BELCHING A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Belching: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00130-6 1. Belching-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on belching. 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 BELCHING ................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Belching......................................................................................... 7 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. ALTERNATIVE MEDICINE AND BELCHING ................................................................. 15 Overview...................................................................................................................................... 15 National Center for Complementary and Alternative Medicine.................................................. 15 Additional Web Resources ........................................................................................................... 17 General References ....................................................................................................................... 20 CHAPTER 3. PATENTS ON BELCHING .............................................................................................. 21 Overview...................................................................................................................................... 21 Patents on Belching ..................................................................................................................... 21 Patent Applications on Belching.................................................................................................. 22 Keeping Current .......................................................................................................................... 24 CHAPTER 4. BOOKS ON BELCHING ................................................................................................. 27 Overview...................................................................................................................................... 27 Book Summaries: Federal Agencies.............................................................................................. 27 Chapters on Belching ................................................................................................................... 28 CHAPTER 5. MULTIMEDIA ON BELCHING ....................................................................................... 35 Overview...................................................................................................................................... 35 Video Recordings ......................................................................................................................... 35 CHAPTER 6. PERIODICALS AND NEWS ON BELCHING .................................................................... 37 Overview...................................................................................................................................... 37 News Services and Press Releases................................................................................................ 37 Newsletter Articles ...................................................................................................................... 38 Academic Periodicals covering Belching...................................................................................... 39 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 41 Overview...................................................................................................................................... 41 U.S. Pharmacopeia....................................................................................................................... 41 Commercial Databases ................................................................................................................. 42 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 45 Overview...................................................................................................................................... 45 NIH Guidelines............................................................................................................................ 45 NIH Databases............................................................................................................................. 47 Other Commercial Databases....................................................................................................... 49 APPENDIX B. PATIENT RESOURCES ................................................................................................. 51 Overview...................................................................................................................................... 51 Patient Guideline Sources............................................................................................................ 51 Finding Associations.................................................................................................................... 53 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 55 Overview...................................................................................................................................... 55 Preparation................................................................................................................................... 55 Finding a Local Medical Library.................................................................................................. 55 Medical Libraries in the U.S. and Canada ................................................................................... 55 ONLINE GLOSSARIES.................................................................................................................. 61 Online Dictionary Directories ..................................................................................................... 62 BELCHING DICTIONARY............................................................................................................ 63
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INDEX ................................................................................................................................................ 85
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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 belching 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 belching, 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 belching, 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 belching. 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 belching, 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 belching. 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 BELCHING Overview In this chapter, we will show you how to locate peer-reviewed references and studies on belching.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and belching, 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 “belching” (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: •
Etiology of Dyspepsia: Implications for Empirical Therapy Source: Canadian Journal of Gastroenterology. 16(9): 635-641. September 2002. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Fax (905) 829-4799. E-mail:
[email protected]. Summary: Dyspepsia describes a symptom complex thought to arise in the upper gastrointestinal tract and includes, in addition to epigastric pain or discomfort, symptoms such as heartburn, acid regurgitation, excessive burping or belching, a feeling of slow digestion, early satiety, nausea, and bloating. This article considers the etiology and definitions of dyspepsia and their implications for empirical therapy. The authors state that based on the evidence that heartburn cannot be reliably distinguished from other dyspeptic symptoms, the Rome definition appears to be too narrow and
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restrictive. The definition is particularly ill suited to the management of uninvestigated dyspepsia at the level of primary care. In patients presenting with uninvestigated dyspepsia, a symptom benefit is associated with a 'test and treat' approach for Helicobacter pylori infection. A substantial proportion of those who do not benefit prove to have esophagitis on endoscopy. In those with functional dyspepsia, the benefits of H. pylori eradication, if any, appear to be modest. Hence, a 'symptom and treat' acidsuppression trial with proton pump inhibitors (PPIs), and a 'test and treat' strategy for H. pylori are two acceptable empirical therapies for patients with uninvestigated dyspepsia. 1 appendix. 42 references. •
Dental Erosion Caused by Silent Gastroesophageal Reflux Disease Source: JADA. Journal of the American Dental Association. 133 (6): 734-737. June 2002. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: Gastroesophageal reflux disease (GERD) is a relatively common condition in which stomach acid may be refluxed (returned) up through the esophagus and into the oral cavity, resulting in tooth enamel erosion. Symptoms such as belching, unexplained sour taste, and heartburn usually alert the patient to the condition. In silent GERD, however, these symptoms do not occur, and enamel erosion of the posterior dentition may be the first indication of GERD. In this article, the authors present the case of a 30 year old man who came to a dental clinic with enamel erosion on the occlusal surfaces of his posterior teeth and the palatal surfaces of his maxillary anterior teeth. He reported no history of gastrointestinal disease or heartburn. The authors conclude that enamel erosion may be a clinical sign of silent GERD that allows the dentist to make the initial diagnosis. Referral to a physician or gastroenterologist is necessary to define the diagnosis; however, dental expertise may be essential in differentiating between diagnoses such as bulimia, attrition, and abrasion. Successful treatment of the medical condition is necessary before dental rehabilitation can be initiated successfully. 4 figures. 17 references.
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Sorting out the most Common GI Complaints Source: Patient Care. 36(3): 21-22, 25-26, 28, 31. February 15, 2002. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Millions of patients have gastrointestinal (GI) symptoms including belching (burping), intestinal gas (flatulence), abdominal distension, and indigestion, among others. Most of these do not signal the presence of a serious illness, but the practitioner's advice on preventing and treating nuisance symptoms can be enormously valuable to patients. This article helps primary care providers sort out the most common GI complaints. The authors stress that even trivial GI complaints deserve careful attention in the history and physical. Ominous symptoms include anemia, dysphagia (swallowing difficulties), bleeding, and weight loss. Once a potentially serious GI disorder has been ruled out, prevention and treatment efforts against the patient's most troublesome complaints can be initiated. Alpha-D-galactosidase may reduce gas associated with bean consumption; patients should be encouraged to incorporate these valuable foods in their diets. Sorbitol containing products may cause excessive gas production, even diarrhea. Patients should not increase their fiber consumption without increasing their fluid intake. Heartburn is usually well managed with H2 receptor antagonists and proton pump inhibitors. The authors caution that testing for gallstones is not indicated, unless
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the patient has the characteristic severe pain associated with this condition. And eradicating Helicobacter pylori in a patient with nonulcer dyspepsia usually does not reduce the symptoms. 1 figure. 1 table. 6 references. •
Altered Visceral Perception Is Responsible for Functional (Nonulcer) Dyspepsia Source: Practical Gastroenterology. 23(5): 57-58, 60-61. May 1999. Contact: Available from Shugar Publishing, Inc. 99B Main Street, Westhampton Beach, NY 11978. (631) 288-4404. Fax (631) 288-4435. E-Mail:
[email protected]. Summary: This article discusses functional (nonulcer) dyspepsia, considering the role of altered visceral perception in this common problem. The term dyspepsia usually refers to upper abdominal pain or discomfort, but also may include early satiety (fullness), postprandial (after a meal) abdominal bloating or distention, nausea, vomiting, belching, and sometimes even heartburn. Dyspeptic symptoms can be episodic or persistent and are often exacerbated by eating. An organic cause is found in approximately half of those patients complaining of dyspeptic symptoms. In the remaining patients, no cause is apparent and the dyspepsia is idiopathic, i.e., functional, essential, or nonulcer dyspepsia. Criteria for diagnosing functional dyspepsia were recommended by a group of investigators meeting in Rome, Italy, in 1991 and included the following: chronic or recurrent upper abdominal discomfort (pain) or one or more of the other dyspeptic symptoms; symptoms must have been present for at least one (and preferably more than 3 months); symptoms should be present more than 25 percent of the time; and there should be an absence of clinical, biochemical, endoscopic, or sonographic evidence of organic disease that could explain the symptoms. Over the years, the motor disorder hypothesis has been losing ground to the augmented visceral perception hypothesis as an explanation for symptoms in patients with nonulcer dyspepsia. Augmented visceral perception of balloon and barostatic distention, of esophageal and gastroduodenal acid, and of duodenal juice in the stomach offer examples of augmented visceral sensitivity to both mechanical and chemical stimuli. 1 table. 24 references.
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Getting a Grip on Gas Source: Digestive Health and Nutrition. p. 16-19. March-April 2000. 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 familiarizes readers with the physiology underlying a common occurrence: flatulence (passing gas). The author stresses that everyone must pass gas, either from the anus or through the mouth as a burp. It is part of eating a healthful diet, particularly one high in fiber, and it is also part of having a healthy digestive system. The author explains why some of the gas is odorous, discusses the interaction of diet and flatulence, and describes both over the counter (OTC) and prescription medications for reducing gas, pain, and bloating. The author notes that irritable bowel syndrome (IBS) should be considered first for the person who has pain and bloating, but many other conditions of the stomach and small intestine may cause these symptoms. The author concludes with a brief discussion of belching, that includes suggestions for reducing problematic belching. Readers are encouraged to discuss this topic with their physicians because, while sometimes it is embarrassing or uncomfortable, treatment options do exist. The article includes the website of the American Gastroenterological
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Association (www.gastro.org/gas.html) for patients wanting additional information. 1 figure. •
Gastrointestinal Symptoms and Health Related Quality of Life in Patients with Arthritis Source: Journal of Rheumatology. 27(6): 1373-1378. June 2000. Contact: Available from Journal of Rheumatology. 920 Yonge Street, Suite 115, Toronto, ON M4W 3C7 Canada. (416) 967-5155. Fax (416) 967-7556. Summary: This article reports on a study undertaken to evaluate the relationship between gastrointestinal (GI) symptoms and health related quality of life (QOL) in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). A total of 1,773 patients with arthritis participating in a long term outcome study (OA of the hip or knee, n = 648; RA, n = 1,125) completed mailed surveys that included assessments of GI symptoms and overall GI symptom severity, and measures of disease and psychological status. The overall response rate exceeded 85 percent. Dyspepsia (heartburn, bloating, or belching) and upper abdominal or epigastric pain were identified as the most important GI contributors to reduction in QOL, and the simultaneous presence of both these symptoms was associated with lower QOL compared to those without symptoms. These differences in GI symptoms and GI severity, however, were reduced substantially when the effects of functional disability, pain, and depression were adjusted for. The authors conclude that QOL is significantly impaired among unselected arthritis patients with GI symptoms compared to those without these symptoms. Dyspepsia and upper abdominal or epigastric pain are more strongly related to QOL measures than are other GI symptoms, and are common among arthritis patients. It is possible to construct a simple scale of these 2 symptoms or to use the VAS GI severity scale and get a clinically useful idea of the current level of GI distress and alteration of QOL by GI problems. Two components of impairment can be identified: one that is smaller and unrelated to disease or psychological factors, and a second that is larger and includes these factors. Because GI symptoms can alter function, pain, and psychological status, it is likely that the true effect of GI symptoms on QOL is somewhere between the unadjusted and adjusted values determined in this study. 1 figure. 5 tables. 31 references.
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Intestinal Gas: What Do We Offer the Patient? Source: Endoscopy Review. 8(5): 43-46. June 1991. Summary: This article reviews the origins, evaluations, and treatments for belching; bloating and distention; and the excessive passage of flatus. These problems are commonly referred to as intestinal gas. The author believes that the most common cause of belching is chronic eructation, in which the patient repeatedly aspirates air into the esophagus and then regurgitates it. Chronic belchers have associated irritable bowel syndrome (IBS), which becomes aggravated by the aspirated air, leading to more eructation. Behavioral control of voluntary eructation is the recommended treatment. Bloating and distention also are associated with IBS, although colon cancer and Crohn's disease should be ruled out. The author believes that most patients with bloating have a motility disorder rather than excessive bowel gas, and notes that simple reassurance and explanation of the problem can lead to dramatic improvement. Anecdotal experiences related to drug and dietary treatments of patients with bloating and distention are included. Evaluation of patients complaining of excessive flatus begins with monitoring the extent of the problem. For patients who greatly exceed the normal limits of gas
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production, the author recommends a diet low in carbohydrates. Drug treatment and control of malodorus flatus are also discussed. •
Medical Care of Intestinal Gas Source: Metro Wash By-Pass. 84(64): 3. May 1991. Contact: Available from United Ostomy Association. Metropolitan Washington Chapter, Washington Hospital Center, East Building, Room 3102, 110 Irving Street, N.W., Washington, DC 20010. (202) 877-6019. Summary: This brief article discusses the medical treatment of intestinal gas. Excessive gastrointestinal gas is a common problem that may cause belching, bloating, abdominal discomfort, and frequent passage of gas. The author lists 11 steps in a regimen designed to prevent or reduce intestinal gas problems.
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Dietary Adequacy in Patients with Diabetic Gastroparesis Source: Journal of the American Dietetic Association. 97(4): 420-422. April 1997. Summary: This brief research report describes a study undertaken to investigate dietary intake and adequacy in patients with diabetic gastroparesis (delayed gastric emptying due to diabetes mellitus). Approximately 50 percent of patients with diabetes have some delay in gastric emptying as one component of autonomic neuropathy. Diabetic gastroparesis is most commonly found in patients with insulin-dependent diabetes mellitus (IDDM) who have a long-standing history of poorly controlled diabetes. In this cross-sectional study, 10 patients were studied throughout a 5 week period. Study measures included gastroparesis (by gastric emptying study), height and weight of subjects, body mass index (BMI), glycated hemoglobin (HbA1c) levels, home blood glucose measurements, physical activity (self-recorded), and gastrointestinal symptoms (measured with a daily questionnaire). Symptoms of appetite, abdominal pain after meals, difficulty swallowing, acid regurgitation, bloating, belching, nausea, vomiting, halitosis (bad breath), heartburn, flatulence (gas), constipation, and diarrhea were recorded. Outcome variables of primary interest were dietary intakes of energy (calories) and macronutrients. The authors had hypothesized that postprandial (after meal) difficulties may influence a patient to reduce the quantity and frequency of food intake. Also, blood glucose control may be difficult to achieve because of slow and unpredictable gastric emptying. Their results did not observe any significant associations between symptom severity and dietary variables, or between dietary adequacy and age, BMI, HbA1c level, and medication use. However, patients who are not physically active (versus active patients) may be at greater risk of consuming inadequate diets. The small sample size is noted as a limitation of the study. The authors conclude that relationships between dietary intake, food choices, and gastrointestinal symptoms might be evident with a larger group. 2 tables. 16 references. (AA-M).
Federally Funded Research on Belching The U.S. Government supports a variety of research studies relating to belching. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration
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database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to belching. 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 belching.
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with belching, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “belching” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for belching (hyperlinks lead to article summaries): •
A case of inability to belch. Author(s): Tomizawa M, Kusano M, Aoki T, Ohashi S, Kawamura O, Sekiguchi T, Mori M. Source: Journal of Gastroenterology and Hepatology. 2001 March; 16(3): 349-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11339431
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A modified fundoplication which preserves the ability to belch. Author(s): Menguy R. Source: Surgery. 1978 September; 84(3): 301-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=356314
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Acute airway obstruction in achalasia. Possible role of defective belch reflex. Author(s): Becker DJ, Castell DO. Source: Gastroenterology. 1989 November; 97(5): 1323-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2676685
(FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH). 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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Alteration of the upper esophageal sphincter belch reflex in patients with achalasia. Author(s): Massey BT, Hogan WJ, Dodds WJ, Dantas RO. Source: Gastroenterology. 1992 November; 103(5): 1574-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1426877
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Belching and bloating: facts and fantasy after antireflux surgery. Author(s): Tew S, Ackroyd R, Jamieson GG, Holloway RH. Source: The British Journal of Surgery. 2000 April; 87(4): 477-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10759746
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Belching and the development of Boerhaave's syndrome. Author(s): Spronk PE, Beishuizen A, van der Hoven B. Source: Intensive Care Medicine. 2001 January; 27(1): 330. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280666
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Belching caused inversion of the inserted gastroscope. Author(s): Sundblad M. Source: Lakartidningen. 1990 October 24; 87(43): 3513. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2233029
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Belching, bloating, and flatulence. How to help patients who have troublesome abdominal gas. Author(s): Rao SS. Source: Postgraduate Medicine. 1997 April; 101(4): 263-9, 275-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9126217
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Belching. Author(s): Russell JG. Source: Lancet. 1991 February 2; 337(8736): 312. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1671161
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Belching: dyspepsia or gastroesophageal reflux disease? Author(s): Lin M, Triadafilopoulos G. Source: The American Journal of Gastroenterology. 2003 October; 98(10): 2139-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14572558
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Chest pain and inability to belch. Author(s): Waterman DC, Castell DO. Source: Gastroenterology. 1989 January; 96(1): 274-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2909435
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Control of belching by the lower oesophageal sphincter. Author(s): Wyman JB, Dent J, Heddle R, Dodds WJ, Toouli J, Downton J. Source: Gut. 1990 June; 31(6): 639-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2379867
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Diagnostic sign of otitis media: belching and pain. Author(s): Newman AJ. Source: Pediatrics. 1969 September; 44(3): 457. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5809911
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Dysfunction of the belch reflex. A cause of incapacitating chest pain. Author(s): Kahrilas PJ, Dodds WJ, Hogan WJ. Source: Gastroenterology. 1987 October; 93(4): 818-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3623025
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Eructation and antidepressants. Case reports/fluoxetine, dosulepin (or dothiepin) Author(s): Tricot S, Vandel P, Francois T, Bonin B. Source: Therapie. 1994 January-February; 49(1): 49-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8091365
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Eructation flambe. Author(s): Tolliver BA, Berry MA, DiPalma JA. Source: Journal of Clinical Gastroenterology. 1994 April; 18(3): 267-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8034944
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Eructation in seizure. Author(s): Cole M. Source: Archives of Neurology. 1984 February; 41(2): 135. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6691805
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Gastric cancer associated with incomplete pyloric obstruction and belching combustible gas. Author(s): Zhang YL, Wang PL. Source: Chinese Medical Journal. 1984 January; 97(1): 66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6428835
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Hiccups, eructation, and other uncommon prodromal manifestations of herpes zoster. Author(s): Berlin AL, Muhn CY, Billick RC. Source: Journal of the American Academy of Dermatology. 2003 December; 49(6): 11214. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639397
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Image of the month. Defective belch reflex secondary to achalasia. Author(s): Eckardt VF, Grebe P. Source: Gastroenterology. 2002 July; 123(1): 7, 400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12105826
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Mechanism and timing of nasopharyngeal closure during swallowing and belching. Author(s): Dua K, Shaker R, Ren J, Arndorfer R, Hofmann C. Source: The American Journal of Physiology. 1995 June; 268(6 Pt 1): G1037-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7611403
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Mechanisms of airway protection and upper esophageal sphincter opening during belching. Author(s): Shaker R, Ren J, Kern M, Dodds WJ, Hogan WJ, Li Q. Source: The American Journal of Physiology. 1992 April; 262(4 Pt 1): G621-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1566845
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Off-period belching due to a reversible disturbance of oesophageal motility in Parkinson's disease and its treatment with apomorphine. Author(s): Kempster PA, Lees AJ, Crichton P, Frankel JP, Shorvon P. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1989; 4(1): 47-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2927402
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Partial relief of anginal chest pain by belching. Author(s): Bauman D. Source: Jama : the Journal of the American Medical Association. 1977 August 8; 238(6): 481. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=577568
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Pneumomediastinum after belching. Author(s): de la Fuente Aguado J, Roman F, Hernaez JM, Provencio M, de Letona JM. Source: Lancet. 1990 December 1; 336(8727): 1390. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1978210
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Repetitive belching, aerophagia, and torticollis in Huntington's disease: a case report. Author(s): Hu MT, Chaudhuri KR. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1998 March; 13(2): 363-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9539359
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Repetitive eructation as a manifestation of obsessive-compulsive disorder. Author(s): Zella SJ, Geenens DL, Horst JN. Source: Psychosomatics. 1998 May-June; 39(3): 299-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9664782
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Role of upper esophageal reflex and belch reflex dysfunctions in noncardiac chest pain. Author(s): Gignoux C, Bost R, Hostein J, Turberg Y, Denis P, Cohard M, Wolf JE, Fournet J. Source: Digestive Diseases and Sciences. 1993 October; 38(10): 1909-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8404413
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Study of belching ability in antireflux surgery patients and normal volunteers. Author(s): Smith D, King NA, Waldron B, Cullen PT, Millar B, Fenwick M, Campbell FC. Source: The British Journal of Surgery. 1991 January; 78(1): 32-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1900210
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Tachyarrhythmias triggered by swallowing and belching. Author(s): Wilmshurst PT. Source: Heart (British Cardiac Society). 1999 March; 81(3): 313-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10026360
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The beneficent belch. Author(s): Pope CE 2nd. Source: Gastroenterology. 1992 November; 103(5): 1685-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1426888
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Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Belching as a symptom of myocardial ischaemia. Author(s): Smith J, Carley S. Source: Emergency Medicine Journal : Emj. 2001 November; 18(6): 467. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11696505
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Unusual case of belching. Author(s): Okojie XG. Source: British Medical Journal. 1968 December 14; 4(632): 708. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5723395
Studies
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Upper esophageal sphincter function during belching. Author(s): Kahrilas PJ, Dodds WJ, Dent J, Wyman JB, Hogan WJ, Arndorfer RC. Source: Gastroenterology. 1986 July; 91(1): 133-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3710062
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CHAPTER 2. ALTERNATIVE MEDICINE AND BELCHING Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to belching. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to belching and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “belching” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to belching: •
An aversive-thought/belching syndrome: a somatic expression of unpleasant thought content. Author(s): TISLOW R. Source: Life Sciences. 1964 December; 74: 1501-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14248644
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Commentary on common alimentary symptoms. Author(s): Jones FA. Source: Trans Med Soc Lond. 1965; 81: 126-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5825320
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Effects of new fish oil derivative on fatty acid phospholipid-membrane pattern in a group of Crohn's disease patients. Author(s): Belluzzi A, Brignola C, Campieri M, Camporesi EP, Gionchetti P, Rizzello F, Belloli C, De Simone G, Boschi S, Miglioli M, et al.
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Source: Digestive Diseases and Sciences. 1994 December; 39(12): 2589-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7995183 •
Flatulence and other discomforts associated with consumption of cowpea (Vigna unguiculata). Author(s): Ndubuaku VO, Uwaegbute AC, Nnanyelugo DO. Source: Appetite. 1989 December; 13(3): 171-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2596840
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Irritable bowel syndrome in Nigerians. Author(s): Atoba MA. Source: Digestive Diseases and Sciences. 1988 April; 33(4): 414-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3349888
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Stimulating eructation and vomition in normal and bloated ruminants with alkaloidal extracts from Veratrum spp. Author(s): Mullenax CH, Buck WB, Keeler RF, Binns W. Source: Am J Vet Res. 1966 January; 27(116): 211-22. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5913029
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The effect of arginine or glycine supplementation on gastrointestinal function, muscle injury, serum amino acid concentrations and performance during a marathon run. Author(s): Buchman AL, O'Brien W, Ou CN, Rognerud C, Alvarez M, Dennis K, Ahn C. Source: International Journal of Sports Medicine. 1999 July; 20(5): 315-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10452229
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The effects of relaxation response meditation on the symptoms of irritable bowel syndrome: results of a controlled treatment study. Author(s): Keefer L, Blanchard EB. Source: Behaviour Research and Therapy. 2001 July; 39(7): 801-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11419611
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Uses of hypnosis in the treatment of uncontrollable belching: a case report. Author(s): Spiegel SB. Source: Am J Clin Hypn. 1996 April; 38(4): 263-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8799034
Alternative Medicine 17
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to belching; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Atherosclerosis Source: Healthnotes, Inc.; www.healthnotes.com Chronic Candidiasis Source: Healthnotes, Inc.; www.healthnotes.com Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.drkoop.com Heartburn Source: Integrative Medicine Communications; www.drkoop.com Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com
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Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com Raynaud's Disease Source: Healthnotes, Inc.; www.healthnotes.com Raynaud's Phenomenon Source: Prima Communications, Inc.www.personalhealthzone.com Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com Schizophrenia Source: Healthnotes, Inc.; www.healthnotes.com •
Chinese Medicine Baohe Wan Alternative names: Bache Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Binglang Sixiao Wan Alternative names: Binglang Sixiao Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Caodoukou Alternative names: Katsumada Galangal Seed; Semen Alpiniae Katsumadai Source: Chinese Materia Medica Chaihu Shugan Wan Alternative names: Chaihu Shugan Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Chenxiang Huaqi Wan Alternative names: Chenxiang Huaqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Doukou Alternative names: Round Cardamon Fruit; Fructus Amomi Rotundus Source: Chinese Materia Medica Gaoliangjiang Alternative names: Lesser Galangal Rhizome; Rhizoma Alpiniae Officinarum Source: Chinese Materia Medica Heshi Alternative names: Wild Carrot Fruit; Nanheshi; Fructus Carotae Source: Chinese Materia Medica
Alternative Medicine 19
Muxiang Fenqi Wan Alternative names: Muxiang Fenqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shugan Hewei Wan Alternative names: hugan Hewei Pills; Shugan Hewei Wan (Shu Gan He Wei Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Xiangyuan Alternative names: Citron Fruit; Fructus Citri Source: Chinese Materia Medica Xuanfuhua Alternative names: Inula Flower; Flos Inulae Source: Chinese Materia Medica Zisugeng Alternative names: Perilla Stem; Caulis Perillae Source: Chinese Materia Medica •
Herbs and Supplements DHA Source: Integrative Medicine Communications; www.drkoop.com Docosahexaenoic Acid (DHA) Source: Integrative Medicine Communications; www.drkoop.com Eicosapentaenoic Acid (EPA) Source: Integrative Medicine Communications; www.drkoop.com EPA Source: Integrative Medicine Communications; www.drkoop.com Evening Primrose Alternative names: Oenothera biennis, Sun Drop Source: Integrative Medicine Communications; www.drkoop.com GLA (Gamma-Linolenic Acid) Source: Prima Communications, Inc.www.personalhealthzone.com Hydrastis Alternative names: Goldenseal; Hydrastis canadensis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Oenothera Biennis Source: Integrative Medicine Communications; www.drkoop.com Sun Drop Source: Integrative Medicine Communications; www.drkoop.com
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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 3. PATENTS ON BELCHING 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.4 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 “belching” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on belching, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Belching By performing a patent search focusing on belching, 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
4Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on belching: •
Adjustable baby bottleneck Inventor(s): Brankley; Jacob R. (10509 Qualla Rd., Chesterfield, VA 23832) Assignee(s): none reported Patent Number: 5,588,548 Date filed: June 2, 1995 Abstract: An adjustable baby bottleneck is provided for connecting a conventional infant bottle 20 to a conventional baby nipple 22 through an angular or adjustable bottleneck portion 24 for transforming standard baby bottles into an improved device for feeding infants. The angularly adjustable bottleneck portion may be either set and fixed from an angle of 0 to 60 degrees and includes a mounted securing ring 46 at one end for mating with the top of a standard baby nursing bottle and at the other end includes means for mating with a standard nipple with an adjustable portion disposed between the bottle mating and nipple mating ends of the adjustable baby bottleneck. The angularly adjustable configuration of the adjustable baby bottleneck and internal channelling provides feeding advantages for the infant over a wide range of feeding positions to reduce burping, belching and infant colic resulting from the introduction of air from either the inside of the bottle or sides of the nipple during feeding irrespective of the feeding position of the infant. Excerpt(s): The present invention pertains to a baby bottleneck for mounting between a standard baby bottle and a standard baby bottle nipple which allows the neck portion to be angularly maintained to provide a more natural flow of foods to nursing infants. More particularly the invention pertains to an adjustable baby bottleneck which accepts on one end a standard infant nursing bottle and at the other end accepts a standard infant nursing nipple and which between the two ends of the adjustable bottleneck provides an angular setting from between 0 degrees to 60 degrees to provide a more natural delivery of food to nursing infants to accommodate a variety of feeding positions of nursing infants. The adjustability and setting of the baby bottleneck as well as its adaption to the use of disposable liners allows the utilization of standard baby bottles and the use of standard infant nipples which can be easily cleaned and sterilized with the adjustable baby bottleneck. The adjustability and setting of the neck portion as well as the utilization of the tapered and offset channelling passage reduces the amount of air drawn into the baby's stomach during feeding through either the bottle or around the sides of the standard nipple. Web site: http://www.delphion.com/details?pn=US05588548__
Patent Applications on Belching As of December 2000, U.S. patent applications are open to public viewing.5 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 belching: 5
This has been a common practice outside the United States prior to December 2000.
Patents 23
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Pharmaceutical compositions of a non-enteric coated proton pump inhibitor with a carbonate salt and bicarbonate salt combination Inventor(s): Gupta, Pramod; (Gurnee, IL), Taneja, Rajneesh; (Libertyville, IL) Correspondence: Wood, Phillips, Katz, Clark & Mortimer; Citicorp Center; Suite 3800; 500 West Madison Street; Chicago; IL; 60661-2511; US Patent Application Number: 20020192299 Date filed: December 26, 2001 Abstract: A method for treating gastric acid disorders with a non-enteric coated proton pump inhibitor in a pharmaceutically acceptable carrier including a bicarbonate salt of a Group IA metal and a carbonate salt of a Group IA metal; and a pharmaceutical composition of a non-enteric coated proton pump inhibitor in a pharmaceutically acceptable carrier including a bicarbonate salt of a Group IA metal and a carbonate salt of a Group IA metal are disclosed. A presently preferred proton pump inhibitor is lansoprazole, a presently preferred bicarbonate salt is sodium bicarbonate, and a presently preferred carbonate salt is sodium carbonate. The composition is a fast-acting formulation which reduces the undesirable belching associated with proton pump inhibitor formulations that contain high doses of sodium bicarbonate. Excerpt(s): The invention is directed to a method for treating gastric acid disorders with a non-enteric coated proton pump inhibitor in a pharmaceutically acceptable carrier including a bicarbonate salt of a Group IA metal and a carbonate salt of a Group IA metal; and a pharmaceutical composition of a non-enteric coated proton pump inhibitor in a pharmaceutically acceptable carrier including a bicarbonate salt of a Group IA metal and a carbonate salt of a Group IA metal. A presently preferred proton pump inhibitor is lansoprazole, a presently preferred bicarbonate salt is sodium bicarbonate, and a presently preferred carbonate salt is sodium carbonate. The composition is a fast-acting formulation which reduces the undesirable belching associated with proton pump inhibitor formulations that contain high doses of sodium bicarbonate. Lansoprazole is a substituted benzimidazole which inhibits gastric acid secretions. It belongs to a class of compounds called proton pump inhibitors (PPI). The key action mechanism of the PPIs is inhibition of H.sup.+/K.sup.+-adenosine triphosphate (also known as acid pump or proton pump), an enzyme present in the gastric parietal cells. These drugs are metabolized in the parietal cells to active sulfenamide metabolites that inactivate the sulfhydryl group of the proton pump, thus reducing the hydrogen ion secretion. Lansoprazole is a lipophilic weak base with poor aqueous solubility at low pH. It is unstable in low pH solutions and undergoes rapid acid-catalyzed degradation, though it is relatively stable at neutral or high pH. Due to the pH sensitivity of lansoprazole described above, effective drug delivery is problematic, as the pH of the gastric environment is acidic and the pH of the intestinal region is relatively alkaline. For the drug to be therapeutically active after oral administration, it should be protected from the acid present in the gastric juices. Further, the drug should reach the upper small intestinal region in an intact, absorbable form, where the drug can be rapidly absorbed to reduce acid production. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Prosthesis having a sleeve valve Inventor(s): Dua, Kulwinder S.; (Brookfield, WI), Karpiel, John A.; (Winston-Salem, NC), Moore, Scott T.; (Rural Hill, NC) Correspondence: Cook Group Patent Office; P.O. Box 2269; Bloomington; IN; 47402 Patent Application Number: 20020032487 Date filed: June 7, 2001 Abstract: Disclosed is a pressure sensitive prosthesis (10) that includes a tubular member (11) having a passageway (12) extending therethrough and a sleeve (13) attached about one end of the tubular member. The sleeve functions as a one-way valve to permit fluid flowing through the sleeve lumen (15) in a first direction (17) and under a first pressure, while collapsing in response to fluid flowing in a second direction 18 where the pressure that exceeds that of the first direction or pressure. One aspect of the invention includes an esophageal anti-reflux expandable prosthesis wherein the sleeve is adapted to invert back through the tubular stent frame to permit belching or vomiting (fluid or materials under a third, significantly higher pressure). Another aspect of the invention includes a tubular drainage stent (60), such as a biliary or urethral stent in which the sleeve opens to permit passage of fluids, then collapses to prevent retrograde flow. Excerpt(s): This application claims priority of provisional application Serial No. 60/211,753, filed Jun. 14, 2000, and is a continuation-in-part of co-pending U.S. patent application Ser. No. 09/386,173, filed Aug. 31, 1999, which claims priority to provisional application Ser. No. 60/098,542, filed Aug. 31, 1998. This invention relates generally to medical devices and, in particular, to an indwelling valved prosthesis. Anti-reflux esophageal prosthesis or stents are typically placed in the lower esophagus and through the lower esophageal sphincter to maintain the patency thereof due to the presence of a cancerous tumor commonly found in the vicinity thereof. The cancerous tumor growth typically impinges the flow of food and fluids through the esophagus. Lower esophageal cancer in the United States presently occurs at the rate of approximately 12,000 patients per year. The incidence in the United States is approximately 5.1 per 100,000 people, which is rising particularly in white male patients. Esophageal prosthesis or stents are typically utilized in these cancerous patients. However, these devices are not FDA approved for benign tumors which also cause blockage or partial stenosis of the esophagus. Esophageal prosthesis or stents are utilized in Europe and other countries for benign tumor conditions, but not in the United States at this time. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with belching, 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 “belching” (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 belching.
Patents 25
You can also use this procedure to view pending patent applications concerning belching. 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 4. BOOKS ON BELCHING Overview This chapter provides bibliographic book references relating to belching. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on belching 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 “belching” (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 belching: •
Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones Source: New York, NY: Oxford University Press. 1992. 227 p. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This book offers advice on how to take care of and avoid a whole complex of disturbances categorized as indigestion. The author begins with an overview of the anatomy and physiology of digestion, including a chapter on terminology and definitions. After an additional chapter on diagnostic testing, the author turns to specific problems, including acid related problems (heartburn, esophagitis, and hiatal hernia), peptic ulcers, nonulcer dyspepsia, chest pain, gallbladder problems and gallstones, pancreatic diseases, jaundice, malabsorption and maldigestion, food intolerance and
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food allergies, the impact of aging on the upper digestive tract (including the role of medications and drug interactions), and the brain gut connection. The appendices of the book offer coverage of related problems, including belching, nausea and vomiting, dry mouth and bitter taste, difficulty in tasting, lump in the throat, butterflies, difficulties in swallowing, delayed stomach emptying, the effects of diabetes on the upper digestive system, and the controversy over yeast. The author hopes to foster a cooperative dialogue between patients and their physicians as they work together to diagnose and manage upper digestive tract problems. A subject index concludes the book. 8 figures. 6 tables. •
Irritable Bowel Syndrome and the Mind-Body Brain-Gut Connection Source: Columbus, OH: Parkview Publishing. 1997. 302 p. Contact: Available from Parkview Publishing. P.O. Box 1103, Columbus, OH 43216. (888) 599-6464 or (614) 258-4848. Fax (614) 258-7272. PRICE: $19.95. ISBN: 0965703894. Summary: This book offers readers a guide to understanding and treating their functional gastrointestinal (GI) disorders, focusing on irritable bowel syndrome (IBS). The author emphasizes the role that individuals can play in managing their own symptoms and future. The book is framed around eight steps to positive change; eight chapters cover the GI tract and the mind-body connection; the common functional GI disorders; healing with diagnosis and education; understanding one's own symptoms and GI tract; identifying gut 'triggers'; emphasizing self-care and wellness; taking action if symptoms persist; and managing the functional GI disorder. Specific topics include the interplay between stress, psychology and symptoms; colitis and inflammatory bowel disease (IBD); the International Foundation for Functional Gastrointestinal Disorders (IFFGD); self-tests for personal and psychological problems; the role of a history of abuse; cognitive behavioral factors; food and symptom diaries; food allergy versus food intolerance and sensitivity; inflammation and infection; the menstrual cycle; seasonal changes; nutrition; weight; exercise; the impact of alcohol, nicotine, and tobacco; the use of an elimination diet; stress, emotional, and psychological issues; chronic pain management; and managing the symptoms of chest pain, heartburn, dysphagia, dyspepsia, nausea, vomiting, aerophagia (burping and belching), abdominal bloating, rectal gas and flatulence, abdominal pain, diarrhea, constipation, bowel incontinence, and anal and rectal pain. The book includes black and white photographs, charts, and figures; a subject index concludes the volume.
Chapters on Belching In order to find chapters that specifically relate to belching, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and belching 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 “belching” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on belching:
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Functional Gastroduodenal Disorders Source: in Drossman, D.A., et al., eds. Rome II: The Functional Gastrointestinal Disorders. 2nd ed. McLean, VA: Degnon Associates, Inc. 2000. p. 299-350. Contact: Available from Degnon Associates, Inc. Rome II Management, 6728 Old McLean Village Drive, McLean, VA 22101. Fax: 703-556-8729. Email:
[email protected]. Website: www.romecriteria.org. PRICE: $79.95 plus shipping and handling. ISBN: 965683729. Summary: An important group of patients with functional gastrointestinal disorders have chronic symptoms that, somewhat arbitrarily, are attributed to the gastroduodenal region. This includes patients who complain of epigastric or upper abdominal pain or discomfort, in the absence of peptic ulcer or other organic upper gastrointestinal diseases, patients who complain of excess belching and are air swallowers, and patients who have recurrent unexplained vomiting. This chapter on functional gastroduodenal disorders is from a text that reviews the diagnosis, pathophysiology, and treatment of functional gastrointestinal disorders. The chapter covers six disorders: ulcer-like dyspepsia, dysmotility-like dyspepsia, unspecified dyspepsia, aerophagia, and functional vomiting. For each condition, the authors discuss definition, epidemiology, diagnostic criteria, clinical evaluation, physiologic features, psychological features, and treatment options. A listing of recommendations for future research concludes the chapter. 1 appendix. 2 figures. 5 tables. 207 references.
•
Gas and Bloating Source: in Bonci, L. American Dietetic Association Guide to Better Digestion. Hoboken, NJ: John Wiley and Sons, Inc. 2003. p. 155-165. Contact: Available from John Wiley and Sons, Inc. Customer Care Department, One Wiley Drive, Somerset, NJ 08875. (800) 762-2974 or (317) 572-3993. Fax (317) 572-4002. Website: www.wiley.com. PRICE: $14.95 plus shipping and handling. ISBN: 0471442232. Summary: Coping with a gastrointestinal disorder, whether it is irritable bowel syndrome (IBS), gas (flatulence), constipation, heartburn, or another condition, can be embarrassing and debilitating. While medical treatments and prescriptions can offer relief, one of the most important ways patients can help themselves is in their dietary choices. This chapter on gas and bloating is from a book that describes how patients can self-manage their digestive disorders through dietary choices. In this chapter, the author first discusses the causes of gas and bloating, then covers the symptoms of the condition (belching or burping, flatulence, abdominal bloating, abdominal pain), diagnostic considerations, the use of medications and supplements to alleviate gas and bloating, the impact of dietary choices on gas and bloating, supplements that can increase symptoms, eating behaviors that can cause gas and bloating, and other factors that contribute to gas and bloating. The author concludes that intestinal gas, bloating, and belching are usually a result of food choices and eating behaviors. All of the over the counter medications are useless if the patient does not try to work on what is eaten and how it is eaten. 2 figures.
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Functional Dyspepsia: Diagnosis and Treatment Source: in McDonald, J.W.D.; Burroughs, A.K.; Feagan, B.G., eds. Evidence Based Gastroenterology and Hepatology. London, UK: BMJ Publishing Group. 1999. p. 140150.
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Contact: Available from BMJ Publishing Group. BMA Books, BMA House, Tavistock Square, London WCIH 9JR. Fax 44 (0)20 7383 6402. E-mail:
[email protected]. Website: www.bmjbooks.com. PRICE: Contact publisher for price. Summary: Functional dyspepsia, often referred to as non-ulcer dyspepsia, is an important health problem with a very high prevalence in the general population. This chapter on the diagnosis and treatment of functional dyspepsia is from a book that emphasizes the approaches of evidence based medicine in gastroenterology (the study of the gastrointestinal tract and gastrointestinal diseases) and hepatology (the study of the liver and liver diseases). The author of this chapter notes that the cardinal feature of functional dyspepsia is unexplained pain or discomfort centered in the upper part of the abdomen. Epigastric pain or discomfort may be accompanied by other symptoms such as excessive burping or belching, nausea, bloating, postprandial (after eating a meal) fullness, early satiety, or burning sensations. Functional dyspepsia is a diagnosis of exclusion and generally requires the performance of an upper gastrointestinal endoscopy. In practice, physicians often decide on a trial of empiric therapy for patients presenting with the symptom of dyspepsia. Endoscopy may give a patient reassurance that there is no serious underlying disease, and this may have a powerful beneficial therapeutic effect. It is reasonable to prescribe a period of acid suppression with either an H2 receptor antagonist or a proton pump inhibitor (PPI) in patients with functional dyspepsia. For all these treatments, it is possible that patients with unrecognized GERD represent the main responders. Whether eradication therapy for H. pylori will lead to a sustained improvement of functional dyspepsia symptoms is currently unresolved. However, given that H. pylori is a true pathogen, capable of producing peptic ulcers and sometimes gastric (stomach) cancer, the author recommends that eradication therapy be prescribed when the presence of the infection is documented. 66 references. •
Gas and Flatulence Source: in Brandt, L., et al., eds. Clinical Practice of Gastroenterology. Volume One. Philadelphia, PA: Current Medicine. 1999. p. 646-651. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: Gas related gastrointestinal (GI) complaints usually take one of three forms: excessive or repetitive belching; abdominal pain, bloating and distention; or excessive passage of flatus (gas) per rectum. This chapter on gas and flatulence is from a lengthy textbook that brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. The author of this chapter outlines a rational approach to the treatment of the flatulent patient based on studies of the normal physiology of intestinal gas production, composition, and excretion and the proven role of gas in the production of GI symptoms. The author contends that physicians often order complex and expensive diagnostic studies and prescribe a variety of drugs that have little chance of brining relief to their patients. Gas can enter the gut as the result of air swallowing, bacterial metabolism, or diffusion from the blood. Chronic, repetitive belching is usually a manifestation of a nervous habit, although the person with this complaint often is convinced that there must be serious disease causing excessive gas production in the upper tract. Patients with the common complaint of abdominal pain and bloating usually have irritable bowel syndrome (IBS) that manifests as a motility disorder that interferes with the orderly passage of gas through the gut. The passage of large volumes of intestinal gas per rectum may just be an annoying cause of social
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embarrassment, or it may cause a person to think something is seriously wrong. However, when manifesting without other symptoms (diarrhea or weight loss), this common symptom is virtually never caused by serious organic disease. 2 figures. 5 tables. 13 references. •
Ineffective Therapies Source: in Manu, P. Pharmacotherapy of Common Functional Syndromes: EvidenceBased Guidelines for Primary Care Practice. Binghamton, NY: Haworth Medical Press. 2000. p. 153-167. Contact: Available from Haworth Medical Press, an imprint of Haworth Press, Inc. 10 Alice Street, Binghamton, New York 13904-1580. (800) HAWORTH or (800) 429-6784. Outside United States and Canada (607) 722-5857. Fax (800) 895-0582. E-mail:
[email protected]. Website: www.haworthpressinc.com. PRICE: $69.95 plus shipping and handling. ISBN: 0789005883. Summary: This chapter is from a book that evaluates drug therapies for each of the four major functional disorders: chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), and premenstrual syndrome. In this chapter, the fourth of six short chapters that focus on IBS, the author introduces and reviews the ineffective therapies presently in use for the condition. The author focuses on dietary fiber, lactase, and ondansetron. The author's evidence based analysis of a number of studies demonstrates that research performed in the past two decades has established with a high degree of certainty that the administration of dietary fiber is not useful for treating IBS. Lactose (milk sugar) maldigestion can be identified in close to one third of patients diagnosed with IBS, and the symptoms of lactose intolerance or maldigestion are so close to those for IBS as to prevent the clinical identification of this subgroup. Treatment with lactase provided no statistical improvement over placebo. The author reports on a study of ondansetron, in which the drug treatment did not decrease significantly the severity of abdominal pain or the total number of symptoms experienced during the trial. Stool consistency increased after ondansetron therapy. In another study, ondansetron was similar to placebo with regard to its effect on abdominal pain, abdominal distention, backache, urinary symptoms, and depression and anxiety. The only symptoms improved by ondansetron in this population with IBS were postprandial (after a meal) discomfort, belching, and heartburn.
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Digestion, Absorption, and Transport Source: in Whitney, E.N., Cataldo, C.B., and Rolfes, S.R. Understanding Normal and Clinical Nutrition. 4th ed. St. Paul, MN: West Publishing Company. 1994. p. 66-91. Contact: Available from West Publishing. 620 Opperman Drive, St. Paul, MN 55164. (800) 340-9378 or (612) 687-7000. PRICE: $67.00. ISBN: 0314041788. Summary: This chapter on digestion, absorption, and transport is from an introductory medical textbook on nutrition. Topics include the anatomy of the digestive tract, the muscular action of digestion, the secretions of digestion, the final stage of digestion, anatomy of the absorptive system, the anatomy and physiology of the intestinal cells, the circularly systems (vascular and lymphatic), regulation of digestion and absorption, and gastrointestinal hormones and nerve pathways. The chapter concludes with study questions, clinical application questions, and a 'highlight' section of case reports of common digestive problems. These problems include choking on food, vomiting, diarrhea, constipation, belching and gas, and heartburn. 9 figures. 1 table. 8 references. (AA-M).
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Gut Feelings Source: in King, J.E., ed. Mayo Clinic on Digestive Health. Rochester, MN: Mayo Clinic. 2000. p. 27-46. Contact: Available from Mayo Clinic Health Information. 5505 36th Street, SE, Grand Rapids, MI 49512. (800) 291-1128. Website: www.mayoclinic.com. PRICE: $14.95 plus shipping and handling. ISBN: 1893005046. Summary: This chapter on digestive tract symptoms ('gut feelings') is from a comprehensive guidebook from the Mayo Clinic that focuses on a variety of digestive symptoms, including heartburn, abdominal pain, constipation, and diarrhea, and the common conditions that are often responsible for these symptoms. Written in nontechnical language, the book includes practical information on how the digestive system works, factors that can interfere with its normal functioning, and how to prevent digestive problems. This chapter reviews the most common digestive complaints, including difficulty swallowing (dysphagia), chest pain and heartburn, belching (burping), bloating and intestinal gas (flatulence or farting), indigestion, nausea and vomiting, abdominal pain, diarrhea or constipation, bleeding, and weight loss. For each of these symptoms, the authors consider the possible causes, and treatment options, including lifestyle or habit changes that may help the problem. One sidebar reviews lactose intolerance (problems digesting the sugars in dairy products); another reviews the problem and treatment of hemorrhoids. Readers are referred to other chapters in the book for additional information about specific problems.
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Indigestion and Dyspepsia, or the Stomach and Its Discontents: Getting the Words Right Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 19-22. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on terminology is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. The author reviews the different terms that patients and physicians use, including indigestion, dyspepsia, heartburn, belching (gas), and flatulence. These problems of indigestion (dyspepsia) are important because they are so common; perhaps as many as one quarter of the population will complain of some of these kinds of symptoms over a 6 month period. The author explores the different kinds of indigestion, including those related to organic disease (such as peptic ulcer, gallstones, or pancreatitis) and those that do not have an organic basis (functional disorders). In addition, the author emphasizes that functional disorders are very real, even if their diagnosis by classic measures such as x-rays is uncertain. Many functional disorders are due to problems in gastrointestinal motility, or the movement of the contents of the digestive tract. The author encourages readers to keep close track of their symptoms, as different symptoms point to different etiologies (causes) which can in turn be treated.
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Disorders of the Upper Sphincter and Proximal Esophagus Source: in Snape, W.J., ed. Consultations in Gastroenterology. Philadelphia, PA: W.B. Saunders Company. 1996. p. 177-186.
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Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. PRICE: $125.00. ISBN: 0721646700. Summary: This chapter, from a gastroenterology text, considers disorders of the upper sphincter and proximal esophagus. Disorders of the upper esophageal sphincter (UES) may involve its function during swallowing and, less commonly, during belching. Topics related to the components of UES include UES during deglutition, the opening mechanism of UES during swallowing, cricopharyngeal achalasia, cricopharyngeal bar, Zenker's diverticulum, UES and central nervous system (CNS) disorders, and UES disorders during belching. Structural abnormalities of the most proximal portion of the esophagus may induce obstruction and, because of the proximity to the pharynx, could present with symptoms of cervical dysphagia. Topics in the second section include proximal esophageal rings, the Plummer-Vinson syndrome, proximal esophageal stricture, and collagen vascular diseases and the esophagus. The author concludes that swallow-related disorders of UES and proximal esophagus result in similar symptoms and complications. These symptoms and complications are shared by many other causes of pharyngeal phase dysphagia. For this reason, basic diagnostic studies such as barium swallow studies need to include the proximal esophagus. 7 figures. 1 table. 16 references. (AA-M).
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CHAPTER 5. MULTIMEDIA ON BELCHING Overview In this chapter, we show you how to keep current on multimedia sources of information on belching. 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 belching is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “belching” 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 “belching” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on belching: •
Your Digestive System Source: Los Angeles, CA: National Health Video, Inc. 1999. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Blvd., Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail:
[email protected]. PRICE: $89.00 plus shipping and handling. Summary: This health education videotape program reviews the digestive system and basic digestive problems. Narrated by a registered dietitian, the program defines digestion as the process by which food is changed to nourishment for the body. The program first reviews the anatomy of the digestive system, including the mucosa of the mouth, stomach and small intestine; the role of the muscle movements of swallowing and peristalsis; and the lower esophageal sphincter. Swallowing disorders are mentioned briefly. The program then discusses the causes of and therapy for heartburn (gastroesophageal reflux disease, or GERD), gas (belching and flatulence), constipation, hemorrhoids, and peptic ulcers. Lifestyle changes are emphasized as the least invasive,
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most effective treatment for most digestive problems; the role of exercise is also noted. Drug therapy is discussed as a useful option, but caution is advised when using long term drug therapy for digestive concerns. The videotape includes footage of everyday people, interviews between physicians and patients, and graphics to help explain the physiology and anatomy covered in the discussion.
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CHAPTER 6. PERIODICALS AND NEWS ON BELCHING Overview In this chapter, we suggest a number of news sources and present various periodicals that cover belching.
News Services and Press Releases One of the simplest ways of tracking press releases on belching 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 “belching” (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 belching. 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 “belching” (or synonyms). 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
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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 “belching” (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 “belching” (or synonyms). If you know the name of a company that is relevant to belching, 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 “belching” (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 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 “belching” (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 belching:
Periodicals and News
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Belching: It May be a Social No-No, but It's Perfectly Normal Source: Environmental Nutrition. 24(10): 7. October 2001. Contact: Available from Hepatitis B Coalition. Immunization Action Coalition, 1573 Selby Avenue, Suite 229, St. Paul, MN 55104. (612) 647-9009. Fax (612) 647-9131. E-mail:
[email protected]. Website: www.winternet.com. Summary: This brief newsletter article answers common questions about belching and the embarrassment that is associated with frequent belching (burping). The author notes that belching is a normal physiological response to eating that helps vent air (gas) from the stomach. Nearly all gas trapped in the stomach comes from swallowed air; gas does not typically originate in the stomach. It is quite normal to unconsciously swallow air during meals, especially when eating and drinking quickly. Other triggers for swallowing air are chewing gum, sucking on hard candies, drinking carbonated beverages (including beer), smoking, and poor-fitting dentures. Persistent belching that is accompanied by other symptoms (such as pain or vomiting) should be brought to the attention of a health care provider. The article concludes with six strategies to reduce the amount of belching.
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How to Reduce Belching Source: Mayo Clinic Health Letter. 14(1): 3. January 1996. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037. Summary: This brief newsletter article provides readers with a list of tips for how to reduce belching. Suggestions focus on reducing the amount of air swallowed by eating meals slowly, avoiding chewing gum or sucking on hard candy, and quitting smoking, among others.
Academic Periodicals covering Belching Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to belching. In addition to these sources, you can search for articles covering belching 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 7. 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 belching. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with belching. 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 belching: Nicotine •
Systemic - U.S. Brands: Commit; NicoDerm CQ; Nicorette; Nicotrol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202407.html
Omeprazole •
Systemic - U.S. Brands: Prilosec http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202423.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 Institute6: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
6
These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:8 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
7
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 8 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway9 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “belching” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 334 2 38 0 9 383
HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.13 Simply search by “belching” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
9
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
10
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
Physician Resources
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Coffee Break: Tutorials for Biologists14 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.15 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
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/.
14 Adapted 15
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 16 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
51
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 belching 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 belching. 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 belching. 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 “belching”:
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Colonic Diseases http://www.nlm.nih.gov/medlineplus/colonicdiseases.html Dietary Supplements http://www.nlm.nih.gov/medlineplus/dietarysupplements.html Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Gastroesophageal Reflux/Hiatal Hernia http://www.nlm.nih.gov/medlineplus/gastroesophagealrefluxhiatalhernia.html Giardia Infections http://www.nlm.nih.gov/medlineplus/giardiainfections.html Stomach Disorders http://www.nlm.nih.gov/medlineplus/stomachdisorders.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on belching. 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: •
Belching: Is it Normal? Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2001. [6 p.]. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail:
[email protected]. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members. Summary: This brochure reviews belching (burping) and the occurrence of aerophagia (swallowing air). Belching after a large meal is physiologically normal, indeed a necessary venting of air from the stomach. Air swallowing is normal, although it contributes no discernible benefit. The author reviews the physiology of aerophagia and the mechanisms that might contribute to aerophagia (including stress, thumb sucking, gum chewing, rapid eating, and poorly fitting dentures). The author also describes the clinical features of belching and treatment options for repetitive or uncomfortable belching. One sidebar offers dietary tips to help reduce problems with gas. The brochure concludes with a brief description of the International Foundation for
Patient Resources
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Functional Gastrointestinal Disorders (IFFGD), a nonprofit education and research organization (www.iffgd.org). 1 figure. 2 references. 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 belching. 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/
•
WebMDHealth: 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 belching. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with belching. 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 belching. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797.
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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 “belching” (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 “belching”. 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 “belching” (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 “belching” (or a synonym) into the search box, and click “Submit Query.”
55
APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.17
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
17
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
18
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
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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/
Finding Medical Libraries
59
•
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
61
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
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on belching: •
Basic Guidelines for Belching Belching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003080.htm
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Signs & Symptoms for Belching Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Dyspepsia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003260.htm Heartburn Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm
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Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •
Background Topics for Belching Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Relieved by Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002288.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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BELCHING 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] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerophagia: A condition that occurs when a person swallows too much air. Causes gas and frequent belching. [NIH] 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] 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] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] 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]
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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] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angina: Chest pain that originates in the heart. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] 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] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Articular: Of or pertaining to a joint. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs.
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These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] 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 swallow: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called an esophagram. [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] Beer: An alcoholic beverage usually made from malted cereal grain (as barley), flavored with hops, and brewed by slow fermentation. [NIH] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]
Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] 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 duct: A tube through which bile passes in and out of the liver. [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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber.
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Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Butterflies: Slender-bodies diurnal insects having large, broad wings often strikingly colored and patterned. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] 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] Carbonated Beverages: Drinkable liquids combined with or impregnated with carbon dioxide. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH]
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Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] 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
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classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compulsions: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] 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] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deglutition: The process or the act of swallowing. [NIH] Dental Abutments: Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU]
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Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [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 procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]
Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [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] Distention: The state of being distended or enlarged; the act of distending. [EU] Diurnal: Occurring during the day. [EU] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dothiepin: A tricyclic antidepressant with some tranquilizing action. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity
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of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Elastin: The protein that gives flexibility to tissues. [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] Emergency Medicine: A branch of medicine concerned with an individual's resuscitation, transportation and care from the point of injury or beginning of illness through the hospital or other emergency treatment facility. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emetic: An agent that causes vomiting. [EU] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Eructation: The ejection of gas or air through the mouth from the stomach. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH]
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Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagram: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called a barium swallow. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Evacuation: An emptying, as of the bowels. [EU] Extracellular: Outside a cell or cells. [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]
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] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [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 Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]
Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH]
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Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower 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 Hormones: Hormones secreted by the gastrointestinal mucosa that affect the timing or the quality of secretion of digestive enzymes, and regulate the motor activity of the digestive system organs. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastroscope: A thin, lighted tube used to view the inside of the stomach. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Genital: Pertaining to the genitalia. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [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] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH]
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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] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [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] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatology: The field of medicine concerned with the functions and disorders of the liver. [NIH]
Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] 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] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] 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] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH]
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Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] 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] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Ingestion: Taking into the body by mouth [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] 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] 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] Intracellular: Inside a cell. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [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] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress.
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Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [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]
Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lesion: An area of abnormal tissue change. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [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]
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] Macronutrients: Nutrients in the diet that are the key sources of energy, namely protein, fat, and carbohydrates. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Mammary: Pertaining to the mamma, or breast. [EU] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [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] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH]
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Meninges: The three membranes that cover and protect the brain and spinal cord. [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: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Processes: Conceptual functions or thinking in all its forms. [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] 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] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [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] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU]
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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] Nipples: The conic organs which usually give outlet to milk from the mammary glands. [NIH]
Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orderly: A male hospital attendant. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic 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] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Cells: Cells in the stomach wall that make hydrochloric acid. [NIH]
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Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [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] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] 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] 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] 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] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [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] 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] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the
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convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] 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] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] 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] Prosthesis: An artificial replacement of a part of the body. [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] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]
Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [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] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] 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]
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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] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] 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] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] 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] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ruminants: A suborder of the order Artiodactyla whose members have the distinguishing feature of a four-chambered stomach. Horns or antlers are usually present, at least in males. [NIH]
Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] 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] 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] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH]
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Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [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 Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] 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] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [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] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
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Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] 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] Systemic: Affecting the entire body. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] 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] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Topical: On the surface of the body. [NIH] Torticollis: Wryneck; a contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH]
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Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] 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] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]
Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] 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]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [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] 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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Venous: Of or pertaining to the veins. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [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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INDEX A Abdomen, 30, 63, 65, 66, 70, 74, 75, 78, 81, 83 Abdominal, 4, 5, 6, 7, 9, 28, 29, 30, 31, 32, 61, 63, 67, 69, 75, 77, 79 Abdominal Pain, 5, 7, 28, 29, 30, 31, 32, 63, 75 Abrasion, 4, 63 Adenine, 63 Adenosine, 23, 63 Adenosine Triphosphate, 23, 63 Adverse Effect, 63, 64, 80 Aerophagia, 11, 28, 29, 52, 63 Affinity, 63, 75, 81 Agonist, 63, 64, 69, 77 Airway, 8, 11, 63 Airway Obstruction, 8, 63 Algorithms, 63, 65 Alimentary, 15, 63, 69 Alkaline, 23, 63, 65 Alkaloid, 64, 76, 77 Alternative medicine, 38, 64 Alveoli, 64, 68 Ampulla, 64, 70 Anal, 28, 64 Anatomical, 64, 66, 70, 74 Anemia, 4, 64 Anesthesia, 63, 64 Angina, 64 Anginal, 11, 64 Antibody, 63, 64, 67, 74 Antidepressant, 64, 69, 71 Antigen, 63, 64, 67, 73, 74 Anus, 5, 64, 66, 67, 71, 80 Anxiety, 31, 64, 77 Anxiolytic, 64, 77 Apomorphine, 11, 64 Aqueous, 23, 64, 65 Arginine, 16, 64 Articular, 64, 77 Asymptomatic, 64, 77 Autodigestion, 64, 77 Autonomic Neuropathy, 7, 64 B Bacteria, 64, 65, 71, 76 Barium, 33, 65, 71 Barium swallow, 33, 65, 71 Base, 23, 63, 65, 75, 83
Beer, 39, 65 Benign, 24, 65, 72 Benign tumor, 24, 65 Bile, 65, 71, 72, 75 Bile Acids, 65, 72 Bile duct, 65 Bile Pigments, 65, 75 Biliary, 24, 65, 77 Biliary Tract, 65, 77 Biochemical, 5, 65, 77, 80 Biological Transport, 65, 69 Biotechnology, 8, 38, 47, 65 Bladder, 64, 65, 74, 83 Bloating, 3, 5, 6, 7, 9, 28, 29, 30, 32, 65, 72, 74, 75, 77 Blood Glucose, 7, 65, 73, 74 Blood pressure, 65, 81 Blood vessel, 65, 66, 81, 83 Body Fluids, 66, 70, 81 Body Mass Index, 7, 66 Body Regions, 66, 67 Bone Marrow, 66, 75 Bowel, 6, 16, 28, 64, 66, 69, 74, 81 Bowel Movement, 66, 69, 81 Bulimia, 4, 66 Butterflies, 28, 66 C Carbohydrates, 7, 66, 75 Carbon Dioxide, 66 Carbonated Beverages, 39, 66 Cardiovascular, 64, 66, 80 Cardiovascular System, 64, 66 Case report, 10, 11, 16, 31, 66 Caudal, 66, 78 Cell, 63, 65, 66, 67, 68, 69, 71, 74, 76, 77, 78, 79, 82 Central Nervous System, 33, 66, 72, 76, 80 Cervical, 33, 66, 82 Cervix, 66, 67 Chest Pain, 10, 11, 12, 27, 28, 32, 67 Cholinergic, 67, 77 Chronic, 5, 6, 17, 28, 29, 30, 31, 67, 71, 74, 77, 81, 83 Chronic Fatigue Syndrome, 31, 67 Cisplatin, 67, 77 Clinical trial, 8, 47, 67 Cloning, 65, 67 Colic, 22, 67
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Colitis, 28, 67, 74, 75 Collagen, 33, 67, 79 Colon, 6, 67, 74, 75 Complement, 67, 68 Complementary and alternative medicine, 15, 20, 68 Complementary medicine, 15, 68 Compulsions, 68, 77 Computational Biology, 47, 68 Connective Tissue, 66, 67, 68, 75 Constipation, 7, 28, 29, 31, 32, 35, 68, 71, 75 Contraindications, ii, 68 Crowns, 68, 69 Curative, 68, 82 Cytotoxic, 68, 77 Cytotoxic chemotherapy, 68, 77 D Dairy Products, 32, 68 Degenerative, 68, 77 Deglutition, 33, 68 Dental Abutments, 68, 69 Dentition, 4, 68 Dentures, 39, 52, 69 Deuterium, 69, 73 Diabetes Mellitus, 7, 69, 72, 73 Diagnostic procedure, 21, 38, 69 Diaphragm, 69, 73 Diarrhea, 4, 7, 28, 31, 32, 69, 71, 75 Dietary Fiber, 31, 69 Dietitian, 35, 69 Diffusion, 30, 65, 69 Digestion, 3, 27, 29, 31, 35, 63, 65, 66, 69, 70, 72, 74, 75, 78, 81 Digestive system, 5, 28, 32, 35, 69, 71, 72 Digestive tract, 28, 31, 32, 64, 69, 80 Direct, iii, 41, 69, 80 Distal, 69, 72, 79 Distention, 5, 6, 30, 31, 69 Diurnal, 66, 69 Diverticulum, 33, 69 Dopamine, 64, 69, 76 Dorsal, 69, 78 Dothiepin, 10, 69 Drug Interactions, 28, 42, 69 Duct, 64, 70, 80, 81 Duodenum, 65, 70, 71, 77, 78, 81 Dyspepsia, 3, 5, 6, 9, 28, 29, 30, 32, 61, 70, 74 Dysphagia, 4, 17, 28, 32, 33, 70 E Elastin, 67, 70
Electrolyte, 70, 81, 83 Electrons, 65, 70, 74, 79 Emergency Medicine, 12, 70 Emergency Treatment, 70 Emetic, 64, 70 Empiric, 30, 70 Empirical, 3, 70 Enamel, 4, 70 Endometrium, 70, 76 Endoscope, 70 Endoscopic, 5, 70 Endoscopy, 4, 6, 30, 70 Environmental Health, 46, 48, 70 Enzyme, 23, 70, 71, 78 Epigastric, 3, 6, 29, 30, 70, 77 Eructation, 6, 10, 12, 16, 70 Erythrocytes, 64, 66, 70 Esophageal, 5, 9, 11, 12, 13, 24, 33, 70, 72 Esophageal Stricture, 33, 70 Esophagitis, 4, 27, 71, 72 Esophagram, 65, 71 Esophagus, 4, 6, 24, 32, 33, 65, 69, 70, 71, 72, 73, 75, 78, 80, 81 Evacuation, 68, 71 Extracellular, 68, 71, 81 F Family Planning, 47, 71 Fat, 66, 71, 75 Fatigue, 67, 71 Feces, 68, 71, 81 Fermentation, 65, 71 Fistula, 71 Flatulence, 4, 5, 7, 9, 16, 28, 29, 30, 32, 35, 71 Flatus, 6, 30, 71 Fluoxetine, 10, 71 Functional Disorders, 31, 32, 71 G Gallbladder, 27, 63, 65, 69, 71, 72 Gas, 4, 5, 6, 7, 9, 10, 28, 29, 30, 31, 32, 35, 39, 52, 63, 65, 66, 69, 70, 71, 73, 74 Gastric, 7, 10, 23, 30, 64, 71, 72, 73, 77, 78 Gastric Acid, 23, 71, 77 Gastric Emptying, 7, 71, 72 Gastric Juices, 23, 71, 78 Gastroduodenal, 5, 29, 71 Gastroenterologist, 4, 71 Gastroenterology, 3, 5, 8, 9, 10, 11, 12, 13, 29, 30, 32, 33, 72 Gastroesophageal Reflux, 4, 9, 17, 35, 52, 72
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Gastroesophageal Reflux Disease, 4, 9, 17, 35, 72 Gastrointestinal, 3, 4, 6, 7, 16, 28, 29, 30, 31, 32, 52, 53, 71, 72, 80, 81 Gastrointestinal Hormones, 31, 72 Gastrointestinal tract, 3, 30, 71, 72, 80, 81 Gastroparesis, 7, 72 Gastroscope, 9, 72 Gene, 65, 72 Genital, 64, 72 Gland, 72, 75, 77, 80, 81 Glucose, 7, 65, 69, 72, 73, 74 Glucose Intolerance, 69, 72 Glycine, 16, 72, 76 Goats, 68, 72 Governing Board, 72, 78 H Halitosis, 7, 72 Headache, 72, 79 Health Education, 35, 73 Heartburn, 3, 4, 5, 6, 7, 17, 27, 28, 29, 31, 32, 35, 61, 73, 74 Hemoglobin, 7, 64, 70, 73 Hemorrhoids, 32, 35, 73 Hepatology, 8, 29, 30, 73 Herpes, 10, 73 Herpes Zoster, 10, 73 Hiatal Hernia, 27, 52, 73 Hormone, 73, 74, 75, 80 Hydrochloric Acid, 73, 77 Hydrogen, 23, 65, 66, 69, 73, 76, 79 Hydrolysis, 67, 73, 78, 79 Hydroxylysine, 67, 73 Hydroxyproline, 67, 73 Hyperbilirubinemia, 73, 75 Hypersensitivity, 73, 80 I Idiopathic, 5, 73 Impairment, 6, 74 Incision, 74 Incompetence, 72, 74 Incontinence, 28, 74 Indigestion, 4, 27, 32, 74 Infection, 4, 28, 30, 74, 75, 76, 80, 81 Inflammation, 28, 67, 71, 73, 74, 77, 78, 83 Inflammatory bowel disease, 28, 74 Ingestion, 72, 74, 78 Insomnia, 74, 79 Insulin, 7, 74 Insulin-dependent diabetes mellitus, 7, 74 Internal Medicine, 72, 74
Intestinal, 4, 6, 7, 23, 27, 29, 30, 31, 32, 74, 75 Intestine, 66, 74, 75, 78 Intracellular, 74, 75 Invasive, 35, 74 Involuntary, 74, 80 Ions, 65, 70, 73, 74 Irritable Bowel Syndrome, 5, 6, 16, 28, 29, 30, 31, 71, 74 J Jaundice, 27, 73, 75 K Kb, 46, 75 L Large Intestine, 69, 74, 75, 80 Lesion, 75, 83 Linkages, 73, 75 Lipid, 74, 75 Lipophilic, 23, 75 Liver, 30, 63, 65, 69, 71, 72, 73, 75 Localized, 74, 75, 78, 83 Lower Esophageal Sphincter, 24, 35, 72, 75 Lymph, 66, 75 Lymph node, 66, 75 Lymphatic, 31, 74, 75, 81, 82 M Macronutrients, 7, 75 Malabsorption, 27, 75 Mammary, 75, 77 Maxillary, 4, 75 MEDLINE, 47, 75 Membrane, 15, 63, 68, 75, 76, 77, 78, 79 Membrane Proteins, 75, 79 Meninges, 66, 76 Menstrual Cycle, 28, 76, 79 Menstruation, 76 Mental, iv, 7, 46, 48, 71, 74, 76, 79, 83 Mental Processes, 76, 79 Microorganism, 76, 78 Modification, 76, 79 Molecular, 47, 49, 65, 68, 76, 83 Molecule, 64, 65, 67, 73, 76, 79 Morphine, 64, 76 Motility, 6, 11, 30, 32, 71, 76, 80 Motion Sickness, 76 Motor Activity, 72, 76 Mucosa, 35, 72, 76 N Nausea, 3, 5, 7, 28, 30, 32, 61, 72, 74, 76, 77, 79, 83 Nervous System, 66, 76, 81, 82 Neuroleptic, 76, 77
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Neurons, 76, 77, 82 Neuropathy, 65, 76 Neurotransmitter, 63, 69, 72, 76, 81, 82 Nicotine, 28, 42, 77 Nipples, 22, 77 Nonulcer Dyspepsia, 5, 27, 77 O Obsessive-Compulsive Disorder, 12, 77 Omeprazole, 42, 77, 79 Ondansetron, 31, 77 Oral Hygiene, 72, 77 Orderly, 30, 77 Osteoarthritis, 6, 77 Otitis, 10, 77 Otitis Media, 10, 77 P Palliative, 77, 82 Pancreas, 63, 69, 72, 74, 77 Pancreatic, 27, 72, 77 Pancreatic Juice, 72, 77 Pancreatitis, 32, 77 Parietal, 23, 77, 78 Parietal Cells, 23, 77 Parietal Lobe, 77, 78 Parkinsonism, 64, 78 Pathogen, 30, 78 Pathophysiology, 29, 78 Patient Education, 52, 56, 58, 62, 78 Pelvis, 63, 78, 83 Pepsin, 78 Peptic, 17, 18, 27, 29, 30, 32, 35, 78 Peptic Ulcer, 17, 18, 27, 29, 30, 32, 35, 78 Perception, 5, 78 Peristalsis, 35, 78 Pharmacologic, 64, 78, 82 Pharynx, 33, 72, 78 Physiologic, 29, 63, 76, 78, 79 Physiology, 5, 11, 27, 30, 31, 36, 52, 72, 78 Plants, 64, 66, 72, 78, 82 Plasma, 72, 73, 78 Pneumonia, 68, 78 Poisoning, 64, 76, 78 Polypeptide, 67, 78 Posterior, 4, 64, 69, 77, 78 Postprandial, 5, 7, 30, 31, 78 Practice Guidelines, 48, 78 Premenstrual Syndrome, 31, 79 Prevalence, 30, 79 Progressive, 77, 79 Proline, 67, 73, 79 Prosthesis, 24, 68, 79 Protein S, 65, 79
Proteins, 64, 67, 75, 76, 78, 79, 80, 82 Proton Pump, 4, 23, 30, 77, 79 Proton Pump Inhibitors, 4, 23, 79 Protons, 73, 79 Proximal, 32, 33, 69, 79 Psychology, 28, 68, 79 Psychotherapy, 79 Public Policy, 47, 79 Q Quality of Life, 6, 79 R Radiation, 79, 83 Radioactive, 73, 79 Reassurance, 6, 30, 79 Receptor, 4, 30, 64, 69, 77, 79, 80 Rectal, 28, 80 Rectum, 30, 64, 66, 67, 69, 71, 74, 75, 80 Refer, 1, 67, 73, 76, 80 Reflex, 8, 9, 10, 11, 12, 80 Reflux, 4, 24, 72, 80 Regimen, 7, 80 Regurgitation, 3, 7, 72, 73, 80 Response rate, 6, 80 Resuscitation, 70, 80 Retrograde, 24, 80 Rheumatoid, 6, 18, 80 Rheumatoid arthritis, 6, 80 Ribose, 63, 80 Ruminants, 16, 72, 80 S Salivary, 69, 80 Salivary glands, 69, 80 Screening, 67, 80 Secretion, 23, 72, 74, 77, 80 Serotonin, 71, 76, 77, 80, 83 Serum, 16, 67, 80 Side effect, 41, 63, 80, 82 Small intestine, 5, 35, 70, 73, 74, 80 Social Environment, 79, 81 Sodium, 23, 81 Sodium Bicarbonate, 23, 81 Soma, 81 Somatic, 15, 81 Spastic, 75, 81 Specialist, 53, 81 Sphincter, 9, 10, 11, 13, 32, 33, 81 Spinal cord, 66, 76, 80, 81 Spleen, 75, 81 Stenosis, 24, 81 Stent, 24, 81 Stimulus, 80, 81
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Stomach, 4, 5, 22, 28, 30, 32, 35, 39, 52, 63, 64, 65, 69, 70, 71, 72, 73, 75, 76, 77, 78, 79, 80, 81 Stool, 31, 67, 74, 75, 81 Stress, 4, 28, 52, 71, 74, 76, 80, 81 Stricture, 81 Subacute, 74, 81 Subclinical, 74, 81 Substance P, 80, 81 Supplementation, 16, 82 Suppression, 4, 30, 82 Symptomatic, 77, 82 Synaptic, 76, 77, 82 Synaptic Transmission, 77, 82 Systemic, 42, 66, 74, 81, 82 T Therapeutics, 42, 82 Thymus, 75, 82 Tinnitus, 77, 82 Tissue, 64, 65, 66, 68, 70, 75, 76, 77, 80, 81, 82 Topical, 81, 82 Torticollis, 11, 82 Toxic, iv, 76, 77, 82 Toxicity, 69, 82 Toxicology, 48, 82 Toxins, 64, 74, 82
Trachea, 78, 82 Transfection, 65, 82 Trauma, 71, 72, 77, 82, 83 Tricyclic, 69, 83 Tryptophan, 67, 80, 83 Tunica, 76, 83 U Ulcer, 29, 30, 77, 83 Ulceration, 78, 83 Uraemia, 77, 83 Urinary, 31, 74, 83 Urine, 65, 74, 83 Uterus, 66, 67, 70, 76, 83 V Vascular, 31, 33, 74, 83 Vasculitis, 77, 83 Venous, 73, 79, 83 Vertigo, 77, 83 Vesicular, 73, 83 Veterinary Medicine, 47, 83 Viscera, 81, 83 Visceral, 5, 65, 83 W Windpipe, 78, 83 X X-ray, 32, 65, 71, 83
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