some evidence that public awareness about AIDS has modified the respondents' sexual behavior, causing them to adopt some aspects of safer sexual conduct, although only 25 percent reported using a condom during each sexual encounter. Nearly all respondents would take the HIV-antibody test if a sex partner were found to be HIV positive.

•

Special Report: Arthritis Source: Boston, MA: Harvard Medical School. 1999. 46 p. Contact: Available from Harvard Medical School. Health Publications Group, Department SR, P.O. Box 380, Boston, MA 02117-0380. PRICE: $16.00 plus shipping and handling. Summary: This report provides people who have arthritis with information on the features, diagnosis, and treatment of osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). The report begins by explaining the difference between arthritis and rheumatism. This is followed by an overview of the joints and the immune system in rheumatic diseases. Topics include types of joints, joint design, the functioning of the immune system, the occurrence of inflammation in arthritis, and the role of genetics. The report then discusses OA, RA, and AS in terms of their evolution, symptoms, possible causes, diagnosis, and treatment. Other seronegative spondyloarthropathies, including Reiter's syndrome, psoriatic arthritis, and enteropathic arthritis, are described. A section of the report is devoted to the diagnosis of rheumatic diseases, focusing on obtaining a medical history; assessing pain and stiffness; conducting a physical examination by observing how the patient moves, examining the joints for abnormalities, and moving the joints through their range of motion to detect pain, resistance, unusual sounds, and instability; and performing studies such as blood tests, radiography, other imaging techniques, and arthrocentesis. Another section focuses on using physical therapy to treat people who have arthritis. Modalities discussed are heat and cold therapy, exercise, diathermy, and transcutaneous electrical nerve stimulation. In addition, the report provides suggestions on living with arthritis.

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They focus on diet; rest during periods of acute inflammation; exercise; joint protection; and ways of coping with depression, stress, and sexual needs. The report also includes a glossary and a list of resources. 1 appendix and 8 figures. •

Human Immunodeficiency Virus (HIV) Infection Contact: American Academy of Physician Assistants, 950 N Washington St, Alexandria, VA, 22314, (703) 836-2272, http://www.aapa.org/. Summary: This statement presents the policies of the American Academy of Physician Assistants regarding Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV). Following an introductory section which outlines the risk factors involved in HIV transmission, the epidemiology of AIDS, and the symptoms of the disease, the statement declares that the code of ethics of this profession demands health-service accessibility to all persons, including those with AIDS or HIV infection. Physician assistants are urged to participate in education and HIV-specific training programs in order to maintain updated information about HIV infection including diagnosis, management, treatment, and counseling of HIV-positive persons. The Academy calls on Federal, State, and local governments to enact or strengthen laws prohibiting discrimination against HIV-positive persons in the areas of employment, housing, education, insurance, health service accessibility, and other civil rights. The policy statement maintains that, while the HIV-antibody test is appropriate when needed for early diagnosis, compulsory blood tests for entire populations are unjustifiable ethically or practically. Furthermore, the Academy does not recommend routine testing of hospitalized or pre-operative patients without their informed consent. Finally, the statement supports anonymous reporting and anonymous population-based studies and suggests that HIV-positive persons should be encouraged to notify their sexual or needle-sharing partners of their infection. Legislation should prohibit any disclosure of identifying information pertaining to an individual's HIV status without express consent, except when clearly required for medical or legal reasons.

The NLM Gateway13 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.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “blood tests” (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.

13 14

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

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

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

Items Found 143956 233 1775 215 7 146186

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 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.17 Simply search by “blood tests” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists18 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.19 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.20 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/.

15

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

16

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

17

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. 18 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 19

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. 20 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/.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on blood tests 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 blood tests. 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 blood tests. 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 “blood tests”:

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Other guides Anemia http://www.nlm.nih.gov/medlineplus/anemia.html Blood Transfusion and Donation http://www.nlm.nih.gov/medlineplus/bloodtransfusionanddonation.html Cancer http://www.nlm.nih.gov/medlineplus/cancer.html Children's Health http://www.nlm.nih.gov/medlineplus/childrenshealth.html Heart Attack http://www.nlm.nih.gov/medlineplus/heartattack.html Heart Diseases http://www.nlm.nih.gov/medlineplus/heartdiseases.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Liver Diseases http://www.nlm.nih.gov/medlineplus/liverdiseases.html

Within the health topic page dedicated to blood tests, the following was listed: •

General/Overviews Lab Tests Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/oivd/consumer-lab.html Lab Tests Online Source: American Association for Clinical Chemistry http://www.labtestsonline.org/ Pathologist Is. Source: American Society for Clinical Pathology http://www.ascp.org/general/pub_resources/pathologist.asp Understanding Your Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/index.html Why Doctors Order Laboratory Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest2.html

•

Diagnosis/Symptoms Interpreting Laboratory Test Results Source: National Cancer Institute http://cis.nci.nih.gov/fact/5_27.htm

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Specific Conditions/Aspects Blood Culture Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest3.html Blood Cultures Source: American Association for Clinical Chemistry http://labtestsonline.org/understanding/analytes/blood_culture/test.html Blood Gas Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/blood_gases/test.html Buying Diagnostic Tests from the Internet: Buyer Beware! Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/consumer/buyerbeware.html Helping You Identify Quality Laboratory Services Source: Joint Commission on Accreditation of Healthcare Organizations http://www.jcaho.org/general%2Bpublic/making%2Bbetter%2Bchoices/helping% 2Byou%2Bchoose/lab.htm Home Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/home_testing.html Home-Use Tests Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/oivd/consumer-homeuse.html Screening Tests for Adults (Ages 30-49) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/d_adult.html Screening Tests for Young Adults (Ages 18-29) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/c_youngadult1.html White Blood Cell Count Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/wbc/test.html

•

Children I Had a Lab Test! Source: American Society for Clinical Pathology http://www.ascp.org/general/pub_resources/labtest/ Screening Tests for Children (Ages 2-12) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/b_children.html Screening Tests for Newborns and Infants Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/a_newborn.html

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Latest New Brazil to Offer Massive, Free HIV Testing Source: 10/31/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14490 .html Doctors Urge New Test for Cholesterol Source: 11/06/2003, New York Times Syndicate http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14553 .html

•

Men hCG Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/hcg/test.html

•

Prevention/Screening 24-Hour Urine Collection Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/24hr.pdf ACTH StimulationTest Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/acth.pdf Allergy Test (RAST Test) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/allergy/test.html Antinuclear Antibody Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/ana/test.html Basic Metabolic Panel Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/bmp/bmp.html Blood Sedimentation Rate Test Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HO00025 Calcium Pentagastrin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/calciumpentagastri.pdf Chloride Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/chloride/test.html Clonidine Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/clonidine.pdf

Patient Resources

CO2 Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/co2/test.html Complete Blood Count Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest4.html Comprehensive Metabolic Panel Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/cmp/cmp.html CRH Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/crh.pdf Electrolytes Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest5.html Electromyography and Nerve Conduction Velocities Source: Muscular Dystrophy Association http://www.mdausa.org/publications/Quest/q75ss.html Glomerular Filtration Rate (GFR) Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/glomerular.pdf Glucose Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/glucose/test.html Liver Function Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest6.html Lumbar Puncture (Spinal Tap) Source: Nemours Foundation http://kidshealth.org/parent/general/sick/lumbar_puncture.html Oral Glucose Tolerance Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/oralglu.pdf Potassium Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/potassium/test.html Preparing for a Needle Aspiration Biopsy Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/pepubs/needle.html Secretin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/secretin.pdf Sodium Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/sodium/test.html

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Stool Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest8.html Strep Screen/Throat Culture Source: Nemours Foundation http://kidshealth.org/PageManager.jsp?dn=nemours&article_set=22876&lic=16&c at_id=128 Swallowing Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/swallowing.pdf Therapeutic Drug Monitoring Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/thdm/glance.html Total Protein Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/tp/test.html Tumor Markers Source: National Cancer Institute http://cis.nci.nih.gov/fact/5_18.htm Understanding Your Complete Blood Count Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/pepubs/cbc97.pdf Urine Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest7.html •

Research New Definitions for Healthy Ranges of Alanine Aminotransferase, a Blood Test of Liver Function Source: American College of Physicians http://www.annals.org/cgi/content/full/137/1/I-37

•

Teenager Screening Tests for Teens Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/c_youngadult.html

•

Women hCG Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/hcg/test.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

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(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 blood tests. 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: •

Common Blood Tests: What They Mean, What You Can Do Contact: Project Inform, HIV Treatment Hotline, 205 13th St Ste 2001, San Francisco, CA, 94103, (415) 558-8669, http://www.projectinform.org. Summary: This brochure provides basic information about interpreting laboratory blood tests used to monitor the progress of Human immunodeficiency virus (HIV) infection and to implement drug therapy, if appropriate. It particularly focuses on the T4 - helper cell tests but also covers the P24 - antibody test, the P24 - antigen test, the Beta22 microglobulin test, and the complete blood count. Results of the T4 - helper test are categorized into three ranges, depicting the severity of immediate danger of contracting an AIDS - related infection or initiation of antiviral treatment. It notes that wide variations in results can be minimized by observing long - range trends, testing at the same time each day, using the same laboratory for testing, and not testing when sick or during periods of stress, drug use, or lack of sleep. It also notes that to date, physicians do not agree on when to start drug therapy. Some prefer to wait until the patient becomes ill to initiate drug treatment, even through the virus has been identified.

•

Information for Individuals About AIDS and the Antibody Blood Test Contact: Austin/Travis County Health Department, AIDS Commission, 15 Waller St, Austin, TX, 78702, (512) 469-2070. Summary: This fact sheet offers basic information about Acquired immunodeficiency syndrome (AIDS) and the antibody blood tests for the Human immunodeficiency virus (HIV). The meanings of positive and negative results are discussed. Healthfinder™

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

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Medical Tests of Kidney Function Summary: Healthy kidneys remove wastes and excess fluid from the blood. Blood tests show whether the kidneys are failing to remove wastes. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6520 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 blood tests. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

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

21

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)22: •

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/

22

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

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BLOOD TESTS 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] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acoustic: Having to do with sound or hearing. [NIH] ACTH: Adrenocorticotropic hormone. [EU] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adenomatous Polyposis Coli: An autosomal dominant polyposis syndrome in which the colon contains few to thousands of adenomatous polyps, often occurring by age 15 to 25. [NIH]

Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH]

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Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alanine: A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases immunity, and provides energy for muscle tissue, brain, and the central nervous system. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric

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monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [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] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-fetoprotein: AFP. A protein normally produced by a developing fetus. AFP levels are usually undetectable in the blood of healthy nonpregnant adults. An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and

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stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anthropometry: The technique that deals with the measurement of the size, weight, and proportions of the human or other primate body. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

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] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidote: A remedy for counteracting a poison. [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

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antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiplasmin: A member of the serpin superfamily found in human plasma that inhibits the lysis of fibrin clots which are induced by plasminogen activator. It is a glycoprotein, molecular weight approximately 70,000 that migrates in the alpha 2 region in immunoelectrophoresis. It is the principal plasmin inactivator in blood, rapidly forming a very stable complex with plasmin. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH]

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Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arthroscopy: Endoscopic examination, therapy and surgery of the joint. [NIH] Articular: Of or pertaining to a joint. [EU] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspartate: A synthetic amino acid. [NIH] Aspiration: The act of inhaling. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a

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variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium enema: A procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Bed Rest: Confinement of an individual to bed for therapeutic or experimental reasons. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH]

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Bewilderment: Impairment or loss of will power. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the

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embryonic disc. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood urea: A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases. [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 Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [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] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a

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neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breath Tests: Any tests done on exhaled air. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [NIH] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU]

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Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [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] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [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 Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Adhesion Molecules: Surface ligands, usually glycoproteins, that mediate cell-to-cell adhesion. Their functions include the assembly and interconnection of various vertebrate systems, as well as maintenance of tissue integration, wound healing, morphogenic movements, cellular migrations, and metastasis. [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] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH]

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Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelating Agents: Organic chemicals that form two or more coordination bonds with a central metal ion. Heterocyclic rings are formed with the central metal atom as part of the ring. Some biological systems form metal chelates, e.g., the iron-binding porphyrin group of hemoglobin and the magnesium-binding chlorophyll of plants. (From Hawley's Condensed Chemical Dictionary, 12th ed) They are used chemically to remove ions from solutions, medicinally against microorganisms, to treat metal poisoning, and in chemotherapy protocols. [NIH] Chemopreventive: Natural or synthetic compound used to intervene in the early precancerous stages of carcinogenesis. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Choleretic: A choleretic agent. [EU] 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] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping,

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feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Civil Rights: Legal guarantee protecting the individual from attack on personal liberties, right to fair trial, right to vote, and freedom from discrimination on the basis of race, religion, national origin, age, or gender. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clot Retraction: Retraction of a clot resulting from contraction of platelet pseudopods attached to fibrin strands that is dependent on the contractile protein thrombosthenin. Used as a measure of platelet function. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Codon: A set of three nucleotides in a protein coding sequence that specifies individual amino acids or a termination signal (codon, terminator). Most codons are universal, but some organisms do not produce the transfer RNAs (RNA, transfer) complementary to all codons. These codons are referred to as unassigned codons (codons, nonsense). [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active

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enzyme (holoenzyme). [EU] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Colonic Polyps: Pedunculated or sessile growths arising from the mucous membrane of the colon. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Color Vision Defects: Mild to severe impairment in the ability to discriminate or differentiate hues. This disorder may be acquired as a result of retinal diseases involving the cones (retina) or inherited as an X-linked disorder featuring absent or abnormal cone pigment. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments

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that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Cones (Retina): One of the two photoreceptor cell types in the vertebrate retina. In cones the photopigment is in invaginations of the cell membrane of the outer segment. Cones are less sensitive to light than rods, but they provide vision with higher spatial and temporal acuity, and the combination of signals from cones with different pigments allows color vision. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH]

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Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]

Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [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] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] 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] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Cost-benefit: A quantitative technique of economic analysis which, when applied to

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radiation practice, compares the health detriment from the radiation doses concerned with the cost of radiation dose reduction in that practice. [NIH] Coumarins: Synthetic or naturally occurring substances related to coumarin, the deltalactone of coumarinic acid. Coumarin itself occurs in the tonka bean. The various coumarins have a wide range of proposed actions and uses including as anticoagulants, pharmaceutical aids, indicators and reagents, photoreactive substances, and antineoplastic agents. [NIH] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanide: An extremely toxic class of compounds that can be lethal on inhaling of ingesting in minute quantities. [NIH] Cystoscope: A thin, lighted instrument used to look inside the bladder and remove tissue samples or small tumors. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decompensation: Failure of compensation; cardiac decompensation is marked by dyspnea, venous engorgement, and edema. [EU]

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Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel

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movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Digital rectal examination: DRE. An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities. [NIH] Dilatation: The act of dilating. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discoid: Shaped like a disk. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] 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] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dyspnea: Difficult or labored breathing. [NIH]

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Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electroplating: Coating with a metal or alloy by electrolysis. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH]

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Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [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]

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Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Euthanasia: The act or practice of putting to death people or animals suffering from incurable conditions or diseases. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excrete: To get rid of waste from the body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Faecal: Pertaining to or of the nature of feces. [EU] 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] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fecal occult blood test: A test to check for blood in stool. (Fecal refers to stool; occult means hidden.) [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron

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with the protein apoferritin. [NIH] Fertilizers: Substances or mixtures that are added to the soil to supply nutrients or to make available nutrients already present in the soil, in order to increase plant growth and productivity. [NIH] Fetoprotein: Transabdominal aspiration of fluid from the amniotic sac with a view to detecting increases of alpha-fetoprotein in maternal blood during pregnancy, as this is an important indicator of open neural tube defects in the fetus. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually

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between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] 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] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Frequency: The proportion of one particular allele in the total of all alleles for one genetic locus in a breeding population. [NIH] Gene Order: The sequential location of genes on a chromosome. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH]

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Geriatric: Pertaining to the treatment of the aged. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestures: Movement of a part of the body for the purpose of communication. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [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] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Gonadal: Pertaining to a gonad. [EU]

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Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanidine: A strong organic base existing primarily as guanidium ions at physiological pH. It is found in the urine as a normal product of protein metabolism. It is also used in laboratory research as a protein denaturant. (From Martindale, the Extra Pharmacopoeia, 30th ed and Merck Index, 12th ed) It is also used in the treatment of myasthenia and as a fluorescent probe in HPLC. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haloperidol: Butyrophenone derivative. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemin: Chloro(7,12-diethenyl-3,8,13,17-tetramethyl-21H,23H-porphine-2,18dipropanoato(4-)-N(21),N(22),N(23),N(24)) ferrate(2-) dihydrogen. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body

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stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatotoxic: Toxic to liver cells. [EU] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one

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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] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Histology: The study of tissues and cells under a microscope. [NIH] Holidays: Days commemorating events. Holidays also include vacation periods. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [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] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Cyanide: HCN. A toxic liquid or colorless gas. It is found in the smoke of various tobacco products and released by combustion of nitrogen-containing organic materials. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater

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specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH]

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Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunophenotyping: Process of classifying cells of the immune system based on structural and functional differences. The process is commonly used to analyze and sort Tlymphocytes into subsets based on CD antigens by the technique of flow cytometry. [NIH] 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] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Inertia: Inactivity, inability to move spontaneously. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH]

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Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infuse: To pour (a liquid) into something. [EU] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Infusion Pumps: Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (insulin infusion systems is also available), and other disorders. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin Infusion Systems: Portable or implantable devices for infusion of insulin. Includes open-loop systems which may be patient-operated or controlled by a pre-set program and are designed for constant delivery of small quantities of insulin, increased during food ingestion, and closed-loop systems which deliver quantities of insulin automatically based on an electronic glucose sensor. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the

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laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intraepithelial: Within the layer of cells that form the surface or lining of an organ. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Islet: Cell producing insulin in pancreas. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and

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several other skin diseases. The drug has teratogenic and other adverse effects. [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] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney Pelvis: The flattened, funnel-shaped expansion connecting the ureter to the kidney calices. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lactation: The period of the secretion of milk. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU]

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Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [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] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]

Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Local Government: Smallest political subdivisions within a country at which general governmental functions are carried-out. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

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Lucida: An instrument, invented by Wollaton, consisting essentially of a prism or a mirror through which an object can be viewed so as to appear on a plane surface seen in direct view and on which the outline of the object may be traced. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lupus Erythematosus, Systemic: A chronic, relapsing, inflammatory, and often febrile multisystemic disorder of connective tissue, characterized principally by involvement of the skin, joints, kidneys, and serosal membranes. It is of unknown etiology, but is thought to represent a failure of the regulatory mechanisms of the autoimmune system. The disease is marked by a wide range of system dysfunctions, an elevated erythrocyte sedimentation rate, and the formation of LE cells in the blood or bone marrow. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and

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spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammography: Radiographic examination of the breast. [NIH] Manometry: Tests that measure muscle pressure and movements in the GI tract. [NIH] Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] 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 Health: The state wherein the person is well adjusted. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH]

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Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Midwifery: The practice of assisting women in childbirth. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocyte: A type of white blood cell. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

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Musculoskeletal System: Themuscles, bones, and cartilage of the body. [NIH] Mutagenic: Inducing genetic mutation. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Myeloproliferative Disorders: Disorders in which one or more stimuli cause proliferation of hemopoietically active tissue or of tissue which has embryonic hemopoietic potential. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Myopathy: Any disease of a muscle. [EU] 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] 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] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatal period: The first 4 weeks after birth. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] 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

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system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nitrosamines: A class of compounds that contain a -NH2 and a -NO radical. Many members of this group have carcinogenic and mutagenic properties. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Medicine: A specialty field of radiology concerned with diagnostic, therapeutic, and investigative use of radioactive compounds in a pharmaceutical form. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Nutrition Assessment: Evaluation and measurement of nutritional variables in order to assess the level of nutrition or the nutritional status of the individual. Nutrition surveys may be used in making the assessment. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH]

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Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Occult Blood: Chemical, spectroscopic, or microscopic detection of extremely small amounts of blood. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogenes: Genes which can potentially induce neoplastic transformation. They include genes for growth factors, growth factor receptors, protein kinases, signal transducers, nuclear phosphoproteins, and transcription factors. When these genes are constitutively expressed after structural and/or regulatory changes, uncontrolled cell proliferation may result. Viral oncogenes have prefix "v-" before the gene symbol; cellular oncogenes (protooncogenes) have the prefix "c-" before the gene symbol. [NIH] Opacity: Degree of density (area most dense taken for reading). [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] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Ornithine: An amino acid produced in the urea cycle by the splitting off of urea from arginine. [NIH] Ornithine Decarboxylase: A pyridoxal-phosphate protein, believed to be the rate-limiting compound in the biosynthesis of polyamines. It catalyzes the decarboxylation of ornithine to form putrescine, which is then linked to a propylamine moiety of decarboxylated Sadenosylmethionine to form spermidine. EC 4.1.1.17. [NIH] Orthopaedic: Pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopaedics. [EU] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable

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to the solvent). [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ostomy: Surgical construction of an artificial opening (stoma) for external fistulization of a duct or vessel by insertion of a tube with or without a supportive stent. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] 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] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU]

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Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Paternity: Establishing the father relationship of a man and a child. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Care Management: Generating, planning, organizing, and administering medical and nursing care and services for patients. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Peripheral blood: Blood circulating throughout the body. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and

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peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phlebotomy: The letting of blood from a vein. Although it is one of the techniques used in drawing blood to be used in diagnostic procedures, in modern medicine, it is used commonly in the treatment of erythrocytosis, hemochromocytosis, polycythemia vera, and porphyria cutanea tarda. Its historical counterpart is bloodletting. (From Cecil Textbook of Medicine, 19th ed & Wintrobe's Clinical Hematology, 9th ed) Venipuncture is not only for the letting of blood from a vein but also for the injecting of a drug into the vein for diagnostic analysis. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Photoreceptor: Receptor capable of being activated by light stimuli, as a rod or cone cell of the eye. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physician-Patient Relations: The interactions between physician and patient. [NIH] Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians. [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]

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Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] 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] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelet Factor 4: A high-molecular-weight proteoglycan-platelet factor complex which is released from blood platelets by thrombin. It acts as a mediator in the heparin-neutralizing capacity of the blood and plays a role in platelet aggregation. At high ionic strength (I=0.75),

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the complex dissociates into the active component (molecular weight 29,000) and the proteoglycan carrier (chondroitin 4-sulfate, molecular weight 350,000). The molecule exists in the form of a dimer consisting of 8 moles of platelet factor 4 and 2 moles of proteoglycan. [NIH]

Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polychromatic: Erythrocyte that, on staining, shows various shades of blue combined with tinges of pink. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]

Porphyria Cutanea Tarda: A form of hepatic porphyria (porphyria, hepatic) characterized by photosensitivity resulting in bullae that rupture easily to form shallow ulcers. This condition occurs in two forms: a sporadic, nonfamilial form that begins in middle age and has normal amounts of uroporphyrinogen decarboxylase with diminished activity in the liver; and a familial form in which there is an autosomal dominant inherited deficiency of uroporphyrinogen decarboxylase in the liver and red blood cells. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may

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be infused without repeated needle sticks. Also called a port. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] 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] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [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] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH] Pregnancy Complications: The co-occurrence of pregnancy and a disease. The disease may precede or follow conception and it may or may not have a deleterious effect on the pregnant woman or fetus. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Preventive Medicine: A medical specialty primarily concerned with prevention of disease and the promotion and preservation of health in the individual. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] 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]

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Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] 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] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]

Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to

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thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Prothrombin Time: Measurement of clotting time of plasma recalcified in the presence of excess tissue thromboplastin. Factors measured are fibrinogen, prothrombin, and factors V, VII, and X. It is used for monitoring anticoagulant therapy with coumarins. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proto-Oncogenes: Normal cellular genes homologous to viral oncogenes. The products of proto-oncogenes are important regulators of biological processes and appear to be involved in the events that serve to maintain the ordered procession through the cell cycle. Protooncogenes have names of the form c-onc. [NIH] Protoporphyrins: Porphyrins with four methyl, two vinyl, and two propionic acid side chains attached to the pyrrole rings. Protoporphyrin IX occurs in hemoglobin, myoglobin, and most of the cytochromes. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Opinion: The attitude of a significant portion of a population toward any given proposition, based upon a measurable amount of factual evidence, and involving some degree of reflection, analysis, and reasoning. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

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Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Putrescine: A toxic diamine formed by putrefaction from the decarboxylation of arginine and ornithine. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays,

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gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reassurance: A procedure in psychotherapy that seeks to give the client confidence in a favorable outcome. It makes use of suggestion, of the prestige of the therapist. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

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Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] 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] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrospective: Looking back at events that have already taken place. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Ribonucleoside Diphosphate Reductase: An enzyme of the oxidoreductase class that catalyzes the formation of 2'-deoxyribonucleotides from the corresponding ribonucleotides

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using NADPH as the ultimate electron donor. The deoxyribonucleoside diphosphates are used in DNA synthesis. (From Dorland, 27th ed) EC 1.17.4.1. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretin: A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a

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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] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sequester: A portion of dead bone which has become detached from the healthy bone tissue, as occurs in necrosis. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serologic Tests: Diagnostic procedures involving immunoglobulin reactions. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sessile: Attached directly by the base, denoting a tumor without penduncle or stalk; in zoology, attached so that it is not possible to move about. [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] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH]

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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] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Sign Language: A system of hand gestures used for communication by the deaf or by people speaking different languages. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Nitrite: Nitrous acid sodium salt. Used in many industrial processes, in meat curing, coloring, and preserving, and as a reagent in analytical chemistry. It is used therapeutically as an antidote in cyanide poisoning. The compound is toxic and mutagenic and will react in vivo with secondary or tertiary amines thereby producing highly carcinogenic nitrosamines. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Soft tissue sarcoma: A sarcoma that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Specimen Handling: Procedures for collecting, preserving, and transporting of specimens

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sufficiently stable to provide accurate and precise results suitable for clinical interpretation. [NIH]

Spectrophotometry: The art or process of comparing photometrically the relative intensities of the light in different parts of the spectrum. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermidine: A polyamine formed from putrescine. It is found in almost all tissues in association with nucleic acids. It is found as a cation at all pH values, and is thought to help stabilize some membranes and nucleic acid structures. It is a precursor of spermine. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Steatosis: Fatty degeneration. [EU] 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] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stoma: A surgically created opening from an area inside the body to the outside. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [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

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be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal tumors: Tumors that arise in the supporting connective tissue of an organ. [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] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sulfuric acid: A strong acid that, when concentrated is extemely corrosive to the skin and mucous membranes. It is used in making fertilizers, dyes, electroplating, and industrial explosives. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. [NIH] Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU]

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Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [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] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Systolic blood pressure: The maximum pressure in the artery produced as the heart contracts and blood begins to flow. [NIH] Tendinitis: Inflammation of tendons and of tendon-muscle attachments. [EU] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thermography: Measurement of the regional temperature of the body or an organ by

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infrared sensing devices, based on self-emanating infrared radiation. [NIH] Thiothixene: A thioxanthine used as an antipsychotic agent. Its effects are similar to the phenothiazine antipsychotics. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [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] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Nodule: A small circumscribed mass of differentiated tissue associated with the thyroid gland. It can be pathogenic or non-pathogenic. The growth of nodules can lead to a condition of nodular goiter. Most nodules appear between the ages of 30 and 50 years and most are benign. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH]

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Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transcutaneous: Transdermal. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH]

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Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor suppressor gene: Genes in the body that can suppress or block the development of cancer. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urea Breath Test: A test used to detect Helicobacter pylori infection. The test measures breath samples for urease, an enzyme H. pylori makes. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the

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kidneys, ureters, bladder, and urethra. [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] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] 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] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH]

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Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vial: A small bottle. [EU] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] 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] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

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

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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]

203

INDEX A Abdomen, 11, 139, 147, 159, 170, 172, 179, 180, 193, 196 Abdominal, 4, 139, 148, 179, 180, 198 Abdominal Pain, 4, 139, 198 Abscess, 139, 161 Accommodation, 78, 139 Acetaminophen, 8, 13, 139 Acne, 30, 139, 170 Acne Vulgaris, 30, 139, 170 Acoustic, 43, 139, 200 ACTH, 124, 139, 154 Activities of Daily Living, 12, 139 Acute renal, 139, 165 Adenocarcinoma, 139, 165 Adenoma, 18, 40, 80, 139 Adenomatous Polyposis Coli, 17, 139 Adipocytes, 139, 153, 171 Adipose Tissue, 24, 139 Adjustment, 87, 90, 139 Adjuvant, 139, 162 Adrenal Cortex, 139, 154, 184 Adrenal Medulla, 140, 159, 177 Adrenergic, 23, 140, 143, 159, 194 Adverse Effect, 140, 171, 192 Aerosol, 140, 194 Afferent, 140, 171 Affinity, 16, 24, 140, 192 Agar, 140, 182 Age of Onset, 140, 198 Agonist, 140, 148, 177 Alanine, 5, 126, 140 Albumin, 65, 93, 140, 182, 195 Algorithms, 15, 72, 140, 146 Alimentary, 4, 7, 9, 140, 179, 180 Alkaline, 14, 140, 141, 145, 148 Alkaline Phosphatase, 14, 140 Alkaloid, 141, 177 Alleles, 23, 141, 162 Alpha Particles, 141, 187 Alpha-fetoprotein, 93, 141, 161 Alternative medicine, 101, 141 Amino Acid Sequence, 141, 142 Amino Acids, 141, 151, 180, 183, 185, 194, 198 Ammonia, 141, 198 Amplification, 22, 141 Ampulla, 141, 159

Anaemia, 34, 141 Anal, 6, 81, 141, 159, 172 Anal Fissure, 6, 141 Analgesic, 4, 13, 139, 141, 167 Analytes, 123, 124, 125, 126, 141 Anaplasia, 141 Anatomical, 141, 168, 190 Androgens, 139, 141, 154 Anemia, 6, 22, 24, 47, 90, 122, 142, 164 Anesthetics, 142, 159 Angina, 82, 142 Angiography, 6, 79, 142 Angioplasty, 27, 142 Animal model, 9, 142 Anions, 140, 142, 170, 191 Annealing, 142, 183 Anomalies, 6, 20, 142, 195 Anorectal, 15, 142 Anthropometry, 23, 142 Antiallergic, 142, 154 Antibacterial, 9, 142, 193 Antibiotic, 13, 142, 193 Antibodies, 14, 16, 54, 64, 77, 93, 142, 143, 164, 168, 173, 175, 182, 187 Anticoagulant, 67, 73, 76, 77, 142, 185, 186, 200 Antidote, 24, 142, 192 Antigen, 7, 64, 79, 127, 140, 142, 143, 152, 163, 166, 167, 168, 174, 187, 191 Anti-infective, 143, 166 Anti-inflammatory, 13, 44, 89, 139, 143, 144, 154, 163, 167 Anti-Inflammatory Agents, 143, 144, 154 Antimetabolite, 143, 189 Antimicrobial, 8, 66, 143, 156 Antineoplastic, 143, 154, 155, 166, 169 Antineoplastic Agents, 143, 155, 169 Antioxidant, 73, 143, 144 Antiplasmin, 22, 143 Antipsychotic, 143, 196 Antipyretic, 139, 143 Antiserum, 64, 143 Antithrombotic, 16, 143 Antiviral, 127, 143, 170, 189 Anuria, 143, 171 Anus, 141, 142, 143, 145, 147, 159, 161, 188 Anxiety, 12, 144 Anxiolytic, 144, 148

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Blood Tests

Aqueous, 24, 70, 144, 145, 166 Arachidonic Acid, 18, 144, 172, 185 Arginine, 144, 178, 187 Arterial, 27, 34, 53, 82, 144, 163, 167, 185, 195 Arteries, 26, 77, 82, 144, 147, 154, 170, 174, 176, 196 Arterioles, 144, 147, 148, 175 Arteriolosclerosis, 144 Arteriosclerosis, 82, 144 Arthroscopy, 13, 144 Articular, 13, 144, 179 Ascites, 65, 144 Ascorbic Acid, 41, 144, 166 Aspartate, 5, 144 Aspiration, 13, 125, 144, 161 Aspirin, 26, 144 Assay, 16, 17, 20, 24, 72, 144, 167, 187 Asymptomatic, 36, 42, 48, 49, 144, 179 Atmospheric Pressure, 144, 166, 167 Atrial, 144, 200 Atrial Fibrillation, 144, 200 Atrophy, 13, 144 Attenuation, 43, 145 Atypical, 64, 145 Aural, 7, 145 Autodigestion, 145, 179 Autoimmune disease, 14, 145 Autoimmunity, 89, 145 Autonomic, 143, 145, 177 B Bacteria, 8, 142, 145, 146, 158, 160, 174, 175, 193, 199 Bacteriophage, 145, 182 Bacterium, 145, 165 Barium, 6, 51, 145 Barium enema, 51, 145 Base, 23, 76, 83, 145, 156, 164, 171, 191, 198 Basement Membrane, 145, 160, 171 Bed Rest, 25, 145 Benign, 139, 144, 145, 176, 187, 196 Benzodiazepines, 145, 148 Beta-Thromboglobulin, 22, 145 Bewilderment, 146, 153 Bile, 102, 146, 150, 161, 162, 171, 172, 190, 193, 199 Bile Acids, 146, 162, 193 Bile Acids and Salts, 146 Bile Ducts, 146, 161 Bile Pigments, 146, 171 Biliary, 146, 148, 179 Biliary Tract, 146, 148, 179

Bilirubin, 65, 72, 93, 102, 140, 146, 161, 167 Biochemical, 7, 13, 14, 32, 65, 141, 143, 146, 161, 171, 179, 191 Biological response modifier, 146, 169 Biomarkers, 83, 146 Biopsy, 5, 7, 11, 14, 39, 93, 102, 125, 146 Biosynthesis, 144, 146, 178 Biotechnology, 28, 29, 101, 113, 146 Biotransformation, 146 Biphasic, 69, 146 Bladder, 6, 33, 78, 146, 155, 161, 168, 185, 198, 199 Blastocyst, 146, 153, 182 Blood Cell Count, 123, 147, 164 Blood Coagulation, 66, 74, 77, 147, 148, 196 Blood Coagulation Factors, 147 Blood Glucose, 11, 18, 71, 84, 97, 147, 165, 169 Blood Platelets, 147, 182, 191 Blood pressure, 11, 147, 149, 163, 167, 175, 192 Blood transfusion, 27, 64, 147 Blood urea, 103, 147, 171 Body Composition, 24, 147 Body Fluids, 68, 146, 147, 157, 192, 198 Body Mass Index, 147, 179 Bolus, 16, 79, 147 Bolus infusion, 147 Bone Marrow, 147, 159, 173, 194 Bone scan, 13, 147 Bowel, 52, 88, 114, 141, 147, 156, 159, 169, 170, 180, 193, 198 Bowel Movement, 147, 157, 193 Bradykinin, 147, 182 Branch, 68, 135, 148, 162, 173, 178, 180, 186, 192, 195 Breakdown, 147, 148, 156, 162, 178 Breath Tests, 5, 148 Breeding, 148, 162 Bronchi, 148, 159, 197 Buccal, 148, 173 Buffers, 69, 148 Bursitis, 13, 148 Buspirone, 43, 148 C Caesarean section, 45, 148 Calcification, 144, 148 Calcium, 24, 70, 82, 124, 148, 151, 152, 167, 186 Calculi, 148, 164 Caloric intake, 15, 148

Index 205

Capillary, 30, 67, 68, 147, 148, 199 Capsules, 106, 148, 162 Carbohydrate, 7, 148, 154, 163, 183 Carbon Dioxide, 65, 149, 155, 182, 189, 199 Carcinogenesis, 18, 149, 150 Carcinogenic, 149, 169, 177, 185, 192, 193 Carcinoma, 38, 40, 48, 149 Cardiac, 79, 144, 149, 155, 159, 162, 176, 189, 193 Cardiology, 79, 149 Cardiopulmonary, 89, 149 Cardiovascular, 23, 25, 79, 82, 149, 172, 191 Cardiovascular disease, 23, 149 Carotene, 149, 189 Carrier Proteins, 149, 182, 187 Catheterization, 142, 149 Catheters, 74, 149 Cations, 149, 170 Causal, 149, 159 Cause of Death, 84, 149 Cell Adhesion, 22, 149 Cell Adhesion Molecules, 22, 149 Cell Count, 20, 26, 149 Cell Division, 145, 149, 164, 182, 191 Cell proliferation, 144, 149, 178 Central Nervous System, 83, 89, 140, 149, 162, 163, 172, 178, 191 Centrifugation, 72, 150, 164 Cerebral, 83, 150, 154, 159 Cerebrospinal, 150, 191 Cerebrospinal fluid, 150, 191 Cerebrovascular, 149, 150 Cerebrum, 150 Character, 21, 150, 156 Chelating Agents, 69, 150 Chemopreventive, 23, 150 Chemotherapy, 150 Chenodeoxycholic Acid, 150, 199 Chest Pain, 25, 150 Chlorophyll, 150 Choleretic, 150, 199 Cholesterol, 32, 66, 75, 82, 102, 124, 146, 150, 154, 161, 167, 193 Cholinergic, 143, 150, 177 Choroid, 150, 189 Chromosomal, 141, 150 Chromosome, 21, 150, 162, 172, 191 Chronic Disease, 4, 93, 150 Circadian, 82, 150 Circadian Rhythm, 82, 150 CIS, 122, 126, 151, 189

Citric Acid, 73, 151 Citrus, 144, 151 Civil Rights, 91, 117, 151 Clinical study, 151, 154 Clinical trial, 9, 16, 26, 113, 151, 154, 175, 186, 188 Clone, 21, 151 Cloning, 16, 146, 151 Clot Retraction, 151, 182 Coagulation, 20, 66, 74, 77, 147, 151, 165, 182, 196, 200 Cochlea, 151, 169 Cochlear, 151, 196, 199, 200 Cochlear Diseases, 151, 196 Codon, 18, 151 Coenzyme, 144, 151 Cohort Studies, 152, 159 Colitis, 88, 152 Collagen, 82, 145, 152, 153, 162, 182, 185 Colloidal, 140, 152, 191, 194 Colonic Polyps, 48, 152 Colonoscopy, 6, 16, 17, 29, 30, 36, 49, 152 Color Vision Defects, 21, 152 Colorectal, 16, 17, 19, 28, 29, 36, 37, 38, 39, 40, 41, 43, 44, 45, 47, 48, 49, 50, 51, 52, 75, 80, 152 Colorectal Cancer, 16, 17, 28, 36, 37, 39, 40, 41, 43, 44, 47, 48, 49, 50, 51, 52, 75, 80, 152 Complement, 152, 162, 182 Computational Biology, 113, 153 Computed tomography, 4, 11, 54, 93, 153 Computerized axial tomography, 13, 153 Computerized tomography, 153 Conception, 153, 154, 161, 184, 193 Cone, 152, 153, 181, 194 Cones (Retina), 152, 153 Confusion, 84, 153, 157, 198 Congestive heart failure, 100, 153 Conjugated, 146, 150, 153, 176 Connective Tissue, 34, 144, 147, 152, 153, 161, 162, 163, 173, 185, 189, 190, 194, 195 Connective Tissue Cells, 153 Connective Tissue Diseases, 34, 153 Consciousness, 141, 153, 156, 157, 189 Constipation, 4, 15, 35, 143, 153 Constriction, 90, 153, 170, 199 Consultation, 73, 98, 115, 153 Consumption, 11, 52, 153, 164, 177, 189 Contamination, 8, 154, 165 Continuum, 82, 154 Contraception, 32, 154

206

Blood Tests

Contractility, 154, 158 Contraindications, ii, 154 Controlled clinical trial, 16, 22, 154 Controlled study, 41, 154 Convulsions, 154, 158 Coordination, 84, 150, 154 Coronary, 79, 82, 149, 154, 174, 176 Coronary heart disease, 149, 154 Coronary Thrombosis, 154, 174, 176 Cortex, 154, 179 Corticosteroid, 13, 154 Cortisol, 140, 154 Cost Savings, 35, 154 Cost-benefit, 25, 154 Coumarins, 155, 186 Craniocerebral Trauma, 155, 196 Creatinine, 74, 103, 155, 171, 198 Crossing-over, 155, 188 Cross-Sectional Studies, 155, 159 Curative, 155, 195 Cutaneous, 38, 155, 173 Cyanide, 24, 155, 192 Cystoscope, 77, 155 Cytokine, 31, 155 Cytotoxic, 155, 187, 188 D Data Collection, 19, 155 Databases, Bibliographic, 113, 155 Deamination, 155, 198 Decarboxylation, 155, 178, 187 Decidua, 155, 182 Decision Making, 25, 155 Decompensation, 65, 155 Decompression, 114, 156 Decompression Sickness, 156 Degenerative, 92, 156, 165, 179, 189 Dementia, 11, 12, 100, 143, 156 Denaturation, 72, 73, 156, 183 Density, 80, 147, 150, 156, 161, 178, 183, 192 Detergents, 52, 156 Deuterium, 156, 166 Diabetes Mellitus, 7, 18, 156, 163, 165, 169 Diagnostic Imaging, 102, 156 Diagnostic procedure, 38, 63, 101, 156, 181, 191 Dialyzer, 156, 165 Diarrhea, 4, 88, 156 Diastole, 156 Diastolic, 11, 156, 167 Diastolic blood pressure, 11, 156 Diathermy, 116, 156

Dietitian, 96, 115, 156 Digestion, 140, 146, 147, 156, 157, 170, 172, 193 Digestive system, 75, 156 Digestive tract, 6, 10, 157, 192 Digital rectal examination, 6, 157 Dilatation, 142, 157, 184, 199 Dimethyl, 69, 157 Direct, iii, 10, 12, 105, 157, 173, 188, 195 Discoid, 89, 157 Discrimination, 88, 117, 151, 157 Disease Progression, 5, 157, 200 Disorientation, 153, 156, 157 Dissociation, 140, 157 Distal, 17, 157, 162, 186 Dizziness, 84, 157, 199 Drug Interactions, 107, 157 Drug Tolerance, 157, 197 Duct, 141, 149, 157, 160, 179, 190 Duodenum, 146, 157, 159, 179, 190, 193 Dyes, 157, 161, 194 Dyspepsia, 4, 9, 45, 157 Dyspnea, 155, 157 E Eclampsia, 32, 158 Edema, 155, 158, 170, 184, 198 Effector, 152, 158, 177 Effector cell, 158, 177 Efficacy, 5, 15, 16, 21, 22, 25, 148, 158, 197 Ejection fraction, 79, 158 Elasticity, 144, 158 Elastin, 152, 153, 158 Elective, 33, 158 Electrocardiogram, 10, 11, 158 Electrocoagulation, 151, 158 Electrolyte, 74, 154, 158, 171, 175, 184, 192, 198 Electrons, 143, 145, 158, 170, 179, 187, 188 Electroplating, 158, 194 Emboli, 158, 200 Embolism, 158, 186, 200 Embolization, 158, 200 Embryo, 146, 158, 168, 179, 193 Empiric, 13, 15, 158 Encephalopathy, 65, 158 Endarterectomy, 142, 158 Endometrium, 155, 158, 174 Endoscope, 159 Endoscopic, 4, 5, 144, 152, 159, 192 Endoscopy, 6, 7, 9, 36, 48, 159 Endothelial cell, 22, 159 Enema, 159

Index 207

Energy balance, 159, 171 Environmental Health, 112, 114, 159 Enzymatic, 148, 149, 152, 159, 161, 183, 189 Enzyme Inhibitors, 159, 182 Epidemic, 95, 97, 159 Epidemiologic Studies, 4, 159 Epigastric, 159, 179 Epinephrine, 11, 140, 159, 177 Epithelial, 139, 155, 159, 165, 171 Epithelial Cells, 159, 165, 171 Epithelium, 145, 159, 162 Erectile, 90, 159 Erection, 90, 159 ERV, 97, 117, 118, 159, 160 Erythrocytes, 141, 142, 147, 159, 188 Erythropoietin, 50, 159 Esophageal, 160, 162 Esophagitis, 160, 162 Esophagus, 6, 10, 75, 157, 160, 162, 164, 172, 181, 188, 193 Estrogen, 160, 185 Ethnic Groups, 6, 160 Euthanasia, 95, 160 Evacuation, 153, 160 Excrete, 143, 160, 171 Exocrine, 160, 179 Exogenous, 146, 160, 198 Expiratory, 159, 160 Expiratory Reserve Volume, 159, 160 Extracellular, 15, 153, 160, 192 Extracellular Matrix, 15, 153, 160 Extracellular Space, 160 Extraction, 75, 160 F Faecal, 28, 36, 37, 38, 39, 40, 43, 44, 47, 48, 50, 51, 52, 160 Family Planning, 113, 160 Fatigue, 10, 35, 89, 160, 164 Fatty acids, 22, 140, 160, 185, 196 Fatty Liver, 102, 160 Febrile, 160, 173 Feces, 69, 80, 153, 160, 193 Ferritin, 6, 70, 160 Fertilizers, 161, 194 Fetoprotein, 161 Fetus, 141, 159, 161, 182, 184, 193, 199 Fibrin, 143, 147, 151, 161, 182, 196 Fibrinogen, 22, 39, 161, 182, 186, 196 Fibrinolysis, 22, 161 Fibrosis, 5, 10, 14, 31, 39, 161, 190 Fistulas, 6, 161 Flatulence, 4, 161

Flatus, 161, 162 Flow Cytometry, 161, 168 Fold, 16, 161 Follicular Phase, 68, 161 Forearm, 147, 161 Fundus, 18, 161 G Gallbladder, 139, 146, 157, 161 Gallstones, 3, 146, 150, 161, 199 Gamma Rays, 161, 187, 188 Ganglia, 143, 162, 176 Gas, 4, 24, 123, 141, 149, 156, 159, 161, 162, 166, 177, 194, 199 Gastric, 9, 10, 40, 145, 162, 164 Gastric Acid, 10, 162 Gastric Mucosa, 40, 162 Gastrin, 162, 166 Gastritis, 6, 162 Gastroesophageal Reflux, 10, 162 Gastroesophageal Reflux Disease, 10, 162 Gastrointestinal tract, 39, 145, 161, 162, 172, 191, 193, 198 Gelatin, 83, 162, 194 Gene, 6, 18, 20, 21, 23, 141, 146, 162, 166, 167, 178, 191 Gene Expression, 21, 162 Gene Frequency, 6, 162 Gene Order, 21, 162 General practitioner, 38, 46, 54, 162 Genetic Engineering, 81, 146, 151, 162 Genetic testing, 162, 183 Genetics, 21, 23, 89, 90, 116, 162 Genotype, 21, 91, 162, 181 Geriatric, 11, 73, 163 Gestation, 96, 163, 182, 184, 193 Gestational, 96, 163 Gestures, 163, 192 Giant Cells, 163, 190 Gland, 139, 140, 163, 173, 179, 180, 182, 185, 191, 193, 196 Glomerular, 125, 163, 171 Glomerulus, 163 Glucocorticoids, 139, 154, 163 Glucose, 18, 23, 66, 71, 73, 84, 103, 125, 144, 147, 156, 163, 165, 169, 190 Glucose Intolerance, 156, 163 Glucose tolerance, 23, 163 Glucose Tolerance Test, 23, 125, 163 Glucuronic Acid, 163, 165 Glutamate, 83, 163 Glycoprotein, 143, 159, 161, 163, 171 Goiter, 163, 196

208

Blood Tests

Gonadal, 163, 193 Gout, 13, 164 Governing Board, 164, 184 Graft, 164, 166 Granulocytes, 164, 200 Growth, 8, 87, 142, 143, 149, 161, 164, 169, 173, 176, 178, 182, 190, 196, 198 Growth factors, 164, 178 Guanidine, 70, 164 H Habitual, 150, 164 Haloperidol, 12, 164 Haptens, 140, 164, 187 Health Care Sector, 80, 164 Health Education, 10, 164 Heart attack, 149, 164 Heart failure, 164 Heartburn, 4, 10, 164 Hematocrit, 102, 147, 164 Hematology, 66, 102, 164, 181 Heme, 69, 146, 164, 176, 183 Hemin, 69, 164 Hemochromatosis, 6, 102, 164 Hemodialysis, 90, 156, 165, 171 Hemoglobin, 6, 18, 43, 69, 70, 73, 75, 142, 147, 150, 159, 164, 165, 186 Hemoglobin A, 18, 43, 73, 150, 165 Hemolytic, 64, 165 Hemorrhage, 27, 155, 158, 165, 194 Hemorrhoids, 6, 165 Hemostasis, 16, 165, 191 Heparin, 74, 106, 165, 182 Hepatic, 5, 65, 140, 163, 165, 172, 183 Hepatitis, 5, 8, 14, 27, 39, 45, 51, 90, 91, 93, 97, 165, 200 Hepatitis A, 8, 27, 165 Hepatocellular, 27, 47, 165 Hepatocellular carcinoma, 27, 47, 165 Hepatocytes, 165 Hepatotoxic, 8, 28, 165 Hepatovirus, 165 Hereditary, 4, 6, 9, 153, 164, 165, 180 Heredity, 139, 162, 166 Heterogeneity, 17, 140, 166 Histology, 5, 43, 114, 166 Holidays, 88, 166 Homogeneous, 144, 154, 166 Homologous, 141, 155, 166, 186, 191, 195 Homozygotes, 6, 166 Hormonal, 145, 154, 166

Hormone, 69, 74, 90, 103, 139, 150, 154, 159, 162, 166, 169, 171, 184, 185, 189, 190, 195, 196 Host, 8, 33, 145, 166, 172, 200 Hybrid, 21, 151, 166 Hydration, 4, 166 Hydrogen, 24, 69, 70, 81, 145, 148, 156, 166, 175, 177, 179, 186 Hydrogen Cyanide, 24, 166 Hydrogen Peroxide, 69, 70, 81, 166 Hydrolysis, 7, 146, 166, 183, 185 Hydrophilic, 64, 156, 166 Hydrophobic, 156, 166 Hydroxylysine, 152, 166 Hydroxyproline, 152, 166 Hydroxyurea, 22, 166 Hyperbaric, 8, 166, 167 Hyperbaric oxygen, 8, 166, 167 Hyperbilirubinemia, 167, 171 Hypercalcemia, 50, 167 Hyperlipidemia, 72, 167 Hyperlipoproteinemia, 7, 167 Hypersensitivity, 38, 167, 172, 189 Hypertension, 5, 144, 149, 167, 170, 184, 198 Hyperthermia, 156, 167 Hyperuricemia, 164, 167 Hypoglycemia, 18, 167 Hypotension, 24, 143, 154, 167 Hypothyroidism, 35, 167 I Ibuprofen, 4, 8, 37, 167 Id, 58, 124, 126, 128, 134, 136, 167 Idiopathic, 167, 190 Illusion, 167, 199 Imaging procedures, 167, 197 Immune response, 26, 139, 142, 145, 154, 164, 167, 168, 194, 200 Immune system, 89, 95, 96, 116, 145, 158, 167, 168, 172, 173, 199, 200 Immunity, 45, 140, 167, 168 Immunoassay, 4, 5, 16, 20, 28, 167 Immunodeficiency, 88, 91, 95, 96, 97, 115, 116, 117, 127, 167, 168 Immunodeficiency syndrome, 88, 91, 95, 96, 97, 115, 116, 117, 127, 168 Immunoelectrophoresis, 140, 143, 168 Immunogenic, 168, 187 Immunoglobulin, 142, 168, 175, 191 Immunologic, 167, 168, 188 Immunology, 33, 53, 139, 140, 168 Immunophenotyping, 74, 168

Index 209

Impairment, 9, 12, 146, 152, 168 Impotence, 90, 159, 168 In situ, 21, 168 In vitro, 77, 168, 183, 191 In vivo, 22, 37, 43, 77, 165, 168, 192, 196 Incision, 66, 148, 168, 170 Incompetence, 162, 168 Incontinence, 88, 168 Indicative, 75, 92, 168, 180, 199 Induction, 141, 143, 156, 168, 185 Inertia, 76, 168 Infarction, 168 Infection, 5, 6, 7, 9, 13, 26, 27, 29, 30, 34, 38, 82, 89, 91, 93, 96, 117, 127, 139, 146, 167, 168, 173, 177, 189, 194, 198, 200 Infertility, 68, 69, 168 Inflammatory bowel disease, 88, 169 Informed Consent, 26, 117, 169 Infuse, 169 Infusion, 71, 169, 197 Infusion Pumps, 71, 169 Ingestion, 41, 163, 169, 183 Inhalation, 140, 169, 183 Initiation, 7, 127, 169, 197 Inlay, 169, 189 Inner ear, 7, 151, 169 Inpatients, 115, 169 Insight, 25, 169 Insulin, 18, 23, 71, 87, 96, 97, 106, 163, 169, 170, 198 Insulin Infusion Systems, 169 Insulin-dependent diabetes mellitus, 169 Insurance, Health, 117, 169 Interferon, 91, 169, 170 Interferon-alpha, 169, 170 Intermittent, 170, 180 Internal Medicine, 6, 20, 29, 41, 42, 49, 164, 170 Intestinal, 18, 114, 149, 150, 163, 170 Intestinal Pseudo-Obstruction, 114, 170 Intestine, 6, 146, 147, 152, 170, 171 Intoxication, 170, 200 Intracellular, 168, 170, 184, 188, 190 Intracranial Hypertension, 170, 196 Intraepithelial, 17, 170 Intramuscular, 170, 179 Intravenous, 4, 24, 27, 53, 169, 170, 179 Intrinsic, 80, 140, 145, 170 Invasive, 5, 7, 9, 71, 79, 82, 84, 167, 170, 173 Ion Channels, 170, 177, 195 Ionizing, 141, 170, 187

Ions, 70, 74, 145, 148, 150, 157, 158, 164, 166, 170, 186 Ischemia, 145, 170 Ischemic stroke, 27, 170 Islet, 19, 170 Isotretinoin, 30, 106, 170 J Jaundice, 102, 167, 171 Joint, 13, 116, 123, 144, 156, 171, 179, 195 K Kb, 112, 171 Kidney Disease, 89, 90, 112, 114, 115, 128, 171 Kidney Failure, 90, 115, 171 Kidney Failure, Acute, 171 Kidney Failure, Chronic, 171 Kidney Pelvis, 171, 198 Kidney Transplantation, 90, 171 Kinetic, 170, 171 L Labyrinth, 151, 169, 171, 191, 199 Lactation, 171, 185 Laminin, 15, 145, 171 Large Intestine, 152, 157, 170, 171, 188, 192 Leptin, 23, 171 Lesion, 114, 171 Lethal, 155, 171 Lethargy, 167, 172 Leukocytes, 147, 164, 170, 172, 180 Leukotrienes, 144, 172 Library Services, 134, 172 Life cycle, 146, 172 Ligament, 172, 185 Ligands, 149, 172 Linkage, 23, 172 Lip, 14, 172 Lipid, 7, 72, 82, 144, 169, 172, 197 Liver cancer, 93, 98, 102, 141, 172 Liver Cirrhosis, 51, 172 Liver Transplantation, 91, 93, 172 Local Government, 117, 172 Localized, 168, 171, 172, 179, 182, 190 Longitudinal Studies, 21, 155, 172 Longitudinal study, 24, 172 Lower Esophageal Sphincter, 162, 172 Lucida, 171, 173 Lumbar, 125, 173 Lumen, 114, 173 Lupus, 13, 26, 76, 77, 89, 173, 195 Lupus Erythematosus, Systemic, 89, 173 Luteal Phase, 68, 173 Lutein Cells, 173, 185

210

Blood Tests

Lymph, 159, 173, 190 Lymph node, 173, 190 Lymphatic, 168, 173, 193 Lymphatic system, 173, 193 Lymphocyte, 38, 143, 173, 174 Lymphocyte Count, 38, 173 Lymphoid, 142, 173 Lytic, 173, 191 M Macrophage, 82, 173 Magnetic Resonance Imaging, 13, 82, 93, 173 Malaise, 11, 173 Malignancy, 50, 173 Malignant, 17, 139, 143, 144, 172, 173, 174, 176, 187, 190 Malignant tumor, 174 Malnutrition, 140, 145, 174 Mammography, 19, 174 Manometry, 15, 114, 174 Mass Screening, 36, 48, 49, 51, 174 Meat, 42, 174, 192 Medial, 81, 144, 174 Mediate, 149, 174 Mediator, 174, 182, 191 MEDLINE, 14, 113, 174 Memory, 11, 12, 156, 174 Meninges, 149, 155, 174 Menopause, 174, 184 Menstrual Cycle, 68, 69, 161, 173, 174, 184 Menstruation, 155, 161, 173, 174 Mental Health, iv, 15, 112, 118, 174, 186 Metabolic disorder, 164, 174 Metabolite, 65, 146, 157, 174 Metastasis, 149, 174 Methionine, 65, 157, 174, 194 MI, 25, 82, 88, 137, 174 Microbe, 174, 197 Microbiology, 38, 145, 175 Microcirculation, 172, 175, 182 Microorganism, 175, 200 Midwifery, 32, 45, 175 Mineralocorticoids, 139, 154, 175 Modeling, 19, 175 Modification, 95, 162, 175 Molecular, 20, 21, 23, 40, 102, 113, 118, 143, 146, 153, 161, 165, 175, 182, 185, 188 Molecule, 142, 145, 151, 152, 157, 158, 166, 175, 179, 183, 185, 188 Monitor, 8, 9, 18, 20, 71, 74, 75, 84, 97, 102, 127, 155, 175, 177 Monoclonal, 16, 175, 187

Monoclonal antibodies, 16, 175 Monocyte, 22, 175 Morphology, 164, 175 Motility, 114, 175, 191 Motion Sickness, 175, 176 Mucins, 175, 190 Mucosa, 7, 80, 162, 173, 175, 185 Mucus, 175, 198 Multicenter study, 17, 18, 175 Musculoskeletal System, 176, 178 Mutagenic, 176, 177, 192 Myasthenia, 164, 176 Myeloproliferative Disorders, 145, 176 Myocardial infarction, 25, 27, 82, 145, 154, 174, 176, 200 Myocardium, 174, 176 Myoglobin, 70, 176, 186 Myopathy, 114, 176 N Nausea, 4, 143, 176, 198 NCI, 1, 111, 122, 126, 151, 176 Necrosis, 168, 174, 176, 190, 191 Need, 3, 5, 14, 17, 24, 28, 35, 39, 64, 77, 79, 87, 93, 95, 97, 101, 114, 116, 129, 176, 197 Needle Sharing, 27, 176 Neonatal, 27, 35, 45, 176 Neonatal period, 28, 176 Neoplasia, 17, 36, 37, 40, 52, 176 Neoplasm, 176, 190 Neoplastic, 141, 176, 178 Nephropathy, 19, 171, 176 Nerve, 116, 125, 140, 174, 176, 178, 180, 190, 193, 197, 199, 200 Nervous System, 83, 140, 149, 174, 176, 177, 194, 195 Networks, 18, 26, 176 Neurologic, 84, 176 Neurons, 162, 176, 177, 195, 199 Neuropathy, 19, 114, 177 Neurotransmitters, 11, 177 Neutrons, 141, 177, 187 Neutrophil, 22, 177 Nicotine, 25, 177 Nitrogen, 103, 141, 156, 166, 171, 177, 198 Nitrosamines, 177, 192 Norepinephrine, 11, 140, 177 Nuclear, 6, 79, 158, 162, 176, 177, 178 Nuclear Medicine, 80, 177 Nuclei, 141, 158, 162, 173, 177, 178, 186, 199 Nucleic acid, 177, 189, 193 Nursing Care, 177, 180

Index 211

Nutrition Assessment, 115, 177 Nutritional Status, 115, 177 O Observational study, 6, 178 Occult, 4, 6, 16, 19, 28, 29, 30, 31, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 55, 69, 70, 74, 75, 77, 78, 80, 160, 178 Oliguria, 171, 178 Oncogenes, 20, 178, 186 Opacity, 156, 178 Ophthalmologic, 89, 178 Ophthalmology, 178 Opsin, 178, 189 Optic Nerve, 178, 189 Organelles, 150, 178 Ornithine, 17, 178, 187 Ornithine Decarboxylase, 17, 178 Orthopaedic, 39, 178 Osmosis, 178 Osmotic, 15, 140, 178, 191 Ossification, 179 Osteoarthritis, 13, 116, 179 Osteogenesis, 9, 179 Osteomyelitis, 8, 179 Osteoporosis, 52, 179 Ostomy, 88, 179 Outpatient, 18, 67, 88, 115, 179 Overweight, 7, 58, 97, 179 Ovulation, 69, 161, 173, 179 Ovum, 155, 163, 172, 179, 184, 185 Oxidation, 143, 146, 179 P Palliative, 179, 195 Pancreas, 3, 139, 146, 157, 165, 169, 170, 179, 190, 198 Pancreatic, 3, 19, 162, 179 Pancreatic cancer, 3, 179 Pancreatic Juice, 162, 179 Pancreatitis, 3, 33, 53, 179 Parenteral, 88, 179, 180 Parenteral Nutrition, 88, 180 Parotid, 180, 190 Particle, 67, 180, 192 Parturition, 180, 185 Paternity, 34, 45, 46, 61, 92, 180 Pathologic, 12, 14, 146, 154, 167, 180, 199 Pathophysiology, 13, 15, 114, 180 Patient Care Management, 13, 180 Patient Compliance, 37, 180 Patient Education, 14, 127, 132, 134, 137, 180

Pelvic, 180, 185 Pepsin, 180, 190 Peptide, 171, 180, 183, 185, 196 Perception, 21, 25, 153, 180, 190 Perfusion, 79, 180 Pericardium, 180, 195 Peripheral blood, 20, 47, 170, 180 Peritoneal, 90, 144, 180 Peritoneal Cavity, 144, 180 Peritoneal Dialysis, 90, 180 Peritoneum, 180 Peroxidase, 69, 70, 75, 180 Peroxide, 181 Pharmaceutical Preparations, 162, 181 Pharmacokinetic, 181 Pharmacologic, 12, 181, 197 Pharynx, 162, 181 Phenotype, 7, 21, 23, 181 Phlebotomy, 26, 181 Phospholipids, 160, 181 Phosphorus, 148, 181 Photocoagulation, 151, 181 Photoreceptor, 21, 153, 181 Physical Examination, 9, 11, 12, 13, 14, 15, 18, 45, 51, 73, 116, 181 Physical Therapy, 116, 181 Physician-Patient Relations, 96, 181 Physicians, Family, 91, 181 Physiologic, 140, 146, 156, 174, 181, 188 Physiology, 3, 25, 79, 149, 164, 181 Pigment, 21, 146, 152, 176, 182 Pilot study, 22, 28, 182 Pituitary Gland, 154, 182 Placenta, 96, 182, 184 Plants, 141, 148, 149, 150, 151, 163, 175, 177, 182, 190, 197 Plaque, 82, 142, 182 Plasma cells, 142, 182 Plasma protein, 72, 140, 182, 185, 191 Plasmin, 22, 143, 182 Plasminogen, 143, 182 Plasminogen Activators, 182 Platelet Activation, 22, 182 Platelet Aggregation, 182, 196 Platelet Count, 5, 67, 182 Platelet Factor 4, 22, 182 Platelets, 16, 67, 102, 145, 182, 183, 196 Poisoning, 24, 35, 150, 170, 176, 183, 192 Polychromatic, 72, 183 Polyethylene, 83, 183 Polymerase, 7, 183 Polymerase Chain Reaction, 7, 183

212

Blood Tests

Polymorphism, 18, 183 Polypeptide, 141, 152, 161, 176, 182, 183, 185 Polyposis, 139, 152, 183 Polysaccharide, 142, 183, 185 Porphyria, 181, 183 Porphyria Cutanea Tarda, 181, 183 Port, 67, 183 Port-a-cath, 183 Posterior, 141, 150, 179, 184 Postmenopausal, 14, 52, 179, 184 Postoperative, 48, 49, 184 Potassium, 125, 175, 184 Practicability, 184, 197 Practice Guidelines, 28, 31, 118, 184 Precancerous, 150, 184 Precursor, 144, 158, 159, 177, 182, 184, 185, 193, 198, 199 Predictive factor, 17, 184 Pre-Eclampsia, 145, 184 Pre-eclamptic, 158, 184 Pregnancy Complications, 97, 184 Prevalence, 6, 23, 25, 27, 48, 184 Preventive Medicine, 35, 66, 133, 184 Probe, 68, 79, 164, 184 Progesterone, 184, 185, 193 Prognostic factor, 185, 194 Progression, 4, 23, 27, 142, 185 Progressive, 7, 12, 65, 82, 144, 156, 157, 164, 171, 176, 179, 182, 185 Projection, 177, 178, 185 Prolactin, 11, 185 Proline, 152, 166, 185 Promoter, 18, 185 Prone, 100, 185 Prophylaxis, 185, 200 Prospective study, 12, 35, 172, 185 Prostaglandins, 144, 185 Prostate, 100, 146, 185, 198 Protein C, 140, 141, 145, 151, 160, 185, 198 Protein Kinases, 178, 185 Protein S, 146, 185 Proteoglycan, 182, 185 Proteolytic, 152, 161, 182, 185 Prothrombin, 5, 22, 65, 185, 186, 196 Prothrombin Time, 5, 65, 186 Protocol, 64, 80, 186 Protons, 141, 166, 170, 186, 187 Proto-Oncogenes, 178, 186 Protoporphyrins, 69, 186 Proximal, 48, 157, 186 Psychiatric, 11, 12, 186

Psychiatry, 11, 186 Psychotherapy, 186, 188 Public Health, 20, 91, 97, 118, 186 Public Opinion, 95, 186 Public Policy, 89, 113, 115, 116, 186 Publishing, 28, 97, 186 Pulmonary, 147, 153, 171, 172, 186, 194, 199, 200 Pulmonary Artery, 147, 186, 199 Pulmonary Edema, 171, 186 Pulmonary Embolism, 186, 200 Pulse, 80, 175, 186 Pustular, 139, 187 Putrescine, 178, 187, 193 Pyogenic, 179, 187 Pyridoxal, 178, 187 R Race, 23, 151, 187 Radiation, 72, 155, 161, 167, 170, 187, 196, 200 Radiation therapy, 167, 187 Radio Waves, 156, 187 Radioactive, 79, 147, 166, 175, 177, 187 Radiography, 116, 142, 187 Radioimmunoassay, 27, 145, 187 Radioimmunotherapy, 187, 188 Radioisotope, 187, 197 Radiological, 65, 122, 123, 187 Radiology, 33, 177, 187 Radiotherapy, 33, 187 Random Allocation, 188 Randomization, 16, 188 Randomized, 18, 19, 24, 26, 50, 158, 188 Reagent, 20, 68, 69, 70, 78, 79, 83, 188, 192 Reassurance, 12, 188 Receptor, 23, 83, 143, 148, 153, 181, 187, 188, 191 Receptors, Serotonin, 188, 191 Recombination, 21, 188 Rectal, 6, 70, 80, 188 Rectum, 48, 75, 142, 143, 145, 147, 152, 157, 161, 162, 168, 169, 171, 185, 188, 194 Recurrence, 18, 20, 47, 150, 188 Red blood cells, 64, 72, 159, 165, 183, 188, 190 Refer, 1, 27, 115, 148, 152, 157, 177, 187, 188, 199 Reflux, 10, 162, 188 Refraction, 188, 193 Regimen, 8, 16, 18, 71, 84, 158, 180, 188 Regurgitation, 162, 164, 188 Relapse, 25, 188

Index 213

Reliability, 5, 19, 22, 53, 188 Remission, 188, 189 Resection, 9, 189 Respiration, 149, 175, 189 Restoration, 14, 181, 189, 200 Resuscitation, 32, 189 Retina, 21, 150, 153, 178, 189, 190, 200 Retinae, 21, 189 Retinal, 21, 152, 153, 178, 189 Retinol, 189 Retinopathy, 19, 181, 189 Retrospective, 4, 189 Rheumatic Diseases, 13, 42, 116, 189 Rheumatism, 116, 167, 189 Rheumatoid, 116, 189 Rheumatoid arthritis, 116, 189 Ribavirin, 91, 189 Ribonucleoside Diphosphate Reductase, 166, 189 Risk factor, 3, 14, 15, 23, 27, 97, 102, 117, 159, 185, 190 Rod, 145, 181, 190 S Saliva, 24, 190 Salivary, 157, 179, 190 Salivary glands, 157, 190 Saponins, 190, 193 Sarcoidosis, 43, 190 Sarcoma, 20, 190, 192 Schizoid, 190, 200 Schizophrenia, 190, 200 Schizotypal Personality Disorder, 190, 200 Scleroderma, 13, 144, 190 Sclerosis, 144, 190 Sebum, 139, 190 Second Messenger Systems, 177, 190 Secretin, 125, 190 Secretion, 19, 22, 139, 150, 154, 163, 167, 169, 171, 175, 190, 191 Segregation, 188, 191 Self Care, 139, 191 Semen, 185, 191 Semicircular canal, 169, 191 Senile, 179, 191 Sensor, 22, 76, 80, 169, 191 Septic, 13, 191 Sequencing, 16, 183, 191 Sequester, 70, 191 Serologic, 15, 65, 167, 191 Serologic Tests, 15, 191 Serology, 5, 7, 30, 191 Serotonin, 11, 143, 148, 188, 191, 198

Serum, 5, 6, 11, 15, 20, 23, 31, 48, 50, 64, 65, 66, 72, 73, 74, 79, 140, 143, 152, 171, 175, 187, 191 Serum Albumin, 65, 187, 191 Sessile, 152, 191 Sex Characteristics, 141, 191, 195 Shock, 191, 197 Shunt, 79, 191 Side effect, 12, 105, 140, 143, 167, 192, 197 Sigmoid, 192 Sigmoidoscopy, 6, 16, 17, 19, 36, 42, 48, 52, 192 Sign Language, 96, 192 Signs and Symptoms, 114, 188, 189, 192, 198 Skeleton, 171, 192 Small intestine, 4, 6, 114, 146, 150, 157, 166, 170, 192 Sodium, 24, 125, 164, 175, 192 Sodium Nitrite, 24, 192 Soft tissue, 13, 31, 147, 192 Soft tissue sarcoma, 31, 192 Solvent, 69, 178, 192 Sound wave, 156, 192 Spatial disorientation, 157, 192 Specialist, 129, 192 Species, 92, 159, 166, 175, 187, 192, 194, 198, 200 Specificity, 17, 48, 69, 140, 192 Specimen Handling, 72, 192 Spectrophotometry, 72, 193 Spectrum, 5, 24, 187, 193 Sperm, 141, 150, 193 Spermidine, 178, 193 Spinal cord, 149, 150, 174, 176, 177, 193 Spleen, 45, 173, 190, 193 Spondylitis, 13, 116, 193 Spontaneous Abortion, 77, 193 Steatosis, 160, 193 Stem Cells, 159, 193 Stent, 82, 179, 193 Sterile, 74, 193 Sterility, 168, 193 Steroid, 13, 146, 154, 190, 193 Stimulus, 145, 154, 158, 170, 193, 196 Stoma, 179, 193 Stool, 5, 6, 7, 16, 17, 40, 41, 44, 70, 75, 126, 160, 168, 171, 193 Strand, 183, 193 Stress, 9, 79, 91, 117, 127, 154, 176, 189, 193 Stroke, 26, 83, 112, 149, 170, 193 Stromal, 20, 194

214

Blood Tests

Stromal tumors, 20, 194 Subacute, 168, 194 Subclinical, 168, 194 Subcutaneous, 71, 84, 139, 158, 179, 194 Subspecies, 192, 194 Substance P, 174, 191, 194 Substrate, 23, 159, 194 Suction, 67, 194 Sulfur, 174, 194 Sulfuric acid, 24, 194 Support group, 88, 91, 96, 194 Suppositories, 162, 194 Suppression, 154, 194 Surfactant, 83, 194 Survival Analysis, 25, 194 Suspensions, 24, 194 Sympathomimetic, 159, 177, 194 Symphysis, 185, 195 Symptomatic, 11, 26, 37, 179, 195 Synapses, 177, 195 Synaptic, 177, 195 Synaptic Transmission, 177, 195 Synergistic, 185, 195 Synovial, 13, 195 Synovial Fluid, 13, 195 Synovial Membrane, 195 Systemic, 8, 27, 51, 77, 89, 106, 107, 147, 159, 168, 170, 187, 190, 195, 200 Systemic lupus erythematosus, 51, 77, 195 Systolic, 11, 167, 195 Systolic blood pressure, 11, 195 T Tendinitis, 13, 195 Teratogenic, 171, 195 Terminator, 151, 195 Testosterone, 90, 195 Therapeutics, 4, 7, 9, 107, 195 Thermal, 157, 177, 183, 195 Thermography, 82, 195 Thiothixene, 12, 196 Thorax, 139, 173, 196 Threshold, 80, 167, 196 Thrombin, 22, 73, 161, 182, 185, 196 Thrombocytes, 67, 183, 196 Thromboembolism, 169, 196 Thromboplastin, 186, 196 Thrombosis, 16, 22, 34, 39, 40, 48, 49, 77, 82, 145, 185, 194, 196 Thromboxanes, 144, 196 Thrombus, 154, 168, 170, 182, 196, 199 Thyroid, 35, 45, 46, 103, 163, 167, 196 Thyroid Gland, 163, 196

Thyroid Nodule, 45, 196 Thyrotropin, 167, 196 Thyroxine, 140, 196 Tinnitus, 7, 196, 200 Tolerance, 4, 16, 163, 197 Tomography, 197 Topical, 166, 170, 197 Toxic, iv, 92, 102, 155, 165, 166, 167, 177, 187, 192, 197 Toxicity, 4, 102, 157, 197 Toxicokinetics, 197 Toxicology, 114, 197 Toxins, 142, 163, 168, 175, 187, 197 Tracer, 79, 197 Trachea, 148, 181, 196, 197 Transcription Factors, 21, 178, 197 Transcutaneous, 35, 116, 197 Transfection, 146, 197 Transfusion, 8, 28, 64, 122, 197 Translational, 17, 197 Translocation, 20, 197 Transmitter, 170, 174, 177, 195, 197 Trauma, 13, 160, 176, 179, 197 Treatment Outcome, 14, 197 Triglyceride, 32, 167, 197 Tryptophan, 152, 191, 198 Tuberculosis, 153, 173, 198 Tumor marker, 146, 198 Tumor suppressor gene, 17, 198 Type 2 diabetes, 23, 198 U Ulcerative colitis, 6, 169, 198 Ultrasonography, 23, 45, 198 Unconscious, 142, 167, 198 Uraemia, 179, 198 Urea, 5, 7, 9, 70, 74, 147, 178, 198 Urea Breath Test, 5, 9, 198 Uremia, 171, 198 Ureter, 78, 171, 198 Urethra, 185, 198, 199 Uric, 164, 167, 198 Urinary, 78, 148, 168, 178, 198 Urinary tract, 78, 198 Urine, 7, 34, 37, 77, 78, 97, 124, 126, 143, 146, 155, 164, 168, 171, 178, 198, 199 Ursodeoxycholic Acid, 11, 199 Uterus, 155, 158, 161, 174, 184, 199 V Vaccine, 98, 106, 107, 139, 186, 199 Vascular, 6, 11, 22, 26, 53, 83, 150, 168, 172, 175, 182, 196, 199 Vasculitis, 179, 199

Index 215

Vasoconstriction, 159, 199 Vasodilators, 7, 199 VE, 35, 199 Vein, 40, 48, 49, 74, 170, 177, 180, 181, 199 Venous, 32, 34, 145, 147, 155, 165, 182, 185, 199, 200 Venous blood, 147, 182, 199 Venous Thrombosis, 32, 145, 199, 200 Ventricle, 186, 195, 199 Ventricular, 79, 158, 199 Ventricular Dysfunction, 158, 199 Venules, 147, 148, 175, 199 Vertebrae, 193, 199 Vertigo, 7, 199, 200 Vestibular, 7, 199, 200 Vestibule, 151, 169, 191, 199 Vestibulocochlear Nerve, 196, 199, 200 Vestibulocochlear Nerve Diseases, 196, 200 Veterinary Medicine, 113, 200 Vial, 67, 200 Viral, 8, 26, 27, 102, 163, 178, 186, 200

Viral Hepatitis, 8, 102, 200 Viral Load, 26, 200 Virulence, 8, 197, 200 Virus, 8, 91, 93, 95, 96, 97, 106, 107, 115, 116, 117, 127, 145, 162, 163, 170, 182, 200 Vitreous Body, 189, 200 Vitro, 77, 165, 200 Vivo, 77, 200 W Warfarin, 6, 26, 200 Weight Gain, 23, 200 White blood cell, 102, 142, 172, 173, 175, 177, 182, 200 Windpipe, 181, 196, 200 Withdrawal, 26, 74, 200 Wound Healing, 149, 200 X Xenograft, 142, 200 X-ray, 13, 45, 82, 145, 153, 161, 177, 187, 200 Y Yeasts, 181, 201

216

Blood Tests

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