Chagas Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

CHAGAS DISEASE 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

ii

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., 1960Chagas Disease: 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: 0-497-00219-1 1. Chagas Disease-Popular works. I. Title.

iii

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

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

iv

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 Chagas disease. 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.

v

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.

vi

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

vii

Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON CHAGAS DISEASE ..................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Chagas Disease.............................................................................. 4 E-Journals: PubMed Central ....................................................................................................... 17 The National Library of Medicine: PubMed ................................................................................ 18 CHAPTER 2. NUTRITION AND CHAGAS DISEASE............................................................................ 55 Overview...................................................................................................................................... 55 Finding Nutrition Studies on Chagas Disease ............................................................................ 55 Federal Resources on Nutrition ................................................................................................... 56 Additional Web Resources ........................................................................................................... 57 CHAPTER 3. ALTERNATIVE MEDICINE AND CHAGAS DISEASE ..................................................... 59 Overview...................................................................................................................................... 59 National Center for Complementary and Alternative Medicine.................................................. 59 Additional Web Resources ........................................................................................................... 65 General References ....................................................................................................................... 66 CHAPTER 4. DISSERTATIONS ON CHAGAS DISEASE ....................................................................... 67 Overview...................................................................................................................................... 67 Dissertations on Chagas Disease ................................................................................................. 67 Keeping Current .......................................................................................................................... 67 CHAPTER 5. BOOKS ON CHAGAS DISEASE ...................................................................................... 69 Overview...................................................................................................................................... 69 Book Summaries: Federal Agencies.............................................................................................. 69 CHAPTER 6. PERIODICALS AND NEWS ON CHAGAS DISEASE ........................................................ 71 Overview...................................................................................................................................... 71 News Services and Press Releases................................................................................................ 71 Academic Periodicals covering Chagas Disease ........................................................................... 73 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 77 Overview...................................................................................................................................... 77 NIH Guidelines............................................................................................................................ 77 NIH Databases............................................................................................................................. 79 Other Commercial Databases....................................................................................................... 81 APPENDIX B. PATIENT RESOURCES ................................................................................................. 83 Overview...................................................................................................................................... 83 Patient Guideline Sources............................................................................................................ 83 Finding Associations.................................................................................................................... 85 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 87 Overview...................................................................................................................................... 87 Preparation................................................................................................................................... 87 Finding a Local Medical Library.................................................................................................. 87 Medical Libraries in the U.S. and Canada ................................................................................... 87 ONLINE GLOSSARIES.................................................................................................................. 93 Online Dictionary Directories ..................................................................................................... 95 CHAGAS DISEASE DICTIONARY............................................................................................. 97 INDEX .............................................................................................................................................. 131

1

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 Chagas disease 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 Chagas disease, 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 Chagas disease, 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 Chagas disease. 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 Chagas disease, 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 Chagas disease. The Editors

1

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

3

CHAPTER 1. STUDIES ON CHAGAS DISEASE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Chagas disease.

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

American Trypanosomiasis (Chagas' Disease) Source: Gastroenterology Clinics of North America. 25(3): 517-533. September 1996. Contact: Available from W.B. Saunders Company, Periodicals Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 654-2452. Summary: This article reviews American trypanosomiasis or Chagas' disease, an illness caused by the protozoan parasite Trypanosoma cruzi. Gastrointestinal (GI) dysfunction is a major problem for many patients with chronic Chagas' disease; the underlying anatomic abnormality in these patients is a denervation of the GI tract. This process of nerve destruction usually develops insidiously over many years, and it is highly variable. Megaesophagus is the most common manifestation of GI Chagas' disease, and mechanical dilation of the esophageal sphincter or surgery in advanced cases usually

4

Chagas Disease

give satisfactory relief of symptoms. Megacolon, particularly of the sigmoid segment, is also common in patients with chronic T. cruzi infections, and its presence can be complicated by fecal impaction or sigmoid volvulus. Patients with advanced megacolon who have resections of the sigmoid colon and most of the rectum generally do well postoperatively. 4 figures. 90 references. (AA-M).

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

Project Title: A GENETIC SYSTEM FOR KINETOPLASTID DRUG DISCOVERY Principal Investigator & Institution: Swindle, John T.; Vice President and Chief Scientific Offi; Complegen, Inc. 1124 Columbia St, Ste 662 Seattle, Wa 981042050 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2004 Summary: (provided by applicant): The goal of this project is to apply a novel, well developed cost effective means of drug target and drug discovery to parasitic disease, focusing on Trypanosoma cruzi and Leishmania, the causative agents of Chagas disease and Leishmanaisis respectively. This project will generate comparative compound screens to identify new anti-kinetoplastid compounds that are broadly applicable to both T. cruzi and Leishmania species. The identification of broad-spectrum therapeutics will facilitate later commercialization by significantly increasing the potential market for new therapeutics, an important attribute since most of the afflicted populations are poor. The experimental approach exploits a novel method for identifying compounds that interact specifically with trypanosomal protein targets but not with the human analogs. In this method, T. cruzi, Leishmania sp., and human genes are introduced into yeast, functionally replacing the cognate yeast genes. A collection of these yeast strains, each bearing a different trypanosomatid or human gene (trypanosomatid and human XenoGene arrays), can be used as compound screening platforms in a high through-put bioassay to identify compounds which specifically inhibit the function of the trypanosome targets but not analogous targets in the human XenoGene array. This application also includes a pilot small molecule screen of selected kinetoplastid targets. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

2

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

Studies

•

5

Project Title: A STRATEGY FOR SPREADING GENES IN CHAGAS DISEASE VECTORS Principal Investigator & Institution: Durvasula, Ravi V.; Epidemiology and Public Health; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2005 Summary: A paratransgenic strategy aimed at decreasing transmission of trypanasoma cruzi, the causative agent of Chagas disease, from reduviid vectors to man is being developed. The symbiotic bacterium, Rhodococcus rhodnii, that resides in the reduviid vector, Rhodnius prolixus, has been transformed to export peptides toxic to T. cruzi and single chain antibodies that may be engineered to target T. cruzi. In this proposal, a strategy to spread engineered symbiotic bacteria in field populations of the vector will be studied. The synthetic fecal paste, CRUZIGARD, that has been formulated to mimic naturally occurring coprophagic methods of symbiont transfer in Rhodnius prolixus will be evaluated as a gene spreading strategy. In Aim I 'the fitness of engineered symbiotic bacteria to compete with wild-type organisms to establish infection in the host vector will be assessed. In co-infection studies of aposymbiotic R. prolixus (bugs that are specially reared to be free of gut-associated bacteria), effects of different gene constructs on fitness will be determined. In Aim 2, the potential non-target gene spread will be evaluated. In closed cage-studies uptake and retention of transgenes by arthropods that do not transmit T. cruzi (ants, crickets, fleas and cockroaches) but-may be exposed to CRUZIGARD will be determined. Furthermore, transfer of genetic material from engineered bacteria to other environmental microbes will be characterized. Aim 3 will involve simulated release of transgeuic microbes in life-size huts that are contained within a greenhouse facility. Huts will be constructed of standard materials and infested with reduviid bugs. Various applications of CRUZIGARD will be used to determine extent of gene spread in a hut and possible hut-to-hut transfer of genetic materials. From these studies, optimal methods for gene delivery via CRUZIGARD can be established. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ADAPTATION OF RIBOZYME TECHNOLOGY TO LEISHMANIA Principal Investigator & Institution: Sturm, Nancy R.; Microbiology and Immunology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by the applicant): Directed ribozyme activity will add a valuable tool to the arsenal of techniques for study of small RNAs, and has not yet been reported in the kinetoplastids. This research is aimed at understanding gene expression in the family Trypanosomatidae, which includes the parasitic protozoan responsible for leishmaniasis, African sleeping sickness, and Chagas Disease. The focus is on the genesis and function of the spliced leader RNA, a small RNA which contributes the 5'end sequence to every nuclear messenger RNA via a trans-splicing reaction. Transsplicing is not found in the human host or insect vector, and thus represents a possible therapeutic target. This proposal outlines two series of experiments aimed at exploring the use of hammerhead ribozymes while elucidating the maturation pathway of the spliced leader RNA in Leishmania tarentolae: 1) Ribozyme activity in cis (monomolecular) will be used to specify the 3' end of the spliced leader RNA. Stable products will allow us to overcome known processing defects for specific mutations in the spliced leader RNA and to examine downstream processing events including 5' methylation and trans-splicing. 2) Ribozymes will be used in trans (hi-molecular) to assay for

6

Chagas Disease

nucleolar trafficking by attaching the ribozyme to a nucleolar U3 snoRNA. The nucleolar ribozyme will be directed against the spliced leader RNA and the spliced leader associated 1 RNA. Efficient ablation of RNA targets has great potential for elucidating the role of conserved sequences, structures and subcellular Iocalization. Once the parameters of the technique are established increasingly ambitious experiments can be designed including targeting of the spliced SL or discrete mRNAs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANTI-TRYPANOSOMAL AGENTS FROM A NEOTROPICAL CLOUDFOREST Principal Investigator & Institution: Setzer, William N.; Professor; Chemistry; University of Alabama in Huntsville Office of Sponsored Programs Huntsville, Al 35899 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-APR-2007 Summary: (provided by applicant): Over 18 million people in tropical and subtropical America are afflicted by American trypanosomiasis or Chagas disease. The disease is caused by the parasitic protozoan Trypanosoma cruzi, which is transmitted by Triatomid ("kissing") bugs. The parasite enters the body through the eyes, mucous membranes, or open wounds. After entering the body, the parasite burrows into cells and begins to multiply, causing rupture of the parasitized cell, and newly produced parasites are then released into the blood. In humans, symptoms of the disease include fever, swelling, and heart and brain damage, usually leading to death. There is currently no effective treatment for this disease. The purpose of this research program is to find new medicines from tropical cloudforest plants for treatment of this parasitic disease. Tropical cloudforests are incredibly diverse, and tropical plants have evolved chemical defenses to protect themselves from being consumed by insects, nematodes, fungus attack, etc. These multitudinous chemicals, developed over millions of years, have varied and diverse structures and interfere with many different biochemical targets. Our hypothesis is that tropical cloudforest plants represent a storehouse of new chemical agents that may also inhibit parasites such as Trypanosoma. These compounds may be promising drug candidates themselves, or they may serve as templates for further synthetic elaboration and optimization. Our plan of attack in this proposal is: (a) to screen our collection of tropical rainforest plant extracts for killing of the parasites in culture, (b) to test our extracts for inhibition of some key enzymes necessary for survival of the protozoa, (c) when we find active extracts, to isolate and determine the structures of the active compounds, (d) to see how active compounds bind to enzyme target molecules, and (e) to determine the effectiveness of new potential drugs a mouse model. The long-term benefit of this research project is the development of new medicines to treat patients with Chagas disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ASSESSMENT OF STROKE RISK AND OUTCOME IN CHAGAS DISEASE Principal Investigator & Institution: Furie, Karen L.; Assistant Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2005 Summary: (provided by applicant): Stroke is an enormous international public health concern, particularly in the developing world where there are limited resources available to provide for an aging population. One of the main contributors to stroke incidence in Brazil is the highly prevalent Chagas disease, a parasitic infection affecting

Studies

7

14% of the population and a major cause of heart failure in Latin America. Chagas disease conveys stroke risk through two established mechanisms, structural cardiac disease and chronic inflammation. Although inflammation is associated with an increased risk of ischemic stroke and poorer outcome, its role has been largely linked to atherogenesis. Chronic inflammation can result in endothelial dysfunction and stimulate the hemostatic system, increasing systemic fibrin production and platelet activation. Adults, young and old, who develop a secondary cardiomyopathy from Chagas, are therefore at higher risk of cardioembolism. Stroke patients usually survive, but can be left with significant disability affecting their health status, productivity, and quality of life. These factors impact caregivers as well. Thus, the social and economic consequences of stroke are vast. The short term goals of this planning grant are to develop a multidisciplinary collaborative infrastructure of investigators and resources in the United States and Brazil to promote clinical stroke research, to provide training for emerging Brazilian clinical stroke researchers, and to determine the resources necessary to support this clinical research effort in future endeavors. As part of this development phase, we will collect pilot data to address two specific aims: (1) to elucidate which of the potential inflammatory and hemostatic markers of stroke risk are associated with chagasic cardiomyopathy, and (2) to determine the mechanism and outcome of stroke in patients with Chagas disease. The long-term goal of this project is to establish noninvasive methods of stroke risk stratification and prediction of stroke outcome in patients with Chagas disease. This work will also facilitate the development of novel anti-trypanosomal, anti-inflammatory, and antithrombotic strategies for stroke prevention and management in Brazil. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BABOON MODEL OF CHAGAS DISEASE: T CRUZI Principal Investigator & Institution: Vandeberg, John L.; Director; Southwest Foundation for Biomedical Res San Antonio, Tx 782450549 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2003 Summary: The overall objectives of this pilot study are to determine the feasibility of developing a nonhuman primate model for research on the etiology of Chagas' disease, to contribute to understanding the clinical condition of nonhuman primates that are naturally infected with Trypanosoma cruzi (the causative agent of Chagas' disease), and to protect against the use of T cruzi infected baboons as organ donors for xenotransplantation. The project will involve surveying 2,600 baboons for seropositivity to determine age-specific, sex-specific, and housing-specific prevalences of T. cruzi infection. The project will determine ages of seroconversion. and the heritability of seropositivity. The chromosomal location of polymorphic genes that confer differential susceptibility to T. cruzi infection will be sought by linkage analysis using 330 microsatellite markers already typed in the pedigreed baboons. The pathology of seropositive animals will be carefully documented at necropsy. Results obtained from this pilot study are expected to justify its expansion into a major model development project. The validation of a naturally occurring nonhuman primate model of Chagas' disease will be a major accomplishment for future research purposes, will enable a better understanding of the clinical condition of animals at the Center, and will provide a means for preventing the inadvertent infection of humans with T. cruzi via xenotransplantation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

8

•

Chagas Disease

Project Title: COMPLEMENT REGULATION IN TRYPANOSOMA CRUZI Principal Investigator & Institution: Norris, Karen A.; Associate Professor; Molecular Genetics & Biochem; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-MAR-1992; Project End 31-MAY-2006 Summary: (provided by the applicant): The goal of this research is the molecular and immunologic characterization of the 160 kDa complement regulatory protein (CRP) of the protozoan parasite, Trypanosoma cruzi, the causative agent of Chagas disease. After infection of the vertebrate host, the bloodstream stage trypomastigote is capable of evading host alternative and classical complement activation pathways, allowing dissemination to targettissues and intracellular replication. This is accomplished through the production of adevelopmentally regulated surface glycoprotein, CRP that restricts complement activation atthe level of C3 convertase formation. Our hypothesis is that immunologic neutralization of theCRP contributes to destruction of the extracellular bloodstream stage, and thus will contribute to protection from disease. We have shown that immunization with plasmid DNA encoding the full length CRP structural gene elicits neutralizing antibodies and protects against a lethal challenge in a murine model of Chagas disease. Three specific aims are designed to optimize the design of vaccine candidates based on the CRP gene and to characterize the immune responses to the protein, in vivo. Specific Aim 1 will provide a molecular analysis of the active domains of CRP and the binding interaction between CRP and its ligand, the complement component C3b. The functional analysis will be carried out using mutant CRP constructs expressed in mammalian cells and assayed for complement restriction activity and C3b binding. In addition, we will use neutralizing anti-CRP monoclonal antibodies and CRP-binding peptides to provide a finer map of activity. Specific Aim 2 will focus on an evaluation of CRP-DNA based vaccines in a murine model of Chagas disease. In these studies we will compare three expression vectors, optimize immunization protocols, and evaluate the range of protection using multiple mouse and parasite strains. In addition, we will examine oral and mucosal vaccine delivery systems and mucosal, sub-lethal challenge regimens. The goal of Specific Aim 3 is to analyze the immune effector mechanisms involved in the pmtective anti-CRP response. The role of immune antibodies will be evaluated in DNA immunized mice to determine if conformationally dependent epitopes are essential to the induction of a protective response. Passive transfer and challenge studies will be conducted and we will test vaccinated mice for the presence of CRP-specific cytotoxic T cells using CRP-expressing target cells. The successful completion of these aims will provide the first functional and immunological evaluation of a critical virulence factor of T. cruzi and provide information and reagents for the use of CRP as a vaccine candidate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: DEVELOPMENT OF PARATRANSGENIC TICKS FOR DISEASE CONTROL Principal Investigator & Institution: Munderloh, Ulrike G.; Research Associate Professor; Entomology; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-APR-2007 Summary: (provided by the applicant): Tick-borne diseases are increasingly diagnosed in humans and animals. Some are due to the resurgence of previously known illnesses, like Rocky Mountain spotted fever (Walker 1995). but others are due to new, emerging

Studies

9

pathogens. Among the spotted fever group (SFG) alone, 8 new human pathogens have been described in the last 15 years (Stenos et al. 1997; Nilsson et al. 1999; Fournier et al. 2000), but they also include viruses, ehilichias and Babesia (Dawson et al. 1991; Thomford et al. 1994; Bakken et al. 1994; Telford et al 1991). Novel, efficient, specific and environmentally acceptable methods that interfere with disease transmission by ticks are urgently needed. Using paratransgenic ticks that carry symbiotic prokaryotes expressing an antimicrobial substance, as has been achieved with the symbiote of the Chagas disease vector, Rhodnius prolixus (Durvasula et aL 1997), could offer a safe and effective way to reduce disease transmission by ticks. A major obstacle to accomplishing this goal has been the lack of culture systems for tick symbiotes. Our laboratory has the largest collection of tick cell lines. We have successfully used these to isolate tickassociated rickettsiae (Munderloh et al. 1998; Weller et al. 1998; Palmer et al. 1999; Simser et al. 2001a,b) from the Lone Star tick (MOAa), the Rocky Mountain wood tick (R. peacockli DAE100R), and the Castor Bean tick (Rmoreli T2). We have characterized these microbes by light and electron microscopy, by using specific antibodies, as well as by PCR and nucleotide sequence analysis of 165 rDNA and other key genes. We are now in the process of defining the cultures to facilitate genetic manipulation of the symbiotes. Ourlong-termaim is the stabletransformation of Rickettsiapeacockii with cecropinA. an insect ponn gene (Hultmark et al. 1983). Infection of ticks with the transformed rickettsia, and interference with pathogen transmission. We plan to target the nonfunctional rompA gene of R. peacockli as a site for homologous transformation, avoiding deleterious effects associated with disruption of a vital gene, e.g. the rpoB gene (troyer et al. 1999). We will take the recent advances in successful transformation of insect-borne rickettsiae as a guide (Rachek et al. 1998; Troyer et al. 1999). and also apply transposome technology (Epicentre). Specifically, we will 1. optimize culture conditions for production of R. peacockii in tick cell culture, exanine its behavior in tick and mammalian cell culture by light and electron microscopy. 2. We will analyze cultured R. peacockii in ticks in terms of tissue tropism and transstadial/transovanal passage, and sensitivity to Cecropin A. Finally, we will work towards 3. stable transformation of R. peacockii with cecropinA. We will then test the transfonnants for antimicrobial activity in vitro and in ticks, and characterize them by sequence analysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ECOEPIDEMIOLOGY OF CHAGAS DISEASE IN NORTHWEST ARGENTINA Principal Investigator & Institution: Kitron, Uriel D.; Professor; Animal Sciences and Veterinary Pathobiology; University of Illinois Urbana-Champaign Henry Administration Bldg Champaign, Il 61820 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-MAY-2007 Summary: (provided by applicant): Chagas disease (American Trypanosomiasis), caused by Trypanosoma cruzi and transmitted by triatomine bugs, is the most important vector-borne disease in Latin America. Despite an ongoing eradication campaign, transmission persists in much of the continent, particularly in the Gran Chaco of northern Argentina, Paraguay and Bolivia, where Triatoma infestans is the main vector. Abundant peridomestic structures (particularly animal corrals) provide a refuge and source for repeated domestic reinfestation, dogs are a continuous source of infection for colonizing triatomine bugs, and sylvatic vectors invading human habitations may also play a role in reintroducing T. cruzi. The long-term goal of this project is to interrupt the reinfestation process and introduction of infection into homes. High degree of spatial, temporal and host heterogeneity with regard to vector and parasite survival,

10

Chagas Disease

reproduction and spread, and ongoing anthropogenic changes have to be considered to understand infestation and infection patterns. Data derived from molecular tools, satellite imagery and field observations and experiments will be integrated into a GIS and mathematical models to elucidate the underlying biological mechanisms and epidemiological processes. The Specific Aims of the project are: 1) To analyze the spatial and temporal pattern of reinfestation by triatomine bugs and distribution of T. cruzi infection in bugs, dogs and people in three rural communities with the aid of satellite imagery, GIS, spatial statistics and other analytical tools; 2) To identify mechanisms underlying these patterns using field observations, field manipulations and experimental studies, and relate changes in these patterns to management strategies, habitat degradation and other anthropogenic changes; 3) To determine the source of colonizing vectors and T. cruzi infection by comparing the genetic makeup of bug and parasite strains using molecular techniques and morphometry; 4) To develop an empirically based, spatially structured mathematical model of the reinfestation and transmission process at the community-wide level; 5) On a coarser scale, to apply the results and develop risk maps of the distribution of household infestation by T. infestans and T. cruzi infection at the village, Department and Province-wide level; to compare effects of standard vs. scientifically designed intervention programs on infestation level and rate of reinfestation in new communities; and 6) To train scientists and NVCP personnel in the use of ecological and epidemiological tools, modeling, GIS and remote sensing techniques for research design and focused control strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EXPRESSION OF THE LEISHMANIA TARENTOLAE SL RNA GENE Principal Investigator & Institution: Campbell, David A.; Microbiology and Immunology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-DEC-1994; Project End 29-FEB-2004 Summary: Leishmaniasis, African Sleeping Sickness and Chagas Disease are fatal or debilitating diseases that afflict over 20 million people annually in tropical countries and are caused by infections with related trypanosomatid protozoa. We are studying features of trypanosomatid gene expression that are shared among the pathogens, but which are absent in the human host. The expression of the parasite's Spliced Leader RNA gene and the role of its primary transcript, the SL RNA, in the maturation of nuclear messenger RNAs (mRNA) via trans-splicing is the focus of our research. We are taking molecular genetic and biochemical approaches to defining the promoter that directs initiation of SL RNA gene transcription, and characterizing protein(s) that bind to the SL RNA gene promoter. In the next funding period we propose to: 1) define the protein-DNA interactions in transcription initiation from the SL RNA gene promoter, and to identify the RNA polymerase that transcribes the SL RNA gene through a genetic approach, 2) define additional regions of the SL RNA gene that are necessary for transcription termination and efficient transcription initiation, and 3) analyze the effect of mutations in the Spliced Leader that may affect translation. These experiments will identify new molecules and elucidate essential protein-DNA and RNA-RNA interactions that distinguish the parasite's metabolism from that of the human host. These unique features represent potential targets for selective therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

•

11

Project Title: FUNCTION OF THE KINETOPLAST IN THE HEMOFLAGELLATES Principal Investigator & Institution: Simpson, Larry P.; Professor; Molecular, Cellular & Dev Biol; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-MAY-1977; Project End 30-APR-2005 Summary: The long term goal of this project is to understand the molecular mechanism of the uridine-insertion/deletion type of RNA editing that occurs in the mitochondrion of kinetoplastid protozoa. The specific aims of this project are as follows: 1. Isolation of mitochondrial proteins and cloning of genes involved in RNA editing. Both enzymatic and structural proteins will be investigated. The genes will be cloned and expressed both in E. coli and as tagged proteins in L. tarentolae, and the recombinant proteins used to generate antibodies. Gene knockouts will be performed either by disruption of both alleles or by RNAi functional knockouts, and the effect on editing assayed both in vivo and in vitro. The recombinant proteins will be used to attempt to reconstitute editing activities in vitro. 2. Investigation of the mechanism of double strand RNA-induced (RNAi) inhibition of gene function. 3. Isolation of a functional 20S editing complex from Trypanosoma brucei procyclic cells; purification and identification of individual proteins and cloning genes. 4. Regulation of editing in T. brucei and Leishmania during life cycle, growth in culture, and during cell cycle. 5. Development of a transient mitochondrial expression system and a stable mitochondrial transformation system for use in studying RNA editing. 6. Investigation of the specific C34-U34 editing of the anticodon of imported tRNATrp in L. tarentolae. These parasites represent the causal agents of a variety of human animal and plant diseases, such as visceral and dermal leishmaniasis, Chagas Disease, African trypanosomiasis, and palm decay diseases. The existence of such a unique metabolic pathway as U-insertion/deletion RNA editing may provide a selective handle for chemotherapeutic intervention without affecting the host. Editing is required for the mt metabolism of these cells. A detailed knowledge of the enzymes involved in editing and the precise molecular pathways may allow the development of drugs which can kill the parasite and not affect the host. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: FUNCTIONAL GENOMICS OF METACYCLOGENESIS IN T.CRUZI Principal Investigator & Institution: Buck, Gregory A.; Professor & Director, Molecular Biol. &; Microbiology and Immunology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Chagas disease, caused by Trypanosoma cruzi, is globally ranked behind malaria and schistosomiasis as the third most serious parasitic disease, and remains the most serious parasitic disease in Latin America in terms of disability adjusted life years. Despite recent progress controlling dissemination of T. cruzi in reduviid bugs, no treatment is available for chronic Chagas disease, and acute infections can only be treated with highly toxic drugs. Thus, there is a critical need for new approaches to treatment of T. cruzi infections. Metacyclogenesis is the process by which non-infectious "insect form" epimastigotes of T. cruzi differentiate into infectious metacyclic trypomastigotes. This process is the subject of much interest among scientists because of the implications for treatment/prevention of Chagas disease. We have used an axenic model system for metacyclogenesis, begun a nonredundant microarray of sequence-verified cDNA sequences, and established an exogenously regulated expression system that can be used to dissect this important differentiation system. The

12

Chagas Disease

specific aims of the project are: 1) To establish and validate comprehensive microarrays of T. cruzi genes expressed during differentiation of epimastigotes into metacyclic trypomastigotes. 2) To use these DNA microarrays to identify T. cruzi genes that are differentially expressed during metacyclogenesis. 3) To use known potentiators of T. cruzi metacyclogenesis to identify 5-10 candidate genes that trigger, control or direct the differentiation process. 4) To document the function of these regulatory genes by in silico analysis, overexpression, knockout of the endogenous genes, or regulated inhibition of expression (e.g., using RNAi), using our regulated T. cruzi gene expression system. We anticipate identifying several hundred differentially regulated genes in Specific Aim #2. In Specific Aim #3, we will screen out most of the genes that are not directly causal in the differentiation process and select 5-10 candidates for regulatory genes for further analysis. In Specific Aim #4, we will use our regulatable T. cruzi genetic system and RNAi to establish the functions and roles of the differentially expressed genes that play a probable Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENETIC ANALYSIS OF PURINE METABOLISM IN LEISHMANIA DONO Principal Investigator & Institution: Ullman, Buddy; Professor; Biochem and Molecular Biology; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-JUN-1983; Project End 31-MAR-2003 Summary: Amalgamating tools of molecular biology, genetics, biochemistry, structural biology, and immunochemistry, this proposal offers a thorough interdisciplinary analysis of three key enzymes of the purine salvage pathway of Leishmania. These enzymes are hypoxanthine-guanine phosphoribosyltransferase (HGPRT), adenine phosphoribosyltransferase (APRT), and xabthine phosphoribosyltransferase (XPRT). As protozoan parasites are auxotrophic for purines, HGPRT, APRT, and XPRT provide an important, if not vital, nutritional function for the parasite, and HGPRT initiates the intracellular metabolism of allopurinol, a lead compound that has shown therapeutic efficacy in both leishmaniasis and Chagas disease. The proposed investigations constitute a logical step in the validation of these enzymes as potential therapeutic targets and in the implementation of a rational, structure-based strategy of drug discovery, and ultimately drug design, for the treatment and prophylaxis of leishmaniasis and other diseases of parasitic origin. The first objective of this application is to determine the contributions of HGPRT, APRT, XPRT, and adenosine kinase (AK) to purine salvage in L. donovani promastigotes by phenotypic characterization of deltaxprt mutants that will be constructed by targeted gene replacement in wild type, deltahgprt, deltaaprt, deltahgprt/deltaaprt, deltahgprt/ak, deltaaprt/ak, and deltahgprt/deltaaprt/ak genetic backgrounds. Whether HGRPT, APRT, or XPRT function is essential for infectivity or virulence will be tested by generating null mutants in the infective M379 L. mexicana strain. The second specific aim entails a detailed biochemical and structural characterization of the HGRPT, APRT, and XPRT proteins. The first component of Specific Aim II consists of an evaluation of the HGPRT and XPRT molecular models and the APRT structure by site-directed mutagenesis of key amino acids that are conjectured to be involved in catalysis or substrate binding and biochemical characterization of the genetically altered proteins. The second aspect of this aim is to supplement the structure-function studies on HGPRT and XPRT via the introduction of crystallographic methods with the ultimate intention of resolving a 3-D structure of a leishmanial HGPRT or XPRT protein. The final specific aim is to ascertain the intracellular location of the APRT and XPRT proteins by subcellular fractionation of

Studies

13

parasite lysates and by immunofluorescence and immunoelectron microscopy on intact cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GRNA/MRNA INTERACTIONS IN TRYPANSOME RNA EDITING Principal Investigator & Institution: Koslowsky, Donna J.; Associate Professor; Microbiology and Public Health; Michigan State University 301 Administration Bldg East Lansing, Mi 48824 Timing: Fiscal Year 2002; Project Start 01-JAN-2001; Project End 31-DEC-2005 Summary: RNA editing in Trypanosoma brucei is a process that inserts / deletes uridylate residues (U) from mitochondrial pre-mRNA molecules. This phenomenon produces mature mRNAs by creating open reading frames, correcting frame shifts and creating signals for translational initiation and termination. The placement of Us is guided by a small RNA molecule (the guide (g) - RNA) which is complementary to portions of the mature mRNA. While the gRNA is known the carry the information for the editing process, little is known about how the gRNAs are used to direct the editing process. All of the gRNAs identified to date have defined 5' anchor sequences, guiding sequences and a non-encoded 3' uridine tail. The overall objective of this proposal is to understand how the different gRNA elements contribute to the editing process, how they interact with the pre-edited mRNA during editing and ultimately how the gRNA is utilized to direct editing. This objective will be approached using three avenues of research: 1) an analysis of the secondary structure interactions between gRNA and mRNA during the editing process. The extent of the gRNAs interactions with the mRNA will be determined by combining photoaffinity cross linking with structure probing techniques. Defining the structures of the gRNA and the mRNA as they interact during the editing process will help lead to a molecular understanding for the role of the gRNAs in the editing process. 2) An analysis of the tertiary structure of RNAs and proteins in the editing complex. The cross linking patterns of photo-agents attached at homologous sites in different gRNAs and mRNAs will be analyzed to determine if these RNAs contain a common, core tertiary structure. Using site-specific cross linking techniques, the positions of editing proteins in relation to specific regions of the gRNA and mRNA will be analyzed. 3) A determination of the roles of sequence and structure in the kinetics of gRNA/mRNA association. The contribution both sequence and structure make in the overall kinetics of RNA interaction will be analyzed using native and temperature gradient gel electrophoresis and surface plasmon resonance technology. The binding of the gRNA to the mRNA is the fundamental step in RNA editing. An understanding of the nature and relative importance of the elements, which confer specificity on this interaction, is critical to our understanding of the editing process. This research will allow us to begin to understand the structural function relationship of RNAs and protein within the editing complex and greatly enhance our understanding of the mechanism involved in the transfer of information from one RNA molecule to another. Members of the kinetoplastida are the causative agents of African sleeping sickness, Chagas disease and leishmaniasis. Understanding kRNA editing, which is unique to these organisms, will contribute to the fundamental knowledge of the parasite and may lead to the development of new strategies for disease intervention and control. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

14

•

Chagas Disease

Project Title: NEURON SURVIVAL IN CHAGAS DISEASE Principal Investigator & Institution: Pereira, Miercio A.; Professor; Pathology; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2002; Project Start 01-JUL-2000; Project End 30-JUN-2005 Summary: (Adapted from the Investigator's Abstract): Chagas disease, caused by the protozoan Trypanosoma cruzi, progresses through 3 stages: 1) acute disease, characterized by robust parasite growth, immunological disturbances, and peripheral neural degeneration; 2) indeterminate phase, asymptomatic and featuring extensive regeneration of neurons; and 3) chronic phase, characterized by immunological alterations and pronounced degeneration of neurons in the heart and GI tract. Most patients remain asymptomatic and with signs of neuronal regeneration for decades, but for enigmatic reasons, some (<10 percent) undergo extensive degeneration of neurons (along with immunological disturbances) to progress to the fatal chronic disease. Recent studies may provide insights into the molecular basis of neuronal changes in Chagas disease. Picomolar levels of the T. cruzi trans-sialidase (TS) were found to protect several types of neuronal cells from undergoing apoptotic death. What's more, TS synergized with two human neurotrophic cytokines, ciliary neurotrophic factor (CNTF) and leukemia inhibitory factor (LIF), to promote neuronal survival. Therefore, the possibility exists that neuronal regeneration in Chagas disease results from the collaboration of TS with CNTF or LIF. In addition, and most interesting, because about 2.5 percent and 25 percent of normal people are homozygous and heterozygous, respectively, for a null mutation in the CNTF gene, the possibility exists that individuals bearing mutation of this neurotrophic cytokine are more prone to develop extensive degeneration of neurons if infected with T. cruzi and thus to progress to chronic Chagas' disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: SEQUENCING MHC CLASS I PEPTIDES FROM TRYPANOSOMA CRUZI: CHAGAS DISEASE Principal Investigator & Institution: Orlando, Ron; University of Georgia 617 Boyd, Gsrc Athens, Ga 306027411 Timing: Fiscal Year 2002 Summary: We are collaborating on studies of the substrate specificity of mammalian processing a-mannosidases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: STEM CARDIOMYOPATHY

CELL

BASED

THERAPIES

IN

CHAGASIC

Principal Investigator & Institution: Campos De Carvalho, Antonio; Neuroscience; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 30-JUN-2007 Summary: (provided by applicant): Chagas disease is caused by the hemoflagelate parasite Trypanosoma cruzi About 30% of infected individuals develop the cardiac form of the disease, usually decades after the primary infection Cardiac Chagasic patients present cardiomegaly, electrical and mechanical disturbances of heart function. The disease evolutes to congestive heart failure and the only currently available therapy is heart transplantation. Performing heart transplants in chagasic patients is not only expensive, but also difficult, as immunosuppressive drugs can bring about patent

Studies

15

parasitemia due to persistent parasitism in the chronic phase of infection. The major objective of this proposal is to develop an alternative and efficient therapeutical procedure for chronic chagasic cardiomyophaty (CCC), based on transplantation of bone marrow derived stem cells. Murine models of CCC will allow quantification of heart inflammatory foci and degree of fibrosis in treated and untreated animals, using confocal microscopy and morphometric analysis. Functional analysis, performed by conventional electro and ecocardiography will also be performed. Use of syngeneiclabelled bone marrow stem cells, obtained by transfection with fluorescent proteins or from transgenic mice, will permit identification and follow up of the differentiation of the transplanted cells in the heart of the recipient animal. In vitro culture and co-culture systems of cardiomyocytes and marrow stem cells will be used to gain a deeper insight into the signaling pathways that lead to differentiation of the marrow stem cells into cardiomyocytes, using DNA microarray systems. Immunologic repertoires of the treated mice will be compared to those of untreated, age matched infected animals, to evaluate the contribution of attenuation of autoimmune mechanisms to the proposed stem cell therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STEROL BIOSYNTHESIS IN TRYPANOSOMATID PARASITES Principal Investigator & Institution: Buckner, Frederick S.; Medicine; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2005 Summary: The long-term objective of this project is to discover new therapeutics for leishmaniasis and Chagas disease. These infectious diseases are caused by parasitic protozoa of the family, Trypanoisomatidae. Leishmaniasis affects 12 million people in 88 countries with an annual incidence of about 2 million people. Visceral leishmaniasis is fatal if untreated and cutaneous leishmaniasis causes serious morbidity, Chagas disease is caused by Trypanosoma cruzi and is endemic in over 20 countries in Latin America. An estimated 16-18 million persons are chronically infected and at risk for developing life threatening cardiomyopathy or megasyndromes of the gastrointestinal tract. The treatments for leishmania infections are inadequate because of the toxicity of currently available drugs and because of the need to administer the drugs by injection. Treatments for Chagas diseases are highly toxic and do not cure most patients with chronic phase disease. Leishmania species and Trypanosoma cruzi synthesize membrane sterols similar to those of fungi. It has been shown that a number of anti-fungal drugs that act on sterol biosynthesis or directly on ergosterol have anti- lishmanial and antitrypanosomal effects. Our hypothesis is that a characterization of the sterol biosynthesis pathway in Trypanosomatids will lead to novel drug treatments. The specific aims of the research are: 1) Clone Trypanosomatid homologs of selected sterol biosynthesis genes. We will concentrate on five enzymes that are potentially enzymes that are potentially excellent drug targets: squalene synthetase, squalene epoxidase, C14 demethylase, delta 14-reductase, and C8 isomerase. Genes will be cloned with the use of sequences in the parasite genome databases that have high homology scores to sterol biosynthesis genes of other organisms. 2) Characterize the Trypanosomatid homologs of sterol biosynthesis genes. The enzymatic function of the cloned parasite genes will be investigated by heterologous complementation of yeast mutants. We will be prepared for the possibility that Trypanosomatids make sterols by a route that differs from the yeast pathway. 3) Interrupt the sterol biosynthesis genes in Leishmania mexicana and Trypanosoma cruzi. Targeted knockout of sterol biosynthesis genes will be done using selectable drug markers. The enzymes that are shown to be essential for parasite

16

Chagas Disease

viability will be prioritized for subsequent drug studies. 4) Screen sterol biosynthesis inhibitors for anti-Trypanosomatid activity. Test compounds will be obtained from collaborating investigators and pharmaceutical companies. Drugs will be screened in high throughput in vitro systems. The best compounds will be tested in murine models of Chagas disease and leishmaniasis. The drugs discovered in this research program will hopefully provide better future treatment for patients with these devastating diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TRANSGENIC CHARACTERIZATION OF CLASS II MAMMALIAN MANNOSIDASES Principal Investigator & Institution: Moremen, Kelley W.; Professor; University of Georgia 617 Boyd, Gsrc Athens, Ga 306027411 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2003 Summary: We are sequencing the major histocompatability complex (MHC) class I peptides from Trypanosoma cruzi-infected cells. T. cruzi, a protozoan parasite carried by the reduviid bug, is the cause of a debilitating chronic heart disease in South America known as Chagas disease. Unfortunately, this disease cannot be treated except by using harmful chemotherapy. When a human cell encounters a protein, such as the foreign protein secreted by an invading parasite, it presents proteolytic peptide fragments on the surface of the cell associated with the MHC protein. By purifying these peptides using immuno-affinity chromatography, a battery of currently available HPLC techniques, and the gas-phase separation techniques available to us in mass spectrometry, we hope to be able to identify and sequence infection-specific MHC class I peptides so that a vaccine harnessing T-cell-mediated immunology can be developed to fight this fatal disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: TRAPS FOR TRIATOMINE VECTORS OF CHAGAS DISEASE Principal Investigator & Institution: Mclaughlin, John R.; Ipm Technologies, Inc. 4134 N Vancouver Ave, Ste 105 Portland, or 97217 Timing: Fiscal Year 2004; Project Start 15-MAR-2004; Project End 14-MAR-2005 Summary: (provided by applicant): The primary future research requirements for control of vectors of Chagas disease are: 1) Better control techniques, 2) Better vector sampling techniques, 3) Better organization of epidemiological surveillance. This proposal aims to provide the improved vector surveillance technology and new vector control techniques that are imperative to long term management of Chagas disease. The goals of this Phase I SBIR are: 1) to develop known kissing bug attractants into a functional lure system, 2) analyze bug behavior, 3) utilize behavioral information to interface the lure with existing or modified passive triatomine traps to form baited traps, 4) demonstrate the efficacy of attractant-baited traps compared to existing passive traps. Chagas disease is the most serious parasitic disease of Latin America. The World Bank has calculated an annual loss due to Chagas disease to the endemic countries of Latin America equivalent to over US $6.5 billion per year. Control of Chagas disease is now given high priority by Latin American governments. The acute research need for vector control has been identified as improved surveillance. IPM Tech proposes that bug attractants combined with improved trap designs will greatly improve the effectiveness and efficiency of the present inadequate survey activities. The introduction of attractants will also enhance the ability to introduce transgenic lethal symbiotic bacteria [genetically

Studies

17

modified symbiotic bacteria which produce a product that kills the trypanosome causative agent of Chagas disease] into the environment. Attractant-baited kill stations will directly reduce bug populations. Research and development in this area presents commercial opportunities for both surveillance and control technology. The WHO Division of Control of Tropical Diseases control strategy for the elimination of Chagas Disease over the period 1996-2010 is based in part on the interruption of transmission. Robust surveillance is essential to measure the true efficacy of this program. Continued monitoring programs are required to ensure early detection and elimination of reinfestations of the vectors. These factors provide a basis for a continued market for a good surveillance and vector suppression tool. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TROPICAL DISEASES SYMPOSIUM Principal Investigator & Institution: Hill, George C.; Levi Watkins, Jr. Professor and Associat; Microbiology; Meharry Medical College 1005-D B Todd Blvd Nashville, Tn 37208 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (provided by applicant): This proposal requests five-year support for a symposium entitled "Recent Advances in the Immunology, Biochemistry and Molecular Biology of Tropical Diseases". The first symposium of this series will be held at Meharry Medical College, Nashville, Tennessee, on Monday and Tuesday, April 2-3, 2001, and will be entitled "Molecular Biology of Tropical Diseases International Health". The goals of these symposia are threefold: 1. To increase the opportunity for interaction among scientists investigating various organisms which cause tropical diseases. Immunologists, biochemists, molecular biologists and cell biologist come together to discuss recent advances in their area and consider future directions of research. 2. To continue to attract minority students from historically black colleges and universities to Meharry Medical College in order to simulate their interest in research in the biomedical sciences as well as in various areas of tropical diseases. 3. To provide a forum for discussion of Tropical Diseases and International Health and the role minority scientists can play in this effort. The symposia will be sponsored by the Division of Sponsored Research, School of Graduate Studies and Research and the Department of Microbiology at Meharry Medical College. As part of this conference, undergraduate and graduate students from historically black colleges and universities will be encouraged to attend and present posters on research that they are undertaking in various laboratories and discuss ongoing research at our institution. The symposium will include six invited lecturers in various areas in tropical diseases covering areas such as African trypanosomiasis, schistosomiasis, malaria, leishmaniasis, leprosy, and Chagas disease. Ample time will be available for discussions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National

3

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

18

Chagas Disease

Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “Chagas disease” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for Chagas disease in the PubMed Central database: •

"Autoimmune rejection" of neonatal heart transplants in experimental Chagas disease is a parasite-specific response to infected host tissue. by Tarleton RL, Zhang L, Downs MO.; 1997 Apr 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=20545

•

Antibodies to ribosomal P proteins of Trypanosoma cruzi in Chagas disease possess functional autoreactivity with heart tissue and differ from anti-P autoantibodies in lupus. by Kaplan D, Ferrari I, Bergami PL, Mahler E, Levitus G, Chiale P, Hoebeke J, Van Regenmortel MH, Levin MJ.; 1997 Sep 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=23357

•

Autoimmunity in Chagas Disease Cardiopathy: Biological Relevance of a Cardiac Myosin-Specific Epitope Crossreactive to an Immunodominant Trypanosoma cruzi Antigen. by Cunha-Neto E, Duranti M, Gruber A, Zingales B, de Messias I, Stolf N, Bellotti G, Patarroyo ME, Pilleggi F, Kalil J.; 1995 Apr 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=42203

•

Diagnosis of American trypanosomiasis (Chagas' disease) by the new complement fixation test. by Garcia E, Ramirez LE, Monteon V, Sotelo J.; 1995 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=228096

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

4

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

Studies

19

synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Chagas disease (hyperlinks lead to article summaries): •

"Subversive" substrates for the enzyme trypanothione disulfide reductase: alternative approach to chemotherapy of Chagas disease. Author(s): Henderson GB, Ulrich P, Fairlamb AH, Rosenberg I, Pereira M, Sela M, Cerami A. Source: Proceedings of the National Academy of Sciences of the United States of America. 1988 August; 85(15): 5374-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3135548

•

A B-cell activator in Chagas disease. Author(s): Kelly JM. Source: Nature Medicine. 2000 August; 6(8): 865-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10932219

•

A case of megacolon in Rio Grande valley as a possible case of Chagas disease. Author(s): Reinhard K, Fink TM, Skiles J. Source: Memorias Do Instituto Oswaldo Cruz. 2003; 98 Suppl 1: 165-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12687778

•

A comparison of the molecular biology of trypanosomes and leishmaniae, and its impact on the development of methods for the diagnosis and vaccination of leishmaniasis and Chagas disease. Author(s): O'Daly JA. Source: Biol Res. 1993; 26(1-2): 219-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7670534

•

A cost-benefit analysis of Chagas disease control in north-western Argentina. Author(s): Basombrio MA, Schofield CJ, Rojas CL, del Rey EC. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1998 March-April; 92(2): 137-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9764315

•

A cost-benefit analysis of Chagas disease control. Author(s): Schofield CJ, Dias JC. Source: Memorias Do Instituto Oswaldo Cruz. 1991 July-September; 86(3): 285-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1842419

•

A critical review on Chagas disease chemotherapy. Author(s): Rodriques Coura J, de Castro SL. Source: Memorias Do Instituto Oswaldo Cruz. 2002 January; 97(1): 3-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11992141

20

Chagas Disease

•

A model for Chagas disease involving transmission by vectors and blood transfusion. Author(s): Velasco-Hernandez JX. Source: Theoretical Population Biology. 1994 August; 46(1): 1-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8079195

•

A quasi-experimental epidemiological model for evaluating public health programmes: efficacy of a Chagas disease control programme in Brazil. Author(s): Carneiro M, Antunes CM. Source: Bulletin of the World Health Organization. 1994; 72(5): 721-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7955020

•

Absence of a proven resurgence of Chagas disease or cutaneous leishmaniasis in French Guiana over the last two decades. Author(s): Carme B, Aznar C, Pradinaud R. Source: Annals of Tropical Medicine and Parasitology. 2001 September; 95(6): 623-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11672468

•

alpha 4 Integrins and sialyl Lewis x modulation in chronic Chagas disease: further evidence of persistent immune activation. Author(s): Laucella SA, Riarte A, Prado N, Zapata J, Segura EL. Source: Scandinavian Journal of Immunology. 2001 May; 53(5): 514-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11309161

•

American trypanosomiasis: Chagas disease an emerging zoonotic threat in Oklahoma? Author(s): Bradley KK. Source: J Okla State Med Assoc. 1997 July-August; 90(6): 253-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9299897

•

An experimental and clinical assay with ketoconazole in the treatment of Chagas disease. Author(s): Brener Z, Cancado JR, Galvao LM, da Luz ZM, Filardi Lde S, Pereira ME, Santos LM, Cancado CB. Source: Memorias Do Instituto Oswaldo Cruz. 1993 January-March; 88(1): 149-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8246750

Studies

21

•

Antibodies to ribosomal P proteins of Trypanosoma cruzi in Chagas disease possess functional autoreactivity with heart tissue and differ from anti-P autoantibodies in lupus. Author(s): Kaplan D, Ferrari I, Bergami PL, Mahler E, Levitus G, Chiale P, Hoebeke J, Van Regenmortel MH, Levin MJ. Source: Proceedings of the National Academy of Sciences of the United States of America. 1997 September 16; 94(19): 10301-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9294205

•

Antibody-dependent cellular cytotoxicity in chronic human Chagas disease. Author(s): Voltarelli JC, Falcao RP, Santana da Silva J. Source: Parasite Immunology. 1983 July; 5(4): 377-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6413935

•

Anti-heart autoantibodies are more frequently present in Chagas disease patients with dilated cardiomyopathy. Author(s): Nava A, Reyes PA, Monteon V, Raymond Y. Source: The American Journal of Cardiology. 1997 December 15; 80(12): 1646-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9416965

•

Anti-laminin and specific antibodies in acute Chagas disease. Author(s): Gazzinelli R, Galvao LM, Dias JC, Gazzinelli G, Brener Z. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1988; 82(4): 574-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3151413

•

Association of Chagas disease and cancer. Author(s): Sacerdote de Lustig E, Puricelli L, Bal E, Lansetti JC. Source: Medicina (B Aires). 1980 January-February; 40(1): 43-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6776385

•

Autoantibodies in the sera of Trypanosoma cruzi-infected individuals with or without clinical Chagas disease. Author(s): Unterkircher C, Avrameas S, Ternynck T. Source: Journal of Clinical Laboratory Analysis. 1993; 7(1): 60-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8426274

22

Chagas Disease

•

Autoimmunity in Chagas disease cardiopathy: biological relevance of a cardiac myosin-specific epitope crossreactive to an immunodominant Trypanosoma cruzi antigen. Author(s): Cunha-Neto E, Duranti M, Gruber A, Zingales B, De Messias I, Stolf N, Bellotti G, Patarroyo ME, Pilleggi F, Kalil J. Source: Proceedings of the National Academy of Sciences of the United States of America. 1995 April 11; 92(8): 3541-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7536937

•

Autonomic dysfunction in Chagas disease: lack of participation of the vagus nerve. Author(s): Mahler-Araujo MB, Chimelli L. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2000 JulyAugust; 94(4): 405-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11127245

•

Bacterial symbionts of the triatominae and their potential use in control of Chagas disease transmission. Author(s): Beard CB, Cordon-Rosales C, Durvasula RV. Source: Annual Review of Entomology. 2002; 47: 123-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11729071

•

Bacterial symbiosis and paratransgenic control of vector-borne Chagas disease. Author(s): Beard CB, Dotson EM, Pennington PM, Eichler S, Cordon-Rosales C, Durvasula RV. Source: International Journal for Parasitology. 2001 May 1; 31(5-6): 621-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11334952

•

Beauveria bassiana (Hyphomycetes) as a possible agent for biological control of Chagas disease vectors. Author(s): Luz C, Silva IG, Cordeiro CM, Tigano MS. Source: Journal of Medical Entomology. 1998 November; 35(6): 977-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9835689

•

Blood concentration method in the diagnosis of Chagas disease. Author(s): Cedillos RA, De Dimas D, De Hernandez AY. Source: Rev Latinoam Microbiol. 1970 October-December; 12(4): 200-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4993906

Studies

23

•

Blood host sources of Mepraia spinolai (Heteroptera: Reduviidae), wild vector of Chagas disease in Chile. Author(s): Canals M, Cruzat L, Molina MC, Ferreira A, Cattan PE. Source: Journal of Medical Entomology. 2001 March; 38(2): 303-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11296839

•

Bloodstream Trypanosoma cruzi parasites from mice simultaneously express antigens that are markers of acute and chronic human Chagas disease. Author(s): Leguizamon MS, Campetella OE, Reyes MB, Ibanez CF, Basombrio MA, Rincon J, Orn A, Frasch AC. Source: Parasitology. 1991 June; 102 Pt 3: 379-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1907729

•

Case report: the first parasitologically confirmed autochthonous case of acute Chagas disease in Suriname. Author(s): Oostburg BF, Anijs JE, Oehlers GP, Hiwat HO, Burke-Hermelijn SM. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2003 March-April; 97(2): 166-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14584370

•

Chagas disease and human migration. Author(s): Guhl F, Jaramillo C, Vallejo GA, Cardenas A-Arroyo F, Aufderheide A. Source: Memorias Do Instituto Oswaldo Cruz. 2000 July-August; 95(4): 553-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10904414

•

Chagas disease and immunosuppression. Author(s): Ferreira MS. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 325-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677748

•

Chagas disease and kidney transplantation. Author(s): Aulet F, Riarte A, Pattin M, Segura EL, Vazquez M. Source: Transplantation Proceedings. 1991 October; 23(5): 2653. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1926519

•

Chagas disease and transplantation. Author(s): Vazquez MC, Sabbatiello R, Schiavelli R, Maiolo E, Jacob N, Pattin M, Rearte A. Source: Transplantation Proceedings. 1996 December; 28(6): 3301-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8962281

24

Chagas Disease

•

Chagas disease control in Brazil: which strategy after the attack phase? Author(s): Dias JC. Source: Ann Soc Belg Med Trop. 1991; 71 Suppl 1: 75-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1793283

•

Chagas Disease Control Programme in Brazil: a study of the effectiveness of 13 years of intervention. Author(s): Costa FC, Vitor RW, Antunes CM, Carneiro M. Source: Bulletin of the World Health Organization. 1998; 76(4): 385-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9803589

•

Chagas disease diagnosis using polymerase chain reaction, hemoculture and serologic methods. Author(s): Chiari E. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 299-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677740

•

Chagas disease etiology: autoimmunity or parasite persistence? Author(s): Tarleton RL, Zhang L. Source: Parasitology Today (Personal Ed.). 1999 March; 15(3): 94-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10322321

•

Chagas disease in a community in southeast Brazil. I. A serologic follow-up study on a vector controlled area. Author(s): Montoya R, Dias JC, Coura JR. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2003 SeptemberOctober; 45(5): 269-74. Epub 2003 November 12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14743667

•

Chagas disease in an area of recent occupation in Cochabamba, Bolivia. Author(s): Albarracin-Veizaga H, de Carvalho ME, Nascimento EM, Rodrigues VL, Casanova C, Barata JM. Source: Revista De Saude Publica. 1999 June; 33(3): 230-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10456995

•

Chagas disease in dogs from endemic areas of Costa Rica. Author(s): Montenegro VM, Jimenez M, Dias JC, Zeledon R. Source: Memorias Do Instituto Oswaldo Cruz. 2002 June; 97(4): 491-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12118277

Studies

25

•

Chagas disease in Ecuador: a sylvatic focus in the Amazon region. Author(s): Amunarriz M, Chico ME, Guderian RH. Source: J Trop Med Hyg. 1991 June; 94(3): 145-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1904944

•

Chagas disease in Ecuador: evidence for disease transmission in an Indigenous population in the Amazon region. Author(s): Chico M, Sandoval C, Guevara A, Calvopina M, Cooper PJ, Reed SG, Guderian RH. Source: Memorias Do Instituto Oswaldo Cruz. 1997 May-June; 92(3): 317-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9332593

•

Chagas disease in north-west Argentina: infected dogs as a risk factor for the domestic transmission of Trypanosoma cruzi. Author(s): Gurtler RE, Cecere MC, Rubel DN, Petersen RM, Schweigmann NJ, Lauricella MA, Bujas MA, Segura EL, Wisnivesky-Colli C. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1991 November-December; 85(6): 741-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1801342

•

Chagas disease in pregnancy. Author(s): Gilson GJ, Harner KA, Abrams J, Izquierdo LA, Curet LB. Source: Obstetrics and Gynecology. 1995 October; 86(4 Pt 2): 646-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7675398

•

Chagas disease in the Amazon Basin: association of Panstrongylus geniculatus (Hemiptera: Reduviidae) with domestic pigs. Author(s): Valente VC, Valente SA, Noireau F, Carrasco HJ, Miles MA. Source: Journal of Medical Entomology. 1998 March; 35(2): 99-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9538568

•

Chagas disease in the Brazilian Amazon: IV. a new cross-sectional study. Author(s): Coura JR, Junqueira AC, Boia MN, Fernandes O, Bonfante C, Campos JE, Santos L, Devera R. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2002 May-June; 44(3): 159-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12163910

•

Chagas disease of the colon and rectum. Author(s): Todd IP, Porter NH, Morson BC, Smith B, Friedmann CA, Neal RA. Source: Gut. 1969 December; 10(12): 1009-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4243829

26

Chagas Disease

•

Chagas disease or American trypanosomiasis. Author(s): Ben Beard C. Source: Bulletin of the World Health Organization. 1998; 76 Suppl 2: 144. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10063697

•

Chagas disease prevention through improved housing using an ecosystem approach to health. Author(s): Rojas-De-Arias A. Source: Cadernos De Saude Publica / Ministerio Da Saude, Fundacao Oswaldo Cruz, Escola Nacional De Saude Publica. 2001; 17 Suppl: 89-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11426269

•

Chagas disease surgery. Author(s): da Silva AL. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 343-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677753

•

Chagas disease vector control in Tupiza, southern Bolivia. Author(s): Guillen G, Diaz R, Jemio A, Cassab JA, Pinto CT, Schofield CJ. Source: Memorias Do Instituto Oswaldo Cruz. 1997 January-February; 92(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9302405

•

Chagas disease vector control through different intervention modalities in endemic localities of Paraguay. Author(s): Rojas de Arias A, Ferro EA, Ferreira ME, Simancas LC. Source: Bulletin of the World Health Organization. 1999; 77(4): 331-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10327712

•

Chagas disease, from discovery to control - and beyond: history, myths and lessons to take home. Author(s): Morel CM. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 3-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677688

•

Chagas disease, triatomine bugs, and bloodloss. Author(s): Schofield CJ. Source: Lancet. 1981 June 13; 1(8233): 1316. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6112630

Studies

27

•

Chagas disease. Author(s): Goldrick BA. Source: The American Journal of Nursing. 2004 March; 104(3): 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15108566

•

Chagas disease. Author(s): Morel CM, Lazdins J. Source: Nat Rev Microbiol. 2003 October; 1(1): 14-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15040175

•

Chagas disease. American trypanosomiasis. Author(s): Kirchhoff LV. Source: Infectious Disease Clinics of North America. 1993 September; 7(3): 487-502. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8254156

•

Chagas disease. First congenital case report. Author(s): Guzman-Bracho C, Lahuerta S, Velasco-Castrejon O. Source: Archives of Medical Research. 1998 Summer; 29(2): 195-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9650338

•

Chagas disease: a role for autoimmunity? Author(s): Tarleton RL. Source: Trends in Parasitology. 2003 October; 19(10): 447-51. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14519582

•

Chagas disease: an old entity in new places. Author(s): Wendel S. Source: Int J Artif Organs. 1993 March; 16(3): 117-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8314632

•

Chagas disease: another cause of cerebral mass in AIDS. Author(s): del Castillo M, Silva M. Source: The American Journal of Medicine. 1994 March; 96(3): 301-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8154522

•

Chagas disease: criteria of cure and prognosis. Author(s): Gontijo ED, Galvao LM, Eloi-Santos S. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 357-62. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677755

28

Chagas Disease

•

Chagas disease: current epidemiological trends after the interruption of vectorial and transfusional transmission in the Southern Cone countries. Author(s): Moncayo A. Source: Memorias Do Instituto Oswaldo Cruz. 2003 July; 98(5): 577-91. Epub 2003 September 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12973523

•

Chagas disease: epidemiology and prospects for interruption of transmission in the Americas. Author(s): Moncayo A. Source: World Health Stat Q. 1992; 45(2-3): 276-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1462661

•

Chagas disease: from bush to huts and houses. Is it the case of the Brazilian Amazon? Author(s): Coura JR, Junqueira AC, Boia MN, Fernandes O. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 379-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677760

•

Chagas disease: mononuclear cell infiltration but no trypanosomes in the coronary sinus and cardiac veins of chronic patients. Author(s): Franca Lde A, Rocha A, Barbosa AJ, Lopes ER. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1997 JulyAugust; 91(4): 432. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9373643

•

Chagas disease: recombinant Trypanosoma cruzi antigens for serological diagnosis. Author(s): da Silveira JF, Umezawa ES, Luquetti AO. Source: Trends in Parasitology. 2001 June; 17(6): 286-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11378036

•

Chagas disease--a recent meeting on practical aspects. Applied meeting of Chagas disease 4-6 November 1993, Uberaba, Brazil. Author(s): Luquetti AO. Source: International Journal for Parasitology. 1995 July; 25(7): 869-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7558577

•

Changes in isotype composition and antigen recognition of anti-Trypanosoma cruzi antibodies from acute to chronic Chagas disease. Author(s): Umezawa ES, Shikanai-Yasuda MA, Stolf AM. Source: Journal of Clinical Laboratory Analysis. 1996; 10(6): 407-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8951611

Studies

29

•

Characterization of Paraguayan Trypanosoma cruzi strains isolated from acute patients of Chagas disease. Author(s): Acosta N, Maldonado M, Sanabria L, Yaluff G, Fuentes S, Torres S, Ferreira ME, Rojas de Arias A, Shozawa T. Source: Trop Med Parasitol. 1995 September; 46(3): 195-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8533024

•

Chemical control of Chagas disease vectors. Author(s): Zerba EN. Source: Biomed Environ Sci. 1989 March; 2(1): 24-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2511898

•

Chemical ecology of triatomine bugs: vectors of Chagas disease. Author(s): Cruz-Lopez L, Malo EA, Rojas JC, Morgan ED. Source: Medical and Veterinary Entomology. 2001 December; 15(4): 351-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11776453

•

Chemokine receptor expression on the surface of peripheral blood mononuclear cells in Chagas disease. Author(s): Talvani A, Rocha MO, Ribeiro AL, Correa-Oliveira R, Teixeira MM. Source: The Journal of Infectious Diseases. 2004 January 15; 189(2): 214-20. Epub 2004 Jan 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722885

•

Chemotherapy of Chagas disease. Author(s): Urbina JA. Source: Current Pharmaceutical Design. 2002; 8(4): 287-95. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11860367

•

Circulating antibodies to mouse laminin in Chagas disease, American cutaneous leishmaniasis, and normal individuals recognize terminal galactosyl(alpha 1-3)galactose epitopes. Author(s): Towbin H, Rosenfelder G, Wieslander J, Avila JL, Rojas M, Szarfman A, Esser K, Nowack H, Timpl R. Source: The Journal of Experimental Medicine. 1987 August 1; 166(2): 419-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2439642

•

Climatic factors related to Chagas disease transmission. Author(s): Carcavallo RU. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 367-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677757

30

Chagas Disease

•

Clinical and epidemiological aspects of Chagas disease. Author(s): Prata A. Source: The Lancet Infectious Diseases. 2001 September; 1(2): 92-100. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11871482

•

Clinical evolution and morbi-mortality in Chagas disease. Author(s): Chapadeiro E. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 309-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677744

•

Clinical manifestations of peripheral nervous system involvement in human chronic Chagas disease. Author(s): Genovese O, Ballario C, Storino R, Segura E, Sica RE. Source: Arquivos De Neuro-Psiquiatria. 1996 June; 54(2): 190-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8984973

•

Clinical treatment of the digestive form of Chagas disease. Author(s): Meneghelli UG. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 341-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677752

•

Clinical trial of benznidazole and an immunopotentiator against Chagas disease in Chile. Author(s): Apt W, Arribada A, Arab F, Ugarte JM, Luksic I, Sole C. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1986; 80(6): 1010. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3299901

•

Comparative kinetics of bloodmeal intake by Triatoma infestans and Rhodnius prolixus, the two principal vectors of Chagas disease. Author(s): Pereira H, Penido CM, Martins MS, Diotaiuti L. Source: Medical and Veterinary Entomology. 1998 January; 12(1): 84-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9513943

•

Comparison of the complement fixation test and counterelectrophoresis test for the detection of antibodies in Chagas disease. Author(s): Knight RA, Rocha H, Kaye D. Source: Journal of Clinical Microbiology. 1976 January; 3(1): 67-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=815268

Studies

31

•

Comparison of the polymerase chain reaction with two classical parasitological methods for the diagnosis of Chagas disease in an endemic region of north-eastern Brazil. Author(s): Junqueira AC, Chiari E, Wincker P. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1996 March-April; 90(2): 129-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8761570

•

Comparisons of immunological tests for serodiagnosis of Chagas disease in Bolivian patients. Author(s): Breniere SF, Carrasco R, Miguez H, Lemesre JL, Carlier Y. Source: Trop Geogr Med. 1985 September; 37(3): 231-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3934814

•

Congenital Chagas disease of second generation in Santiago, Chile. Report of two cases. Author(s): Schenone H, Gaggero M, Sapunar J, Contreras MC, Rojas A. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2001 July-August; 43(4): 231-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11558005

•

Congenital Chagas disease. Author(s): Bittencourt AL. Source: Am J Dis Child. 1976 January; 130(1): 97-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=813519

•

Considerations on the epidemiology and transmission of Chagas disease in the Brazilian Amazon. Author(s): da Silva Valente SA, de Costa Valente V, Neto HF. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 395-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677763

•

Control of Chagas disease vectors. Author(s): Ramsey JM, Schofield CJ. Source: Salud Publica De Mexico. 2003 March-April; 45(2): 123-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12736992

•

Control of Chagas disease. Author(s): WHO Expert Committee. Source: World Health Organ Tech Rep Ser. 2002; 905: I-Vi, 1-109, Back Cover. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12092045

32

Chagas Disease

•

Criteria of Chagas disease cure. Author(s): Cancado JR. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 331-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677750

•

Cutaneous manifestation of reactivation of Chagas disease in a renal transplant patient: long-term follow-up. Author(s): La Forgia MP, Pellerano G, de las Mercedes Portaluppi M, Kien MC, Chouela EN. Source: Archives of Dermatology. 2003 January; 139(1): 104-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12533185

•

Decreased CD4(+) circulating T lymphocytes in patients with gastrointestinal Chagas disease. Author(s): Lemos EM, Reis D, Adad SJ, Silva GC, Crema E, Correa-Oliveira R. Source: Clinical Immunology and Immunopathology. 1998 August; 88(2): 150-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9714692

•

Density estimates of the domestic vector of Chagas disease, Rhodnius prolixus Stal (Hemiptera: Reduviidae), in rural houses in Venezuela. Author(s): Rabinovich JE, Gurtler RE, Leal JA, Feliciangeli D. Source: Bulletin of the World Health Organization. 1995; 73(3): 347-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7614667

•

Depression of blood monocytes chemotaxis in human chronic Chagas disease. Author(s): Ferreira GG, Argueles E, Oliveira-Lima A. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 1979 NovemberDecember; 21(6): 297-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=121632

•

Detecting domestic vectors of Chagas disease: a comparative trial of six methods in north-west Argentina. Author(s): Gurtler RE, Chuit R, Cecere MC, Castanera MB. Source: Bulletin of the World Health Organization. 1995; 73(4): 487-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7554021

•

Detection and significance of inapparent infection in Chagas disease in western Venezuela. Author(s): Anez N, Crisante G, Rojas A, Carrasco H, Parada H, Yepez Y, Borges R, Guevara P, Ramirez JL. Source: The American Journal of Tropical Medicine and Hygiene. 2001 September; 65(3): 227-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11561709

Studies

33

•

Determinants of the domiciliary density of Triatoma infestans, vector of Chagas disease. Author(s): Gurtler RE, Cecere MC, Rubel DN, Schweigmann NJ. Source: Medical and Veterinary Entomology. 1992 January; 6(1): 75-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1600232

•

Development in the etiologic diagnosis of Chagas disease. Author(s): Camargo ME. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 281-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677735

•

Differential regulation of lymphoproliferative responses to Trypanosoma cruzi antigen in patients with the cardiac or indeterminate form of Chagas disease. Author(s): de Barros-Mazon S, Guariento ME, da Silva CA, Coffman RL, Abrahamsohn IA. Source: Clinical Immunology (Orlando, Fla.). 2004 April; 111(1): 137-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15093563

•

Distribution of domestic triatominae and stratification of Chagas Disease transmission in Oaxaca, Mexico. Author(s): Ramsey JM, Ordonez R, Cruz-Celis A, Alvear AL, Chavez V, Lopez R, Pintor JR, Gama F, Carrillo S. Source: Medical and Veterinary Entomology. 2000 March; 14(1): 19-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10759308

•

Diversity of Trypanosoma cruzi stocks and clones derived from Chagas disease patients. II. Isozyme and RFLP characterizations. Author(s): Lauria-Pires L, Bogliolo AR, Teixeira AR. Source: Experimental Parasitology. 1996 March; 82(2): 182-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8617345

•

Diversity of Trypanosoma cruzi stocks and clones derived from Chagas disease patients: I--Behavioral characterization in vitro. Author(s): Lauria-Pires L, Santana JM, Tavares FS, Teixeira AR. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 1997 May-June; 30(3): 187-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9197152

•

Ecologic niche modeling and potential reservoirs for Chagas disease, Mexico. Author(s): Peterson AT, Sanchez-Cordero V, Beard CB, Ramsey JM. Source: Emerging Infectious Diseases. 2002 July; 8(7): 662-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12095431

34

Chagas Disease

•

Effect of itraconazole on lytic antibodies levels in chronic Chagas disease. Author(s): Venegas J, Zulantay I, Apt W, Solari A, Diaz E, Sanchez G. Source: Parasite. 1997 September; 4(3): 259-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9587610

•

Effects of complement depletion in experimental Chagas disease: immune lysis of virulent blood forms of Trypanosoma cruzi. Author(s): Budzko DB, Pizzimenti MC, Kierszenbaum F. Source: Infection and Immunity. 1975 January; 11(1): 86-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=46840

•

Elimination of the vectorial transmission of Chagas disease in Central American countries: Honduras. Author(s): Ponce C. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 417-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677768

•

Elimination of vector-borne transmission of Chagas disease. Author(s): Silveira A, Vinhaes M. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 405-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677766

•

Emerging Chagas disease in Amazonian Brazil. Author(s): Coura JR, Junqueira AC, Fernandes O, Valente SA, Miles MA. Source: Trends in Parasitology. 2002 April; 18(4): 171-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11998705

•

Emerging Chagas disease: trophic network and cycle of transmission of Trypanosoma cruzi from palm trees in the Amazon. Author(s): Teixeira AR, Monteiro PS, Rebelo JM, Arganaraz ER, Vieira D, Lauria-Pires L, Nascimento R, Vexenat CA, Silva AR, Ault SK, Costa JM. Source: Emerging Infectious Diseases. 2001 January-February; 7(1): 100-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11266300

•

Epidemiology and dynamics of the vectorial transmission of Chagas disease. Author(s): Sherlock IA. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 385-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677761

Studies

35

•

Epidemiology of Chagas disease in Ecuador. A brief review. Author(s): Aguilar V HM, Abad-Franch F, Racines V J, Paucar C A. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 387-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677762

•

Epidemiology of Chagas disease in Guatemala: infection rate of Triatoma dimidiata, Triatoma nitida and Rhodnius prolixus (Hemiptera, Reduviidae) with Trypanosoma cruzi and Trypanosoma rangeli (Kinetoplastida, Trypanosomatidae). Author(s): Monroy C, Rodas A, Mejia M, Rosales R, Tabaru Y. Source: Memorias Do Instituto Oswaldo Cruz. 2003 April; 98(3): 305-10. Epub 2003 July 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886407

•

Epidemiology of Chagas disease in Mexico: an update. Author(s): Guzman-Bracho C. Source: Trends in Parasitology. 2001 August; 17(8): 372-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11685897

•

Epitopes common to Trypanosoma cruzi and mammalian tissues are recognized by sera from Chagas' disease patients: prognosis value in Chagas disease. Author(s): Laucella SA, de Titto EH, Segura EL. Source: Acta Tropica. 1996 December 16; 62(3): 151-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9025983

•

Epizootiology of Chagas disease near a forest settlement in French Guiana. Author(s): Julien-Laferriere D, Esterre P, Frenay C, Dedet JP. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1989 March-April; 83(2): 202-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2514472

•

Etiological treatment of chronic Chagas disease. Author(s): Cancado JR. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2001 May-June; 43(3): 173-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452329

•

Etiology of Chagas disease myocarditis: autoimmunity, parasite persistence, or both? Author(s): Girones N, Fresno M. Source: Trends in Parasitology. 2003 January; 19(1): 19-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12488221

36

Chagas Disease

•

Evaluation of a synthetic tripeptide as antigen for detection of IgM and IgG antibodies to Trypanosoma cruzi in serum samples from patients with Chagas disease or viral diseases. Author(s): Betonico GN, Miranda EO, Silva DA, Houghton R, Reed SG, Campos-Neto A, Mineo JR. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1999 November-December; 93(6): 603-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10717744

•

Evaluation of oral mucosal transudate for immunodiagnosis of Chagas disease. Author(s): Barros M, Duarte Neto AN, Pereira VR, Nakazawa M, Souza WV, Gomes YM, Martinez R. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 1999 July-August; 41(4): 265-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10564924

•

Evaluation of the interaction of leucocytes from Chagas disease patients with trypomastigotes of Trypanosoma cruzi. Author(s): Mosca W, Castes M, Ojeda A, Homsi AE. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1986; 80(6): 975-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3111032

•

Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery. Author(s): Prata A. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 81-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677694

•

Evolution on the immunopathology of Chagas disease. Author(s): Sadigursky M. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 277-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677733

•

Exercise performance and skeletal muscles in patients with advanced Chagas disease. Author(s): Montes de Oca M, Torres SH, Loyo JG, Vazquez F, Hernandez N, Anchustegui B, Puigbo JJ. Source: Chest. 2004 April; 125(4): 1306-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15078739

Studies

37

•

Experimental Chagas disease: phagocytosis of apoptotic lymphocytes deactivates macrophages and fuels parasite growth. Author(s): Lopes MF, DosReis GA. Source: Apoptosis : an International Journal on Programmed Cell Death. 2000 June; 5(3): 221-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11225843

•

Experimental Chagas disease: the influence of sex and psychoneuroimmunological factors. Author(s): Schuster JP, Schaub GA. Source: Parasitology Research. 2001 December; 87(12): 994-1000. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11763443

•

Frequency of interferon- gamma -producing T cells specific for Trypanosoma cruzi inversely correlates with disease severity in chronic human Chagas disease. Author(s): Laucella SA, Postan M, Martin D, Hubby Fralish B, Albareda MC, Alvarez MG, Lococo B, Barbieri G, Viotti RJ, Tarleton RL. Source: The Journal of Infectious Diseases. 2004 March 1; 189(5): 909-18. Epub 2004 February 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14976609

•

Genetic characterization of Trypanosoma cruzi directly from tissues of patients with chronic Chagas disease: differential distribution of genetic types into diverse organs. Author(s): Vago AR, Andrade LO, Leite AA, d'Avila Reis D, Macedo AM, Adad SJ, Tostes S Jr, Moreira MC, Filho GB, Pena SD. Source: American Journal of Pathology. 2000 May; 156(5): 1805-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10793092

•

Geriatrics photo quiz. Chagas disease. Author(s): Shua-Haim JR, Ross JS, Cunha UG, Silva JH. Source: Geriatrics. 1999 October; 54(10): 19, 58-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10542856

•

Glycoconjugates of Trypanosoma cruzi: a 74 kD antigen of trypomastigotes specifically reacts with lytic anti-alpha-galactosyl antibodies from patients with chronic Chagas disease. Author(s): Almeida IC, Krautz GM, Krettli AU, Travassos LR. Source: Journal of Clinical Laboratory Analysis. 1993; 7(6): 307-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8277354

38

Chagas Disease

•

Heart rate turbulence in Chagas disease. Author(s): Ribeiro AL, Schmidt G, Sousa MR, Lombardi F, Gomes ME, Perez AA, Barros MV, Machado FS, Rocha MO. Source: Pacing and Clinical Electrophysiology : Pace. 2003 January; 26(1 Pt 2): 406-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12687855

•

High prevalence of Trypanosoma rangeli and Trypanosoma cruzi in opossums and triatomids in a formerly-endemic area of Chagas disease in Southeast Brazil. Author(s): Ramirez LE, Lages-Silva E, Alvarenga-Franco F, Matos A, Vargas N, Fernandes O, Zingales B. Source: Acta Tropica. 2002 December; 84(3): 189-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12443797

•

Histopathology of specialized and ordinary myocardium and nerves in chronic Chagas disease, with a morphometric study of inflammation and fibrosis. Author(s): Milei J, Storino RA, Beigelman R, Fernandez Alonso G, Matturri L, Rossi L. Source: Cardiologia. 1991 February; 36(2): 107-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1836420

•

Histopathology of the heart conducting system in experimental Chagas disease in mice. Author(s): Molina HA, Milei J, Rimoldi MT, Gonzalez Cappa SM, Storino RA. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1988; 82(2): 241-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3142113

•

HLA and beta-myosin heavy chain do not influence susceptibility to Chagas disease cardiomyopathy. Author(s): Fae KC, Drigo SA, Cunha-Neto E, Ianni B, Mady C, Kalil J, Goldberg AC. Source: Microbes and Infection / Institut Pasteur. 2000 June; 2(7): 745-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10955954

•

HLA-C(*)03 is a risk factor for cardiomyopathy in Chagas disease. Author(s): Layrisse Z, Fernandez MT, Montagnani S, Matos M, Balbas O, Herrera F, Colorado IA, Catalioti F, Acquatella H. Source: Human Immunology. 2000 September; 61(9): 925-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11053636

•

Human behaviour and the propagation of Chagas disease. Author(s): Miles MA. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1977; 70(56): 521-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=402723

Studies

39

•

Humoral immune response to cruzipain and cardiac dysfunction in chronic Chagas disease. Author(s): Duschak VG, Riarte A, Segura EL, Laucella SA. Source: Immunology Letters. 2001 October 1; 78(3): 135-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11578687

•

Identification of Trypanosoma cruzi in human tissues using an immunoperoxidase method: study of acute Chagas disease, congenital form. Author(s): Landman G, Correa Alves A, Mendes NF, Mendes E. Source: Allergologia Et Immunopathologia. 1986 November-December; 14(6): 509-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2435138

•

Immune response in human Chagas disease II. Lymphocyte blastogenesis in patients with chagasic cardiomyopathy. Author(s): Mosca W. Source: Acta Cient Venez. 1980; 31(5): 464-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7034436

•

Immunoassay with recombinant Trypanosoma cruzi antigens potentially useful for screening donated blood and diagnosing Chagas disease. Author(s): Pastini AC, Iglesias SR, Carricarte VC, Guerin ME, Sanchez DO, Frasch AC. Source: Clinical Chemistry. 1994 October; 40(10): 1893-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7923768

•

Immunoglobulin concentration in treated human acute Chagas disease. A follow-up study. Author(s): Schmunis GA, Szarfman A, Coarasa L, Vainstok C. Source: The American Journal of Tropical Medicine and Hygiene. 1978 May; 27(3): 473-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=98063

•

Immunopathology of Chagas disease - a historical overview. Author(s): Tafuri WL. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 247-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677726

•

Immunosuppression in human acute Chagas disease. Author(s): Voltarelli JC, Donadi EA, Falcao RP. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1987; 81(1): 169-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3127955

40

Chagas Disease

•

Implication of transforming growth factor-beta1 in Chagas disease myocardiopathy. Author(s): Araujo-Jorge TC, Waghabi MC, Hasslocher-Moreno AM, Xavier SS, Higuchi Mde L, Keramidas M, Bailly S, Feige JJ. Source: The Journal of Infectious Diseases. 2002 December 15; 186(12): 1823-8. Epub 2002 November 22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12447769

•

Increased plasma levels of tumor necrosis factor-alpha in asymptomatic/"indeterminate" and Chagas disease cardiomyopathy patients. Author(s): Ferreira RC, Ianni BM, Abel LC, Buck P, Mady C, Kalil J, Cunha-Neto E. Source: Memorias Do Instituto Oswaldo Cruz. 2003 April; 98(3): 407-11. Epub 2003 July 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886425

•

Increased prevalence of cholelithiasis in chronic Chagas disease. Author(s): Palmero HA, Caero TF, Iosa DJ, Bas J. Source: Medicina (B Aires). 1982; 42 Suppl 1: 47-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6820466

•

Indeterminate form of Chagas disease. Author(s): Macedo V. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 311-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677745

•

Integrate study of a Bolivian population infected by Trypanosoma cruzi, the agent of Chagas disease. Author(s): Breniere SF, Bosseno MF, Noireau F, Yacsik N, Liegeard P, Aznar C, Hontebeyrie M. Source: Memorias Do Instituto Oswaldo Cruz. 2002 April; 97(3): 289-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048553

•

Integration of Trypanosoma cruzi kDNA minicircle sequence in the host genome may be associated with autoimmune serum factors in Chagas disease patients. Author(s): Simoes-Barbosa A, Barros AM, Nitz N, Arganaraz ER, Teixeira AR. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 249-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677727

•

Interrupting Chagas disease transmission in Venezuela. Author(s): Ache A, Matos AJ. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2001 January-February; 43(1): 37-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11246282

Studies

41

•

Interruption of Chagas disease transmission in the Andean countries: Colombia. Author(s): Guhl F, Vallejo GA. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 413-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677767

•

Involvement of the peripheral sensory nervous system in human chronic Chagas disease. Author(s): Sica RE, Filipini D, Panizza M, Fumo T, Baso S, Lazzari J, Molina HA. Source: Medicina (B Aires). 1986; 46(6): 662-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3114590

•

Is Rhodnius robustus (Hemiptera: Reduviidae) responsible for Chagas disease transmission in Western Venezuela? Author(s): Feliciangeli MD, Dujardin JP, Bastrenta B, Mazzarri M, Villegas J, Flores M, Munoz M. Source: Tropical Medicine & International Health : Tm & Ih. 2002 March; 7(3): 280-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11903991

•

Isozyme variability and differentiation between Rhodnius prolixus, R.robustus and R.pictipes, vectors of Chagas disease in Venezuela. Author(s): Harry M, Galindez I, Cariou ML. Source: Medical and Veterinary Entomology. 1992 January; 6(1): 37-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1600225

•

Isozymic data question the specific status of some blood-sucking bugs of the genus Rhodnius, vectors of Chagas disease. Author(s): Harry M. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1993 JulyAugust; 87(4): 492. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8249094

•

Jejunal flora of patients with megaoesophagus secondary to Chagas disease. Author(s): Machado WM, Moraes-Filho JP, Santos MA, Bettarello A. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1989 March-April; 83(2): 199-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2514471

•

Laboratory-acquired Chagas disease. Author(s): Hofflin JM, Sadler RH, Araujo FG, Page WE, Remington JS. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1987; 81(3): 437-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3120369

42

Chagas Disease

•

Laboratory-acquired Chagas disease: comment. Author(s): Brener Z. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1987; 81(3): 527. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3120375

•

Levels of apolipoproteins and cholesterol of low and high density lipoproteins in asymptomatic Chagas disease. Author(s): Cano RC, Rubiolo ER, Santamarina NO. Source: Medicina (B Aires). 1985; 45(3): 269-72. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3939428

•

Long term evaluation of etiological treatment of Chagas disease with benznidazole. Author(s): Cancado JR. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2002 January-February; 44(1): 29-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11896410

•

Longitudinal radiological study of the esophagus in Chagas disease. Author(s): Castro C. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 329-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677749

•

Long-term control of Chagas disease in Venezuela: effects on serologic findings, electrocardiographic abnormalities, and clinical outcome. Author(s): Acquatella H, Catalioti F, Gomez-Mancebo JR, Davalos V, Villalobos L. Source: Circulation. 1987 September; 76(3): 556-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2957109

•

Lower esophageal sphincter pressure in idiopathic achalasia and Chagas diseaserelated achalasia. Author(s): Lemme EM, Domingues GR, Pereira VL, Firman CG, Pantoja J. Source: Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E. 2001; 14(3-4): 232-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869326

•

Lymphocyte transformation in Chagas disease. Author(s): Tschudi EI, Anziano DF, Dalmasso AP. Source: Infection and Immunity. 1972 December; 6(6): 905-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4629392

Studies

43

•

Lytic antibody titre as a means of assessing cure after treatment of Chagas disease: a 10 years follow-up study. Author(s): Galvao LM, Nunes RM, Cancado JR, Brener Z, Krettli AU. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1993 March-April; 87(2): 220-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8337734

•

Microwave treatment of human milk to prevent transmission of Chagas disease. Author(s): Santos Ferreira C, Amato Neto V, Gakiya E, Bezerra RC, Alarcon RS. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2003 January-February; 45(1): 41-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12751321

•

Minor segmental dyssynergy reflects extensive myocardial damage and global left ventricle dysfunction in chronic Chagas disease. Author(s): de Almeida-Filho OC, Maciel BC, Schmidt A, Pazin-Filho A, Marin-Neto JA. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2002 June; 15(6): 610-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12050602

•

More data on Chagas disease. Author(s): Barrett VJ, Turrens JF. Source: American Journal of Clinical Pathology. 1998 December; 110(6): 818. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9844598

•

Muscle denervation in chronic Chagas disease. Author(s): Sica RE, Sanz OP, Aristimuno GG, Basso S, Pagano MA, Taratuto A, Fumo T, Ratusnu AF, Colombi A. Source: Medicina (B Aires). 1979 September-October; 39(5): 579-88. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=121145

•

Nested case-control study in a serological survey to evaluate the effectiveness of a Chagas disease control programme in Brazil. Author(s): Carneiro M, Moreno EC, Antunes CM. Source: Bulletin of the World Health Organization. 2001; 79(5): 409-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11417036

•

Ninety years of Chagas disease: a success story at the periphery. Author(s): Coutinho M. Source: Social Studies of Science. 1999 August; 29(4): 519-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11623933

44

Chagas Disease

•

NK and LAK functions in human chronic Chagas disease. Author(s): Stracieri AB, Voltarelli JC. Source: Parasite Immunology. 1995 July; 17(7): 381-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8552411

•

Oesophageal manometric studies in patients with chronic Chagas disease and megacolon. Author(s): Heitmann P, Espinoza J. Source: Gut. 1969 October; 10(10): 848-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4981710

•

Paleoparasitology of Chagas disease revaled by infected tissues from Chilean mummies. Author(s): Ferreira LF, Britto C, Cardoso MA, Fernandes O, Reinhard K, Araujo A. Source: Acta Tropica. 2000 February 25; 75(1): 79-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10708009

•

Palm trees as ecological indicators of risk areas for Chagas disease. Author(s): Romana CA, Pizarro JC, Rodas E, Guilbert E. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1999 November-December; 93(6): 594-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10717739

•

Parasite persistence in the aetiology of Chagas disease. Author(s): Tarleton RL. Source: International Journal for Parasitology. 2001 May 1; 31(5-6): 550-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11334941

•

Parasitological cure of Chagas disease: is it possible? Is it relevant? Author(s): Urbina JA. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 349-55. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677754

•

Parasympathetic dysautonomia precedes left ventricular systolic dysfunction in Chagas disease. Author(s): Ribeiro AL, Moraes RS, Ribeiro JP, Ferlin EL, Torres RM, Oliveira E, Rocha MO. Source: American Heart Journal. 2001 February; 141(2): 260-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174350

Studies

45

•

Participation of autonomic nervous system in the pathogenesis of Chagas disease. Author(s): Sterin-Borda LJ, Borda ES. Source: Acta Physiol Pharmacol Ther Latinoam. 1994; 44(4): 109-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7549008

•

Pasteurization of human milk to prevent transmission of Chagas disease. Author(s): Ferreira CS, Martinho PC, Amato Neto V, Cruz RR. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2001 May-June; 43(3): 161-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452325

•

Polymerase chain reaction (PCR) as a laboratory tool for the evaluation of the parasitological cure in Chagas disease after specific treatment. Author(s): Britto C, Cardoso A, Silveira C, Macedo V, Fernandes O. Source: Medicina (B Aires). 1999; 59 Suppl 2: 176-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10668261

•

Polymerase chain reaction detection: new insights into the diagnosis of chronic Chagas disease. Author(s): Britto C, Cardoso MA, Marques P, Fernandes O, Morel CM. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 305-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677742

•

Population structure and genetic typing of Trypanosoma cruzi, the agent of Chagas disease: a multilocus enzyme electrophoresis approach. Author(s): Barnabe C, Brisse S, Tibayrenc M. Source: Parasitology. 2000 May; 120 ( Pt 5): 513-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10840981

•

Predicting triatoma dimidiata abundance and infection rate: a risk map for natural transmission of Chagas disease in the yucatan peninsula of Mexico. Author(s): Dumonteil E, Gourbiere S. Source: The American Journal of Tropical Medicine and Hygiene. 2004 May; 70(5): 514-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15155983

•

Prenatal diagnosis of congenital Chagas' disease (American trypanosomiasis). Author(s): Okumura M, Aparecida dos Santos V, Camargo ME, Schultz R, Zugaib M. Source: Prenatal Diagnosis. 2004 March; 24(3): 179-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15057949

46

Chagas Disease

•

Presence of triatominae (Hemiptera, Reduviidae) and risk of transmission of Chagas disease in Colima, Mexico. Author(s): Espinoza-Gomez F, Maldonado-Rodriguez A, Coll-Cardenas R, HernandezSuarez CM, Fernandez-Salas I. Source: Memorias Do Instituto Oswaldo Cruz. 2002 January; 97(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11992142

•

Prevalence of American trypanosomiasis (Chagas disease) among dogs in Oklahoma. Author(s): Bradley KK, Bergman DK, Woods JP, Crutcher JM, Kirchhoff LV. Source: J Am Vet Med Assoc. 2000 December 15; 217(12): 1853-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132891

•

Probability of transmission of Chagas disease by Triatoma infestans (Hemiptera: Reduviidae) in an endemic area of Santiago del Estero, Argentina. Author(s): Rabinovich JE, Wisnivesky-Colli C, Solarz ND, Gurtler RE. Source: Bulletin of the World Health Organization. 1990; 68(6): 737-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2127382

•

Progress towards interruption of transmission of Chagas disease. Author(s): Moncayo A. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 401-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677765

•

Progress towards the elimination of transmission of Chagas disease in Latin America. Author(s): Moncayo A. Source: World Health Stat Q. 1997; 50(3-4): 195-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9477549

•

Rapid determination of Trypanosoma cruzi urinary antigens in human chronic Chagas disease by agglutination test. Author(s): Katzin AM, Marcipar A, Freilij H, Corral R, Yanovsky JF. Source: Experimental Parasitology. 1989 February; 68(2): 208-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2494054

•

Reactivation of Chagas disease manifested by skin lesions in a patient with AIDS. Author(s): Sartori AM, Sotto MN, Braz LM, Oliveira Junior Oda C, Patzina RA, Barone AA, Shikanai-Yasuda MA. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1999 November-December; 93(6): 631-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10717752

Studies

47

•

Recent developments in the chemotherapy of Chagas disease. Author(s): Docampo R. Source: Current Pharmaceutical Design. 2001 August; 7(12): 1157-64. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11472259

•

Respiratory mechanics in patients with Chagas disease without cardiac insufficiency. Author(s): Vargas FS, Cukier A, Tsanaclis A, Pereira JR, Barretto AC, Romeiro Neto MM. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 1981 NovemberDecember; 23(6): 264-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6808650

•

Right ventricular function in Chagas disease. Author(s): Carrasco HA, Medina M, Inglessis G, Fuenmayor A, Molina C, Davila D. Source: International Journal of Cardiology. 1983; 2(3-4): 325-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6840901

•

Saliva ELISA: a method for the diagnosis of chronic Chagas disease in endemic areas. Author(s): Pinho RT, Pedrosa RC, Costa-Martins P, Castello-Branco LR. Source: Acta Tropica. 1999 January 15; 72(1): 31-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9924959

•

Screening and confirmation in Chagas disease serology - a contribution. Author(s): Oelemann W, Teixeira M, Peralta J. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 307-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677743

•

Sequence of the gene for a Trypanosoma cruzi protein antigenic during the chronic phase of human Chagas disease. Author(s): Buschiazzo A, Campetella OE, Macina RA, Salceda S, Frasch AC, Sanchez DO. Source: Molecular and Biochemical Parasitology. 1992 August; 54(1): 125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1518528

•

Serological diagnosis of Chagas disease with purified and defined Trypanosoma cruzi antigens. Author(s): Umezawa ES, Silveira JF. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 285-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677737

48

Chagas Disease

•

Seroprevalence and sociocultural conditionants of Chagas disease in school-aged children of marginal zones of Asuncion. Author(s): Vera NI, Maldonado M, Yaluff G, Simancas L, de Arias AR. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 1998 July-August; 31(4): 347-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9662961

•

Serum neopterin in patients with Chagas disease. Author(s): Zerlotti H, Grotto W, Costa FF, Carneiro MV, Galiza Neto GC. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1994 January-February; 88(1): 75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8154010

•

Severity of chronic Chagas disease is associated with cytokine/antioxidant imbalance in chronically infected individuals. Author(s): Perez-Fuentes R, Guegan JF, Barnabe C, Lopez-Colombo A, Salgado-Rosas H, Torres-Rasgado E, Briones B, Romero-Diaz M, Ramos-Jimenez J, Sanchez-Guillen Mdel C. Source: International Journal for Parasitology. 2003 March; 33(3): 293-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12670514

•

Specific chemotherapy of Chagas disease: a comparison between the response in patients and experimental animals inoculated with the same strains. Author(s): Andrade SG, Rassi A, Magalhaes JB, Ferriolli Filho F, Luquetti AO. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1992 November-December; 86(6): 624-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1287919

•

Specific chemotherapy of Chagas disease: controversies and advances. Author(s): Urbina JA, Docampo R. Source: Trends in Parasitology. 2003 November; 19(11): 495-501. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14580960

•

Specific immunodiagnosis of Chagas disease: immunodiffusion test using a specific serum anti-Trypanosoma cruzi component 5. Author(s): Breniere FS, Carlier Y, Carrasco R, Molinedo S, Lemesre JL, Desjeux P, Afchain D. Source: Trop Geogr Med. 1987 July; 39(3): 281-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3124314

Studies

49

•

Specific treatment of Chagas disease: current status and new developments. Author(s): Urbina JA. Source: Current Opinion in Infectious Diseases. 2001 December; 14(6): 733-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11964893

•

Studies of cellular immunity in Chagas disease: effect of glutaraldehyde-treated specific antigen on inhibition of leukocyte migration. Author(s): Lelchuk R, Patrucco A, Manni JA. Source: Journal of Immunology (Baltimore, Md. : 1950). 1974 April; 112(4): 1578-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4205534

•

Sudden death in patients with Chagas disease. Author(s): Lopes ER. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 321-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677747

•

Sylvatic vectors invading houses and the risk of emergence of cases of Chagas disease in Salvador, State of Bahia, Northeast Brazil. Author(s): Dias-Lima AG, Sherlock IA. Source: Memorias Do Instituto Oswaldo Cruz. 2000 September-October; 95(5): 611-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10998208

•

The chronic presence of the parasite, and anti-P autoimmunity in Chagas disease: the Trypanosoma cruzi ribosomal P proteins, and their recognition by the host immune system. Author(s): Kaplan D, Vazquez M, Lafon S, Schijman AG, Levitus G, Levin MJ. Source: Biol Res. 1993; 26(1-2): 273-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7545503

•

The ecology of Chagas disease in Chile. Author(s): Schofield CJ, Apt W, Miles MA. Source: Ecol Dis. 1982; 1(2-3): 117-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6821391

•

The epidemiologic importance of Triatoma brasiliensis as a Chagas disease vector in Brazil: a revision of domiciliary captures during 1993-1999. Author(s): Costa J, Almeida CE, Dotson EM, Lins A, Vinhaes M, Silveira AC, Beard CB. Source: Memorias Do Instituto Oswaldo Cruz. 2003 June; 98(4): 443-9. Epub 2003 August 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12937751

50

Chagas Disease

•

The EVI antibody in acute Chagas disease. Author(s): Szarfman A, Cossio PM, Schmunis GA, Arana RM. Source: J Parasitol. 1977 February; 63(1): 149. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=403265

•

The evolution of Chagas disease (American trypanosomiasis) control after 90 years since Carlos Chagas discovery. Author(s): Dias J, Schofield C. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 103-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677697

•

The humoral immune response to the kinetoplastid membrane protein-11 in patients with American leishmaniasis and Chagas disease: prevalence of IgG subclasses and mapping of epitopes. Author(s): Trujillo C, Ramirez R, Velez ID, Berberich C. Source: Immunology Letters. 1999 December 1; 70(3): 203-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10656675

•

The impact of Chagas disease control in Latin America: a review. Author(s): Dias JC, Silveira AC, Schofield CJ. Source: Memorias Do Instituto Oswaldo Cruz. 2002 July; 97(5): 603-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12219120

•

The major cysteine proteinase of Trypanosoma cruzi: a valid target for chemotherapy of Chagas disease. Author(s): Jose Cazzulo J, Stoka V, Turk V. Source: Current Pharmaceutical Design. 2001 August; 7(12): 1143-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11472258

•

The prevalence of clinical peripheral neuropathies in human chronic Chagas disease. Author(s): Woodhouse JI. Source: J R Army Med Corps. 1993 June; 139(2): 54-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8394932

•

The risk of transfusion transmission of Chagas disease in Mexico City. Author(s): Reyes PA, Monteon VM, Hernandez-Becerril N. Source: Transfusion. 2000 May; 40(5): 613. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10827270

Studies

51

•

The role of nitric oxide in the pathogenesis of Chagas disease. Author(s): Silva JS, Machado FS, Martins GA. Source: Frontiers in Bioscience : a Journal and Virtual Library. 2003 May 1; 8: S314-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12877141

•

The role of the immune response on the development of severe clinical forms of human Chagas disease. Author(s): Correa-Oliveira R, Gomes J, Lemos EM, Cardoso GM, Reis DD, Adad S, Crema E, Martins-Filho OA, Costa MO, Gazzinelli G, Bahia-Oliveira LM. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 253-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677728

•

The role of tissue-infiltrating T cells in immunopathology of Chagas disease. Author(s): Dosreis GA. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 279-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677734

•

The Southern Cone Initiative against Chagas disease. Author(s): Schofield CJ, Dias JC. Source: Adv Parasitol. 1999; 42: 1-27. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10050271

•

The use of microhaematocrit tubes for the rapid diagnosis of Chagas disease and malaria. Author(s): La Fuente C, Saucedo E, Urjel R. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1984; 78(2): 278-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6431657

•

The Valsalva maneuver in Chagas disease patients without cardiopathy. Author(s): Oliveira E, Ribeiro AL, Assis Silva F, Torres RM, Rocha MO. Source: International Journal of Cardiology. 2002 January; 82(1): 49-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11786157

•

Total and specific anti-Trypanosoma cruzi immunoglobulin E in pericardial fluid samples from patients with chronic Chagas disease. Author(s): Mineo JR, Rocha A, Costa-Cruz JM, da Silva AM, Silva DA, Goncalves-Pires MD, Lopes ER, Chapadeiro E. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1996 September-October; 90(5): 578-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8944279

52

Chagas Disease

•

Transfusion-associated acute Chagas disease acquired in the United States. Author(s): Grant IH, Gold JW, Wittner M, Tanowitz HB, Nathan C, Mayer K, Reich L, Wollner N, Steinherz L, Ghavimi F, et al. Source: Annals of Internal Medicine. 1989 November 15; 111(10): 849-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2510571

•

Transmission of Chagas disease through renal transplantation: report of a case. Author(s): Figueiredo JF, Martinez R, da Costa JC, Moyses Neto M, Suaid HJ, Ferraz AS. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1990 January-February; 84(1): 61-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2111944

•

Troponin in Chagas disease. Author(s): Arias R, Bastos C, Mota G, Sodre F, Moreira A, Tavares A, Lima JC. Source: The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases. 2003 December; 7(6): 358-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14636473

•

Trypanosoma cruzi defined antigens in the serological evaluation of an outbreak of acute Chagas disease in Brazil (Catole do Rocha, Paraiba). Author(s): Umezawa ES, Shikanai-Yasuda MA, Gruber A, Pereira-Chioccola VL, Zingales B. Source: Memorias Do Instituto Oswaldo Cruz. 1996 January-February; 91(1): 87-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8734955

•

Trypanosoma cruzi parasitemia in chronic Chagas disease: comparison between human immunodeficiency virus (HIV)-positive and HIV-negative patients. Author(s): Sartori AM, Neto JE, Nunes EV, Braz LM, Caiaffa-Filho HH, Oliveira Oda C Jr, Neto VA, Shikanai-Yasuda MA. Source: The Journal of Infectious Diseases. 2002 September 15; 186(6): 872-5. Epub 2002 August 09. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12198628

•

Trypanosoma cruzi stocks isolated from acute Chagas disease patients lead to lethal murine infection. Author(s): Oliveira EC, Stefani MM, Campos DE, Andrade AL, Silva SA, Rassi A, Luquetti AO. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1997 January-February; 91(1): 25-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9093620

Studies

53

•

Trypanosoma cruzi transmission risk index (TcTRI): an entomological indicator of Chagas disease vectorial transmission to humans. Author(s): Catala S, Crocco LB, Morales GF. Source: Acta Tropica. 1997 December; 68(3): 285-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9492913

•

Trypanosoma cruzi ubiquitin as an antigen in the differential diagnosis of Chagas disease and leishmaniasis. Author(s): Telles S, Abate T, Slezynger T, Henriquez DA. Source: Fems Immunology and Medical Microbiology. 2003 June 10; 37(1): 23-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12770756

•

Trypanosoma cruzi: a considerable phylogenetic divergence indicates that the agent of Chagas disease is indigenous to the native fauna of the United States. Author(s): Barnabe C, Yaeger R, Pung O, Tibayrenc M. Source: Experimental Parasitology. 2001 October; 99(2): 73-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11748960

•

Trypanosoma cruzi: genetic structure of populations and relevance of genetic variability to the pathogenesis of Chagas disease. Author(s): Macedo AM, Machado CR, Oliveira RP, Pena SD. Source: Memorias Do Instituto Oswaldo Cruz. 2004 February; 99(1): 1-12. Epub 2004 March 31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15057339

•

Unusual frequency of Negro admixture in necropsies of Chagas disease cases in Bahia, Brazil. Author(s): Nunesmaia HG, Azevedo ES. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 1973 January-February; 15(1): 10-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4634098

•

Use of a recombinant Trypanosoma cruzi protein antigen to monitor cure of Chagas disease. Author(s): Guevara AG, Taibi A, Alava J, Guderian RH, Ouaissi A. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1995 JulyAugust; 89(4): 447-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7570896

54

Chagas Disease

•

Use of recombinant antigens for the diagnosis of Chagas disease and blood bank screening. Author(s): Almeida E, Krieger MA, Carvalho MR, Oelemann W, Goldenberg S. Source: Memorias Do Instituto Oswaldo Cruz. 1990 October-December; 85(4): 513-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2152209

•

Use of two recombinant proteins of Trypanosoma cruzi in the serological diagnosis of Chagas disease. Author(s): Zingales B, Gruber A, Ramalho CB, Umezawa ES, Colli W. Source: Memorias Do Instituto Oswaldo Cruz. 1990 October-December; 85(4): 519-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2152210

•

Value of echocardiography for diagnosis and prognosis of chronic Chagas disease cardiomyopathy without heart failure. Author(s): Viotti RJ, Vigliano C, Laucella S, Lococo B, Petti M, Bertocchi G, Ruiz Vera B, Armenti H. Source: Heart (British Cardiac Society). 2004 June; 90(6): 655-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15145872

•

Views on the autoimmunity hypothesis for Chagas disease pathogenesis. Author(s): Kierszenbaum F. Source: Fems Immunology and Medical Microbiology. 2003 June 10; 37(1): 1-11. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12770754

55

CHAPTER 2. NUTRITION AND CHAGAS DISEASE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Chagas disease.

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

7

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

56

Chagas Disease

The following information is typical of that found when using the “Full IBIDS Database” to search for “Chagas disease” (or a synonym): •

Bednet impregnation for Chagas disease control: a new perspective. Author(s): Liverpool School of Tropical Medicine, UK. Source: Kroeger, A Ordonez Gonzalez, J Behrend, M Alvarez, G Trop-Med-Int-Health. 1999 March; 4(3): 194-8 1360-2276

•

Differences of susceptibility of five triatomine species to pyrethroid insecticides implications for Chagas disease vector control. Author(s): Nucleo de Pesquisas de Produtos Naturais, Laboratorio de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil. [email protected] Source: Oliveira Filho, A M Mem-Inst-Oswaldo-Cruz. 1999; 94 Suppl 1425-8 0074-0276

•

The effect of iron deficiency and iron overload on the evolution of Chagas disease produced by three strains of Trypanosoma cruzi in CFW mice. Author(s): Departamento de Ciencias Biologicas, Universidade Federal de Ouro Preto, Brasil. Source: Pedrosa, M L Silva, M E Silva, M E Silva, M E Nicoli, J R Vieira, E C CompBiochem-Physiol-A. 1990; 97(2): 235-43 0300-9629

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Nutrition

57

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

59

CHAPTER 3. ALTERNATIVE MEDICINE AND CHAGAS DISEASE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Chagas disease. 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 Chagas disease 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 “Chagas disease” (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 Chagas disease: •

A diterpene from Mikania obtusata active on Trypanosoma cruzi. Author(s): Alves TM, Chaves PP, Santos LM, Nagem TJ, Murta SM, Ceravolo IP, Romanha AJ, Zani CL. Source: Planta Medica. 1995 February; 61(1): 85-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7701002

•

A multidisciplinary approach to the study of the fluminense vegetation. Author(s): Kelecom A, Reis GL, Fevereiro PC, Silva JG, Santos MG, Mello Neto CB, Gonzalez MS, Gouvea RC, Almeida GS. Source: Anais Da Academia Brasileira De Ciencias. 2002 March; 74(1): 171-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11960185

60

Chagas Disease

•

A new tactic for Triatoma infestans control: fabrics impregnated with betacypermethrin. Author(s): Wood E, de Licastro SA, Casabe N, Picollo MI, Alzogaray R, Nicolas Zerba E. Source: Revista Panamericana De Salud Publica = Pan American Journal of Public Health. 1999 July; 6(1): 1-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10446509

•

A study of the trypanocidal and analgesic properties from Lychnophora granmongolense (Duarte) Semir & Leitao Filho. Author(s): Grael CF, Vichnewski W, Souza GE, Lopes JL, Albuquerque S, Cunha WR. Source: Phytotherapy Research : Ptr. 2000 May; 14(3): 203-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10815016

•

Activity and residual effect of two formulations of lambdacyhalothrin sprayed on palm leaves to Rhodnius prolixus. Author(s): Mazariego-Arana MA, Ramirez-San Juan E, Alejandre-Aguilar R, NoguedaTorres B. Source: Memorias Do Instituto Oswaldo Cruz. 2002 April; 97(3): 353-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048565

•

Alkaline phosphatase activity in plasma of pregnant chagasic patients. Author(s): Sartori MJ, Lin S, Fretes RE, Ruiz Moreno L, Goldemberg L, de Fabro SP. Source: Rev Fac Cien Med Univ Nac Cordoba. 1997; 55(1-2): 5-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10436610

•

Alpha-2-macroglobulin binds to the surface of Trypanosoma cruzi. Author(s): Coutinho CM, Cavalcanti GH, van Leuven F, Araujo-Jorge TC. Source: Parasitology Research. 1997; 83(2): 144-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9039696

•

American trypanosomiasis. An historical and a human lesson. Author(s): Guerra F. Source: J Trop Med Hyg. 1970 April; 72(4): 83-104 Contd. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4987954

•

Ancistrocongolines A-D, new naphthylisoquinoline alkaloids from ancistrocladus congolensis. Author(s): Bringmann G, Messer K, Brun R, Mudogo V. Source: Journal of Natural Products. 2002 August; 65(8): 1096-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12193010

•

Ancistrotanzanine C and related 5,1'- and 7,3'-coupled naphthylisoquinoline alkaloids from Ancistrocladus tanzaniensis.

Alternative Medicine 61

Author(s): Bringmann G, Dreyer M, Faber JH, Dalsgaard PW, Staerk D, Jaroszewski JW, Ndangalasi H, Mbago F, Brun R, Christensen SB. Source: Journal of Natural Products. 2004 May; 67(5): 743-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15165131 •

Antibody-independent, natural resistance of birds to Trypanosoma cruzi infection. Author(s): Kierszenbaum F, Gottlieb CA, Budzko DB. Source: J Parasitol. 1981 October; 67(5): 656-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6795329

•

Anti-Trypanosoma cruzi activity of green tea (Camellia sinensis) catechins. Author(s): Paveto C, Guida MC, Esteva MI, Martino V, Coussio J, Flawia MM, Torres HN. Source: Antimicrobial Agents and Chemotherapy. 2004 January; 48(1): 69-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693520

•

Bednet impregnation for Chagas disease control: a new perspective. Author(s): Kroeger A, Ordonez-Gonzalez J, Behrend M, Alvarez G. Source: Tropical Medicine & International Health : Tm & Ih. 1999 March; 4(3): 194-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10223214

•

Beneficial effect of selenium supplementation during murine infection with Trypanosoma cruzi. Author(s): Davis CD, Brooks L, Calisi C, Bennett BJ, McElroy DM. Source: J Parasitol. 1998 December; 84(6): 1274-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9920329

•

Bioactive alkyl phenols and embelin from Oxalis erythrorhiza. Author(s): Feresin GE, Tapia A, Sortino M, Zacchino S, de Arias AR, Inchausti A, Yaluff G, Rodriguez J, Theoduloz C, Schmeda-Hirschmann G. Source: Journal of Ethnopharmacology. 2003 October; 88(2-3): 241-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12963150

•

Biological and chemical studies of Pera benensis, a Bolivian plant used in folk medicine as a treatment of cutaneous leishmaniasis. Author(s): Fournet A, Angelo A, Munoz V, Roblot F, Hocquemiller R, Cave A. Source: Journal of Ethnopharmacology. 1992 September; 37(2): 159-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1434690

•

Chagas disease in north-west Argentina: risk of domestic reinfestation by Triatoma infestans after a single community-wide application of deltamethrin. Author(s): Gurtler RE, Petersen RM, Cecere MC, Schweigmann NJ, Chuit R, Gualtieri JM, Wisnivesky-Colli C.

62

Chagas Disease

Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1994 January-February; 88(1): 27-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8153989 •

Chemical constituents of essential oils of muna, Bolivian plants traditionally used as pesticides, and their insecticidal properties against Chagas' disease vectors. Author(s): Fournet A, Rojas de Arias A, Charles B, Bruneton J. Source: Journal of Ethnopharmacology. 1996 July 5; 52(3): 145-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8771455

•

Chemical reactivity studies with naphthoquinones from Tabebuia with antitrypanosomal efficacy. Author(s): Pinto CN, Dantas AP, De Moura KC, Emery FS, Polequevitch PF, Pinto MC, de Castro SL, Pinto AV. Source: Arzneimittel-Forschung. 2000 December; 50(12): 1120-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11190779

•

Comparative evaluation of pyrethroid insecticide formulations against Triatoma infestans (Klug): residual efficacy on four substrates. Author(s): Rojas de Arias A, Lehane MJ, Schofield CJ, Fournet A. Source: Memorias Do Instituto Oswaldo Cruz. 2003 October; 98(7): 975-80. Epub 2004 January 07. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14762528

•

Cross-reactivity of lytic antibodies against blood forms of Trypanosoma cruzi. Author(s): Kierszenbaum F. Source: J Parasitol. 1976 February; 62(1): 134-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=815534

•

Cystatin S in secretory granules fractions isolated from submandibular gland of infected rats by Trypanosoma cruzi. Author(s): Silva GA, Alves JB, Alves MS. Source: Tissue & Cell. 1995 April; 27(2): 167-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7778093

•

Detection of Trypanosoma cruzi in blood specimens of chronic chagasic patients by polymerase chain reaction amplification of kinetoplast minicircle DNA: comparison with serology and xenodiagnosis. Author(s): Avila HA, Pereira JB, Thiemann O, De Paiva E, DeGrave W, Morel CM, Simpson L. Source: Journal of Clinical Microbiology. 1993 September; 31(9): 2421-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8408566

Alternative Medicine 63

•

Differences of susceptibility of five triatomine species to pyrethroid insecticides implications for Chagas disease vector control. Author(s): Oliveira Filho AM. Source: Memorias Do Instituto Oswaldo Cruz. 1999; 94 Suppl 1: 425-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677770

•

Differentiation between Trypanosoma cruzi and T. rangeli by their different complement sensitivity. Author(s): Schottelius J. Source: Tropenmed Parasitol. 1982 September; 33(3): 147-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6814023

•

Ecotopes, natural infection and trophic resources of Triatoma brasiliensis (Hemiptera, Reduviidae, Triatominae). Author(s): Costa J, de Almeida JR, Britto C, Duarte R, Marchon-Silva V, Pacheco Rda S. Source: Memorias Do Instituto Oswaldo Cruz. 1998 January-February; 93(1): 7-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9698835

•

Effect of an essential fatty acid deficient diet on experimental infection with Trypanosoma cruzi in germfree and conventional mice. Author(s): Santos CF, Silva ME, Silva ME, Silva ME, Nicoli JR, Crocco-Afonso LC, Santos JE, Bambirra EA, Vieira EC. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 1992; 25(8): 795-803. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1342611

•

Effect of different formulations of propolis on mice infected with Trypanosoma cruzi. Author(s): de Castro SL, Higashi KO. Source: Journal of Ethnopharmacology. 1995 April; 46(1): 55-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7475123

•

Effects of azadirachtin in Rhodnius prolixus: data and hypotheses. Author(s): Garcia ES, Gonzales MS, Azambuja P. Source: Memorias Do Instituto Oswaldo Cruz. 1991; 86 Suppl 2: 107-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1841982

•

Efficacy of pyrethroid insecticides against domestic and peridomestic populations of Triatoma pallidipennis and Triatoma barberi (Reduviidae:Triatominae) vectors of Chagas' disease in Mexico. Author(s): Ramsey JM, Cruz-Celis A, Salgado L, Espinosa L, Ordonez R, Lopez R, Schofield CJ.

64

Chagas Disease

Source: Journal of Medical Entomology. 2003 November; 40(6): 912-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765670 •

Efficacy of the bisbenzylisoquinoline alkaloids in acute and chronic Trypanosoma cruzi murine model. Author(s): Fournet A, Rojas de Arias A, Ferreira ME, Nakayama H, Torres de Ortiz S, Schinini A, Samudio M, Vera de Bilbao N, Lavault M, Bonte F. Source: International Journal of Antimicrobial Agents. 2000 January; 13(3): 189-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10724023

•

Evaluation of the trypanocidal activity of lignans isolated from the leaves of Zanthoxylum naranjillo. Author(s): Bastos JK, Albuquerque S, Silva ML. Source: Planta Medica. 1999 August; 65(6): 541-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10483375

•

Experimental chemotherapy with combinations of ergosterol biosynthesis inhibitors in murine models of Chagas' disease. Author(s): Maldonado RA, Molina J, Payares G, Urbina JA. Source: Antimicrobial Agents and Chemotherapy. 1993 June; 37(6): 1353-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8328786

•

Experimental treatment of chronic Trypanosoma cruzi infection in mice with 2-npropylquinoline. Author(s): Nakayama H, Ferreira ME, Rojas de Arias A, Vera de Bilbao N, Torres S, Schinini A, Fournet A. Source: Phytotherapy Research : Ptr. 2001 November; 15(7): 630-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11746849

•

From natural products to drugs. Author(s): Croft SL. Source: Current Opinion in Infectious Diseases. 2001 December; 14(6): 717-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11964890

•

Hemocultures from chronic Chagasic patients using EDTA or heparin as anticoagulants. Author(s): Galvao LM, Cancado JR, Rezende DF, Krettli AU. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 1989; 22(7): 841-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2517040

Alternative Medicine 65

•

Impact of residual spraying on Rhodnius prolixus and Triatoma dimidiata in the department of Zacapa in Guatemala. Author(s): Nakagawa J, Cordon-Rosales C, Juarez J, Itzep C, Nonami T. Source: Memorias Do Instituto Oswaldo Cruz. 2003 March; 98(2): 277-81. Epub 2003 May 15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12764447

•

In vitro trypanocidal activity of triterpenes from miconia species. Author(s): Cunha WR, Martins C, da Silva Ferreira D, Crotti AE, Lopes NP, Albuquerque S. Source: Planta Medica. 2003 May; 69(5): 470-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12802734

•

Inactivation of Trypanosoma cruzi trypomastigote forms in blood components with a Psoralen and Ultraviolet A light. Author(s): Gottlieb P, Margolis-Nunno H, Robinson R, Shen LG, Chimezie E, Horowitz B, Ben-Hur E. Source: Photochemistry and Photobiology. 1996 May; 63(5): 562-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8628745

•

Monitoring house reinfestation by vectors of Chagas disease: a comparative trial of detection methods during a four-year follow-up. Author(s): Gurtler RE, Cecere MC, Canale DM, Castanera MB, Chuit R, Cohen JE. Source: Acta Tropica. 1999 March 15; 72(2): 213-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10206120

•

Susceptibility and resistance to insecticides of Chagas disease vectors. Author(s): Zerba EN. Source: Medicina (B Aires). 1999; 59 Suppl 2: 41-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10668241

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/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

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

•

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

66

Chagas Disease

•

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

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

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

•

HealthGate: http://www.tnp.com/

•

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

•

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

•

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

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.

67

CHAPTER 4. DISSERTATIONS ON CHAGAS DISEASE Overview In this chapter, we will give you a bibliography on recent dissertations relating to Chagas disease. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “Chagas disease” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Chagas disease, we have not necessarily excluded non-medical dissertations in this bibliography.

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

Ecology and control of triatomine (Hemiptera: Reduviidae) vectors of Chagas disease in Guatemala, Central America (Rhodnius prolixus, Triatoma dimidiata, Triatoma nitida, Triatoma ryckmani) by Monroy, Maria Carlota, PhD from Uppsala Universitet (Sweden), 2003, 22 pages http://wwwlib.umi.com/dissertations/fullcit/f123889

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

69

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

Screening for Transmissible Diseases Source: Guidelines for the Organization of a Blood Transfusion Service. Contact: World Health Organization, Health Laboratory Technology and Blood Safety Unit, 20 Avenue Appia, 1211 Geneva 27. Summary: This book chapter discusses screening to prevent transmission of infectious diseases through blood and blood products. Topics covered are donor screening for viral hepatitis B, non-A non-B hepatitis, viral hepatitis C; delta agent; Human immunodeficiency virus (HIV), HIV variants such as HIV-2; syphilis and yaws; malaria; Chagas disease (American trypanosomiasis); cytomegalovirus (CMV); antigen testing; and "look-back" programs that trace seropositive donors to determine if they have previously given blood. It is also noted that microfilariae are not transmitted by blood transfusion, and that donors who have had diseases such as dengue fever,

70

Chagas Disease

schistosomiasis, leptospirosis, yellow fever, or encephalitis are not permanently debarred from donating blood after their diseases have been cured.

71

CHAPTER 6. PERIODICALS AND NEWS ON CHAGAS DISEASE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Chagas disease.

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

Green tea compounds have activity against Chagas disease in vitro Source: Reuters Medical News Date: January 02, 2004

72

Chagas Disease

•

First cases of Chagas disease transmitted through transplants reported in US Source: Reuters Medical News Date: March 15, 2002

•

Cerebral tumor-like American trypanosomiasis reported in AIDS patients Source: Reuters Medical News Date: March 17, 1999 The NIH

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

Periodicals and News

73

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 “Chagas disease” (or synonyms).

Academic Periodicals covering Chagas Disease Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Chagas disease. In addition to these sources, you can search for articles covering Chagas disease 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.”

75

APPENDICES

77

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 Institute8: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

8

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

78

Chagas Disease

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

79

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 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:10 •

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

9

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

80

Chagas Disease

•

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 Gateway11 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.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Chagas disease” (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 7353 111 606 44 5 8119

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 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.15 Simply search by “Chagas disease” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

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

12

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). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

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

81

Coffee Break: Tutorials for Biologists16 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.17 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.18 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/.

16 Adapted 17

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. 18 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.

83

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 Chagas disease 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 Chagas disease. 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 Chagas disease. 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 “Chagas disease”:

84

Chagas Disease

Chagas Disease http://www.nlm.nih.gov/medlineplus/chagasdisease.html Lyme Disease http://www.nlm.nih.gov/medlineplus/lymedisease.html Malaria http://www.nlm.nih.gov/medlineplus/malaria.html Parasitic Diseases http://www.nlm.nih.gov/medlineplus/parasiticdiseases.html Pets and Pet Health http://www.nlm.nih.gov/medlineplus/petsandpethealth.html Scabies http://www.nlm.nih.gov/medlineplus/scabies.html

Within the health topic page dedicated to Chagas disease, the following was listed: •

Diagnosis/Symptoms Diagnosis of Parasitic Diseases Source: National Center for Infectious Diseases, Division of Parasitic Diseases http://www.cdc.gov/ncidod/dpd/public/geninfo_diagnosis_diseases.htm

•

Organizations National Center for Infectious Diseases, Division of Parasitic Diseases http://www.cdc.gov/ncidod/dpd/default.htm National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/

•

Research Chagas Disease Source: National Institute of Allergy and Infectious Diseases http://www2.niaid.nih.gov/newsroom/focuson/bugborne01/chagas.htm

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 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 Chagas disease. The drawbacks of this approach are that the information is

Patient Resources

85

not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

86

Chagas Disease

Simply type in “Chagas disease” (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 “Chagas disease”. 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 “Chagas disease” (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 “Chagas disease” (or a synonym) into the search box, and click “Submit Query.”

87

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.19

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

19

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

88

Chagas Disease

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)20: •

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/

20

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

Finding Medical Libraries

89

•

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/

90

Chagas Disease

•

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

91

•

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/

92

Chagas Disease

•

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

93

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Chagas Disease Chagas disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001372.htm

•

Signs & Symptoms for Chagas Disease Arrhythmia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Enlarged lymph nodes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003097.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Generalized swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm

94

Chagas Disease

Irregular heartbeat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Rapid heartbeat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Swallowing difficulties Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm Swallowing difficulty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm •

Diagnostics and Tests for Chagas Disease Blood culture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003744.htm Blood smear Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003665.htm ELISA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003332.htm

•

Background Topics for Chagas Disease Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Cardiac disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Endemic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002362.htm Heart disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Insecticides Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002832.htm

Online Glossaries 95

Peripheral Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002273.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Symptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002293.htm

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

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

•

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

•

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

•

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

97

CHAGAS DISEASE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Ablation: The removal of an organ by surgery. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acute Disease: Disease having a short and relatively severe course. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenine Phosphoribosyltransferase: An enzyme catalyzing the formation of AMP from adenine and phosphoribosylpyrophosphate. It can act as a salvage enzyme for recycling of adenine into nucleic acids. EC 2.4.2.7. [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 Kinase: An enzyme that catalyzes the formation of ADP plus AMP from adenosine plus ATP. It can serve as a salvage mechanism for returning adenosine to nucleic acids. EC 2.7.1.20. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aetiology: Study of the causes of disease. [EU] 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] Affinity Chromatography: In affinity chromatography, a ligand attached to a column binds specifically to the molecule to be purified. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

98

Chagas Disease

Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] AK: Enzyme of the biosynthetic pathway. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allograft: An organ or tissue transplant between two humans. [NIH] Allopurinol: A xanthine oxidase inhibitor that decreases uric acid production. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix.

Dictionary 99

[NIH]

Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulants: Agents that prevent blood clotting. Naturally occurring agents in the blood are included only when they are used as drugs. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antimycotic: Suppressing the growth of fungi. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apolipoproteins A: Lipoproteins found in human blood serum in the high-density and very-high-density lipoprotein fraction (HDL, VHDL). They consist of several different polypeptides, the most important of which are apolipoprotein A-I and A-II. They maintain the structural integrity of the HDL particles and are activators of lecithin:cholesterol acyltransferase (LCAT). Atherosclerotic patients show low apolipoprotein A levels and these apolipoproteins are either absent or present in extremely low plasma concentration in Tangier disease. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH]

100

Chagas Disease

Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspergillosis: Infections with fungi of the genus Aspergillus. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Axenic: Not contaminated by or, associated with any foreign organisms. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its

Dictionary 101

subdivisions is the basal (basement) lamina. [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 duct: A tube through which bile passes in and out of the liver. [NIH] Bioassay: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biomolecular: A scientific field at the interface between advanced computing and biotechnology. [NIH] Biopterin: A natural product that has been considered as a growth factor for some insects. [NIH]

Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blast phase: The phase of chronic myelogenous leukemia in which the number of immature, abnormal white blood cells in the bone marrow and blood is extremely high. Also called blast crisis. [NIH] Blastomycosis: A fungal infection that may appear in two forms: 1) a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2) chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood 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] 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

102

Chagas Disease

with marrow cells. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] 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] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiomegaly: Hypertrophy or enlargement of the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopathy: Any disorder or disease of the heart. In addition to heart disease of inflammatory origin, there are arteriosclerotic cardiopathy, due to arteriosclerosis; fatty cardiopathy, due to growth of fatty tissue; hypertensive cardiopathy, due to high blood pressure; nephropathic cardiopathy, due to kidney disease, thyrotoxic cardiopathy, due to thyroid intoxication; toxic cardiopathy, due to the effect of some toxin; and valvular cardiopathy, due to faulty valve action. [EU] 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] Causal: Pertaining to a cause; directed against a cause. [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]

Dictionary 103

Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Division: The fission of a cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Chloroplasts: Plant cell inclusion bodies that contain the photosynthetic pigment chlorophyll, which is associated with the membrane of thylakoids. Chloroplasts occur in cells of leaves and young stems of higher plants. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic phase: Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Neurotrophic Factor: A neurotrophic factor that promotes the survival of various neuronal cell types and may play an important role in the injury response in the nervous system. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and

104

Chagas Disease

providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] 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] Cockroaches: Insects of the order Dictyoptera comprising several families including Blaberidae, Blattellidae, Blattidae (containing the American cockroach Periplaneta americana), Cryptocercidae, and Polyphagidae. [NIH] Codons: Any triplet of nucleotides (coding unit) in DNA or RNA (if RNA is the carrier of primary genetic information as in some viruses) that codes for particular amino acid or signals the beginning or end of the message. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complement Activation: The sequential activation of serum components C1 through C9, initiated by an erythrocyte-antibody complex or by microbial polysaccharides and properdin, and producing an inflammatory response. [NIH]

Dictionary 105

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] Complementation: The production of a wild-type phenotype when two different mutations are combined in a diploid or a heterokaryon and tested in trans-configuration. [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] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [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] Consciousness: Sense of awareness of self and of the environment. [NIH] Consensus Sequence: A theoretical representative nucleotide or amino acid sequence in which each nucleotide or amino acid is the one which occurs most frequently at that site in the different sequences which occur in nature. The phrase also refers to an actual sequence which approximates the theoretical consensus. A known conserved sequence set is represented by a consensus sequence. Commonly observed supersecondary protein structures (amino acid motifs) are often formed by conserved sequences. [NIH] Conserved Sequence: A sequence of amino acids in a polypeptide or of nucleotides in DNA or RNA that is similar across multiple species. A known set of conserved sequences is represented by a consensus sequence. Amino acid motifs are often composed of conserved sequences. [NIH] Constriction: The act of constricting. [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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Cost-benefit: A quantitative technique of economic analysis which, when applied to radiation practice, compares the health detriment from the radiation doses concerned with the cost of radiation dose reduction in that practice. [NIH] Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative

106

Chagas Disease

ways to achieve a specific set of results. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Diagnostic procedure: A method used to identify a disease. [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] Dihydrotestosterone: Anabolic agent. [NIH] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH]

Dictionary 107

Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disease Transmission: The transmission of infectious disease or pathogens. When transmission is within the same species, the mode can be horizontal (disease transmission, horizontal) or vertical (disease transmission, vertical). [NIH] Disease Transmission, Horizontal: The transmission of infectious disease or pathogens from one individual to another in the same generation. [NIH] Disease Transmission, Vertical: The transmission of infectious disease or pathogens from one generation to another. It includes transmission in utero or intrapartum by exposure to blood and secretions, and postpartum exposure via breastfeeding. [NIH] Disease Vectors: Invertebrates or non-human vertebrates which transmit infective organisms from one host to another. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dross: Residue remaining in an opium pipe which has been smoked; contains 50 % of the morphine present in the original drug. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Ecosystem: A dynamic complex of plant, animal and micro-organism communities and their non-living environment interacting as a functional unit. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] 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

108

Chagas Disease

latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [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

Dictionary 109

passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [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]

Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Fleas: Parasitic, blood-sucking, wingless insects comprising the order Siphonaptera. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention

110

Chagas Disease

of free radical damage is being actively investigated. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Germfree: Free from all living micro-organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Guanine: One of the four DNA bases. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC

Dictionary 111

4.6.1.2. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Transplantation: The transference of a heart from one human or animal to another. [NIH]

Heartbeat: One complete contraction of the heart. [NIH] Helminths: Commonly known as parasitic worms, this group includes the acanthocephala, nematoda, and platyhelminths. Some authors consider certain species of leeches that can become temporarily parasitic as helminths. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heritability: The proportion of observed variation in a particular trait that can be attributed to inherited genetic factors in contrast to environmental ones. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] 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] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H,

112

Chagas Disease

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] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in the formation of nucleic acids by the salvage pathway. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA

Dictionary 113

synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] 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]

Infestation: Parasitic attack or subsistence on the skin and/or its appendages, as by insects, mites, or ticks; sometimes used to denote parasitic invasion of the organs and tissues, as by helminths. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [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] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH]

114

Chagas Disease

Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Introns: Non-coding, intervening sequences of DNA that are transcribed, but are removed from within the primary gene transcript and rapidly degraded during maturation of messenger RNA. Most genes in the nuclei of eukaryotes contain introns, as do mitochondrial and chloroplast genes. [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]

Invertebrates: Animals that have no spinal column. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [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] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Kinetoplastida: An order of flagellate protozoa. Characteristics include the presence of one or two flagella arising from a depression in the cell body and a single mitochondrion that extends the length of the body. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous

Dictionary 115

membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Leishmania: A genus of flagellate protozoa comprising several species that are pathogenic for humans. Organisms of this genus have an amastigote and a promastigote stage in their life cycles. As a result of enzymatic studies this single genus has been divided into two subgenera: Leishmania leishmania and Leishmania viannia. Species within the Leishmania leishmania subgenus include: L. aethiopica, L. arabica, L. donovani, L. enrietti, L. gerbilli, L. hertigi, L. infantum, L. major, L. mexicana, and L. tropica. The following species are those that compose the Leishmania viannia subgenus: L. braziliensis, L. guyanensis, L. lainsoni, L. naiffi, and L. shawi. [NIH] Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Leptospirosis: Infections with bacteria of the genus Leptospira. [NIH] Lethal: Deadly, fatal. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [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] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Lucida: An instrument, invented by Wollaton, consisting essentially of a prism or a mirror through which an object can be viewed so as to appear on a plane surface seen in direct view and on which the outline of the object may be traced. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH]

116

Chagas Disease

Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte Depletion: Immunosuppression by reduction of circulating lymphocytes or by T-cell depletion of bone marrow. The former may be accomplished in vivo by thoracic duct drainage or administration of antilymphocyte serum. The latter is performed ex vivo on bone marrow before its transplantation. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoproliferative: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mannans: Polysaccharides consisting of mannose units. [NIH] Mannosidases: Alpha or beta-Mannoside mannohydrolases. Catalyzes the hydrolysis of terminal, non-reducing alpha or beta-D-mannose residues in mannosides. Deficiency of the alpha form can cause mannosidosis. [NIH] Mannosides: Glycosides formed by the reaction of the hydroxyl group on the anomeric carbon atom of mannose with an alcohol to form an acetal. They include both alpha- and

Dictionary 117

beta-mannosides. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megacolon: Pathological enlargement of the colon. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [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] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH]

118

Chagas Disease

Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Naphthoquinones: Naphthalene rings which contain two ketone moieties in any position. They can be substituted in any position except at the ketone groups. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neopterin: A pteridine derivative present in body fluids; elevated levels result from immune system activation, malignant disease, allograft rejection, and viral infections. (From Stedman, 26th ed) Neopterin also serves as a precursor in the biosynthesis of biopterin. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] 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

Dictionary 119

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] Neutralization: An act or process of neutralizing. [EU] Niche: The ultimate unit of the habitat, i. e. the specific spot occupied by an individual organism; by extension, the more or less specialized relationships existing between an organism, individual or synusia(e), and its environment. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Open Reading Frames: Reading frames where successive nucleotide triplets can be read as codons specifying amino acids and where the sequence of these triplets is not interrupted by stop codons. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH]

120

Chagas Disease

Parasitism: A) The mode of life of a parasite; b) The relationship between an organism (parasite) that derives benefits from, and at the expense of, another organism (host). [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Fragments: Partial proteins formed by partial hydrolysis of complete proteins. [NIH] Perennial: Lasting through the year of for several years. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacokinetics: Dynamic and kinetic mechanisms of exogenous chemical and drug absorption, biotransformation, distribution, release, transport, uptake, and elimination as a function of dosage, and extent and rate of metabolic processes. It includes toxicokinetics, the pharmacokinetic mechanism of the toxic effects of a substance. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Physicochemical: Pertaining to physics and chemistry. [EU] 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]

Pilot study: The initial study examining a new method or treatment. [NIH]

Dictionary 121

Plant Diseases: Diseases of plants. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which

122

Chagas Disease

another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propolis: Resinous substance obtained from beehives; contains many different substances which may have antimicrobial or antimycotic activity topically; its extracts are called propolis resin or balsam. Synonyms: bee bread; hive dross; bee glue. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoal: Having to do with the simplest organisms in the animal kingdom. Protozoa are single-cell organisms, such as ameba, and are different from bacteria, which are not members of the animal kingdom. Some protozoa can be seen without a microscope. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH]

Dictionary 123

Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] 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] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] 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] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of

124

Chagas Disease

treatment. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rickettsia: A genus of gram-negative, aerobic, rod-shaped bacteria often surrounded by a protein microcapsular layer and slime layer. The natural cycle of its organisms generally involves a vertebrate and an invertebrate host. Species of the genus are the etiological agents of human diseases, such as typhus. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents. [NIH]

Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scabies: A contagious cutaneous inflammation caused by the bite of the mite Sarcoptes scabiei. It is characterized by pruritic papular eruptions and burrows and affects primarily the axillae, elbows, wrists, and genitalia, although it can spread to cover the entire body. [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] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large

Dictionary 125

amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Seroconversion: The change of a serologic test from negative to positive, indicating the development of antibodies in response to infection or immunization. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [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] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by

126

Chagas Disease

refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spirochete: Lyme disease. [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] Squalene Synthetase: Catalyzes the rearrangement and reduction of the cyclopropane compound, presqualene pyrophosphate to form squalene, with NADPH as the coenzyme. [NIH]

Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Submandibular: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Substrate Specificity: A characteristic feature of enzyme activity in relation to the kind of substrate on which the enzyme or catalytic molecule reacts. [NIH] 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]

Dictionary 127

Surface Plasmon Resonance: A biosensing technique in which biomolecules capable of binding to specific analytes or ligands are first immobilized on one side of a metallic film. Light is then focused on the opposite side of the film to excite the surface plasmons, that is, the oscillations of free electrons propagating along the film's surface. The refractive index of light reflecting off this surface is measured. When the immobilized biomolecules are bound by their ligands, an alteration in surface plasmons on the opposite side of the film is created which is directly proportional to the change in bound, or adsorbed, mass. Binding is measured by changes in the refractive index. The technique is used to study biomolecular interactions, such as antigen-antibody binding. [NIH] Symbiosis: The living together of organisms of different species. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [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] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Ticks: Blood-sucking arachnids of the order Acarina. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Titre: The quantity of a substance required to produce a reaction with a given volume of another substance, or the amount of one substance required to correspond with a given amount of another substance. [EU]

128

Chagas Disease

Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Transgenes: Genes that are introduced into an organism using gene transfer techniques. [NIH]

Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trans-Splicing: The joining of RNA from two different genes. One type of trans-splicing is the "spliced leader" type (primarily found in protozoans such as trypanosomes and in lower invertebrates such as nematodes) which results in the addition of a capped, noncoding, spliced leader sequence to the 5' end of mRNAs. Another type of trans-splicing is the "discontinuous group II introns" type (found in plant/algal chloroplasts and plant mitochondria) which results in the joining of two independently transcribed coding sequences. Both are mechanistically similar to conventional nuclear pre-mRNA cis-splicing. Mammalian cells are also capable of trans-splicing. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Triatoma: A genus of the subfamily Triatominae. Several species are vectors of Trypanosoma cruzi. [NIH] Triatominae: A subfamily of assassin bugs (Reduviidae) that are obligate blood-suckers of vertebrates. Included are the genera Triatoma, Rhodnius, and Panstrongylus, which are vectors of Trypanosoma cruzi, the agent of Chagas disease in humans. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tropism: Directed movements and orientations found in plants, such as the turning of the sunflower to face the sun. [NIH] Trypanosome: The trypanosomes are small single-celled parasites (protozoa of the genus

Dictionary 129

Trypanosoma) that are found in the blood-stream in certain diseases that are classed together as the "trypanosomiases". [NIH] Trypanosomiasis: Infection with protozoa of the genus Trypanosoma. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Ubiquitin: A highly conserved 76 amino acid-protein found in all eukaryotic cells. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] 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] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH]

130

Chagas Disease

Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yaws: A systemic non-venereal infection of the tropics caused by Treponema pallidum subspecies pertenue. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Yellow Fever: An acute infectious disease primarily of the tropics, caused by a virus and transmitted to man by mosquitoes of the genera Aedes and Haemagogus. [NIH]

131

INDEX A Ablation, 6, 97 Acetylcholine, 97, 119 Actin, 97, 118 Acute Disease, 14, 97 Adenine, 12, 97, 123 Adenine Phosphoribosyltransferase, 12, 97 Adenosine, 12, 97, 102, 112, 127 Adenosine Kinase, 12, 97 Adverse Effect, 97, 125 Aerobic, 97, 117, 124 Aetiology, 44, 97 Affinity, 16, 97 Affinity Chromatography, 16, 97 Agar, 97, 98, 112 Agarose, 98, 112 AK, 12, 98 Algorithms, 98, 101 Alleles, 11, 98 Allograft, 98, 118 Allopurinol, 12, 98 Alternative medicine, 72, 98 Amino Acid Sequence, 98, 99, 105 Amino Acids, 12, 98, 105, 119, 120, 121, 122, 124, 128 Amplification, 62, 98 Anaesthesia, 98, 113 Anal, 98, 109 Analgesic, 60, 98 Analogous, 4, 98, 107, 128 Analytes, 98, 127 Anaphylatoxins, 98, 104 Anemia, 98, 116 Annealing, 98, 121 Antibiotic, 99, 102, 126 Antibodies, 5, 8, 9, 11, 18, 21, 28, 29, 30, 34, 36, 37, 62, 99, 100, 111, 112, 117, 121, 125 Antibody, 21, 43, 50, 61, 97, 99, 104, 108, 111, 112, 113, 117, 123, 125, 127 Anticoagulants, 64, 99 Antifungal, 99, 114 Antigen, 18, 22, 28, 33, 36, 37, 49, 53, 69, 97, 99, 104, 111, 112, 113, 125, 127 Antigen-Antibody Complex, 99, 104 Anti-inflammatory, 7, 99 Antimicrobial, 9, 61, 64, 99, 122 Antimycotic, 99, 122

Antioxidant, 48, 99 Antithrombotic, 7, 99 Anus, 98, 99, 104 Aorta, 99, 129 Apolipoproteins, 42, 99, 115 Apolipoproteins A, 42, 99 Arginine, 98, 99, 119 Arterial, 100, 122, 127 Arteries, 99, 100, 101, 105, 114 Arteriosclerosis, 100, 102 Artery, 100, 114, 117, 123, 124 Aspergillosis, 100, 114 Assay, 5, 20, 100 Asymptomatic, 14, 40, 42, 100 Atrium, 100, 129 Attenuation, 15, 100 Auditory, 100, 117, 129 Autoantibodies, 18, 21, 100 Autoantigens, 100 Autoimmune disease, 100 Autoimmunity, 18, 22, 24, 27, 35, 49, 54, 100 Autonomic Nervous System, 45, 100, 120, 125, 127 Axenic, 11, 100 B Bacteria, 5, 16, 99, 100, 108, 110, 115, 117, 121, 122, 124, 126, 128, 129 Bacterium, 5, 100 Base, 97, 100, 114, 127 Basement Membrane, 100, 114 Bile, 101, 111, 113, 115 Bile duct, 101, 113 Bioassay, 4, 101 Biochemical, 6, 10, 12, 47, 98, 101 Biological response modifier, 101, 113 Biomolecular, 101, 127 Biopterin, 101, 118 Biosynthesis, 15, 64, 101, 118 Biotechnology, 17, 18, 72, 79, 101 Bladder, 101, 129 Blast phase, 101, 103 Blastomycosis, 101, 114 Blood pressure, 101, 102, 117 Blood transfusion, 20, 69, 101 Blood vessel, 101, 108, 116, 125, 126, 127, 129 Body Fluids, 101, 118

132

Chagas Disease

Bone Marrow, 15, 101, 103, 112, 116, 118 Bradykinin, 102, 119 Broad-spectrum, 4, 102 Buccal, 102, 115 C Caffeine, 102, 123 Calcium, 102, 104 Carbohydrate, 102, 121, 125 Carbon Dioxide, 102, 109, 124 Carcinogenic, 102, 113, 122 Cardiac, 7, 14, 18, 22, 28, 33, 39, 47, 54, 94, 102, 118 Cardiomegaly, 14, 102 Cardiomyopathy, 7, 15, 38, 39, 40, 54, 102 Cardiopathy, 18, 22, 51, 102 Case report, 23, 27, 102 Causal, 11, 12, 102 Cell Cycle, 11, 103 Cell Division, 100, 103, 106, 121 Central Nervous System, 97, 100, 102, 103, 110, 127 Cerebral, 27, 72, 103, 116 Cerebrum, 103 Chemotactic Factors, 103, 104 Chemotaxis, 32, 103 Chemotherapy, 16, 19, 29, 47, 48, 50, 61, 64, 103 Chlorophyll, 103, 110 Chloroplasts, 103, 128 Cholelithiasis, 40, 103 Cholesterol, 42, 99, 101, 103, 115 Chromatin, 103, 116 Chromosomal, 7, 98, 103, 121, 124 Chromosome, 103, 111, 115, 124 Chronic Disease, 14, 103 Chronic myelogenous leukemia, 101, 103 Chronic phase, 14, 15, 47, 103 Ciliary, 14, 103 Ciliary Neurotrophic Factor, 14, 103 CIS, 5, 103, 128 Clinical trial, 4, 30, 79, 104, 123 Cloning, 11, 101, 104 Cockroaches, 5, 104 Codons, 104, 119 Coenzyme, 104, 126 Cofactor, 104, 122 Colloidal, 104, 108 Colon, 25, 104, 113, 114, 117, 125 Complement, 8, 18, 30, 34, 63, 98, 104, 105, 110 Complement Activation, 8, 98, 104

Complementary and alternative medicine, 59, 66, 105 Complementary medicine, 59, 105 Complementation, 15, 105 Computational Biology, 79, 105 Congestive heart failure, 14, 105 Connective Tissue, 101, 105, 109, 110, 116, 120 Consciousness, 98, 105, 107 Consensus Sequence, 105 Conserved Sequence, 6, 105 Constriction, 105, 124 Contraindications, ii, 105 Coronary, 28, 105 Cost-benefit, 19, 105 Cost-Benefit Analysis, 19, 105 Cranial, 106, 120, 129 Curative, 106, 127 Cutaneous, 15, 20, 29, 32, 61, 101, 106, 115, 124 Cyclic, 102, 106, 110, 119, 127 Cysteine, 50, 106 Cystine, 106 Cytogenetics, 106, 124 Cytokine, 14, 48, 106 Cytomegalovirus, 69, 106 Cytoplasm, 106, 116, 118, 124 Cytotoxic, 8, 106, 112 Cytotoxicity, 21, 106 D Degenerative, 106, 111 Deletion, 11, 106 Denaturation, 106, 121 Dendrites, 106, 118 Desensitization, 106, 112 Diagnostic procedure, 72, 106 Diffusion, 106, 112, 113 Dihydrotestosterone, 106, 123 Dilated cardiomyopathy, 21, 106 Dilation, 3, 102, 106 Diploid, 105, 107, 121 Direct, iii, 12, 13, 107, 115, 123 Discrete, 6, 107 Disease Transmission, 9, 22, 25, 29, 40, 41, 107 Disease Transmission, Horizontal, 107 Disease Transmission, Vertical, 107 Disease Vectors, 22, 29, 31, 62, 65, 107, 113 Dissociation, 97, 107 Dross, 107, 122 Drug Design, 12, 107 Drug Interactions, 107

133

E Echocardiography, 43, 54, 107 Ecosystem, 26, 107 Effector, 8, 97, 104, 107 Efficacy, 12, 16, 20, 62, 63, 64, 107 Electrons, 99, 100, 107, 119, 123, 127 Electrophoresis, 13, 45, 108 Embryo, 108, 113 Emulsion, 108, 109 Encephalitis, 70, 108 Encephalitis, Viral, 108 Endemic, 15, 16, 24, 26, 31, 38, 46, 47, 94, 108, 116 Endogenous, 12, 100, 108 Endothelium, 108, 119 Endothelium-derived, 108, 119 Endotoxin, 108, 129 Environmental Health, 78, 80, 108 Enzymatic, 11, 15, 102, 104, 108, 115, 121 Enzyme, 6, 19, 45, 97, 98, 104, 107, 108, 110, 121, 122, 123, 126, 127, 130 Epidemiological, 10, 16, 20, 28, 30, 36, 108 Epithelial, 108, 111, 114 Epithelial Cells, 108, 111, 114 Epitope, 18, 22, 108 Erythrocytes, 98, 101, 108 Esophageal, 3, 42, 44, 108 Esophagus, 42, 108, 109, 120, 126 Eukaryotic Cells, 109, 119, 129 Exhaustion, 109, 116 Exogenous, 108, 109, 120 Extracellular, 8, 105, 109 F Family Planning, 79, 109 Fat, 101, 109, 115, 125 Fatigue, 109, 111 Fibrin, 7, 109, 120, 127 Fibrinogen, 109, 127 Fibrosis, 15, 38, 109 Fixation, 18, 30, 109 Flatus, 109, 110 Fleas, 5, 109 Fovea, 109 Fractionation, 12, 109 Free Radicals, 99, 107, 109 Fungus, 6, 110 G Ganglia, 97, 110, 118, 120, 127 Gas, 16, 102, 106, 109, 110, 112, 119 Gastrointestinal, 3, 15, 32, 102, 110, 116, 125 Gastrointestinal tract, 15, 110

Gene, 4, 5, 8, 9, 10, 11, 12, 14, 47, 98, 101, 110, 114, 128 Gene Expression, 5, 10, 12, 110 Genetic Engineering, 101, 104, 110 Genetic testing, 110, 121 Genetics, 8, 12, 106, 110 Germfree, 63, 110 Gland, 62, 110, 116, 124, 126, 127 Glucuronic Acid, 110, 111 Glutathione Peroxidase, 110, 125 Glycoprotein, 8, 109, 110, 114, 129 Governing Board, 110, 121 Gram-negative, 110, 124 Guanine, 12, 110, 123 Guanylate Cyclase, 110, 119 H Habitat, 10, 111, 119 Haploid, 111, 121 Haptens, 97, 111 Health Status, 7, 111 Heart failure, 7, 54, 111 Heart Transplantation, 14, 111 Heartbeat, 94, 111 Helminths, 111, 113 Hemorrhage, 111, 126 Heparin, 64, 111 Hepatitis, 69, 111, 129 Hepatocytes, 111 Heredity, 110, 111 Heritability, 7, 111 Heterogeneity, 9, 97, 111 Homologous, 9, 13, 98, 111 Hormone, 101, 111, 127 Humoral, 39, 50, 111 Humour, 111 Hydrogen, 100, 102, 106, 110, 111, 117, 119 Hydrolysis, 112, 116, 120, 121, 122 Hypothalamus, 100, 112 Hypoxanthine, 12, 112, 130 I Idiopathic, 42, 112 Immune response, 8, 39, 50, 51, 99, 100, 111, 112, 129, 130 Immune Sera, 112 Immune system, 49, 100, 112, 118, 129, 130 Immunity, 34, 42, 49, 112, 128 Immunization, 8, 112, 125 Immunochemistry, 12, 112 Immunodeficiency, 52, 69, 112 Immunodiffusion, 48, 97, 112 Immunofluorescence, 13, 112 Immunologic, 8, 15, 103, 112

134

Chagas Disease

Immunology, 5, 10, 11, 16, 17, 20, 21, 32, 33, 38, 39, 44, 49, 50, 53, 54, 97, 112 Immunosuppression, 23, 39, 112, 113, 116 Immunosuppressive, 14, 112 Immunosuppressive Agents, 112 Impaction, 4, 113 In vitro, 9, 11, 15, 16, 33, 65, 71, 113, 121, 125 In vivo, 8, 11, 111, 113, 116 Incision, 113, 114 Induction, 8, 113 Infestation, 10, 113 Infiltration, 28, 113 Inflammation, 7, 38, 99, 103, 108, 109, 111, 113, 117, 118, 120, 121, 124 Infusion, 113, 128 Initiation, 10, 13, 113 Insecticides, 56, 63, 65, 94, 113, 120 Insight, 15, 113 Interferon, 37, 113 Interferon-alpha, 113 Intestine, 111, 114, 130 Intoxication, 102, 114 Intracellular, 8, 12, 102, 113, 114, 119, 124, 125 Intrinsic, 97, 100, 114 Introns, 114, 128 Invasive, 7, 112, 114 Invertebrates, 107, 114, 128 Involuntary, 114, 118 Ischemic stroke, 7, 114 Itraconazole, 34, 114 K Kb, 78, 114 Ketoconazole, 20, 114 Kidney Disease, 78, 102, 114 Kidney Transplantation, 23, 114 Kinetics, 13, 30, 114 Kinetoplastida, 13, 35, 114 L Labile, 104, 114 Laminin, 21, 29, 100, 114 Large Intestine, 114, 123, 130 Larynx, 114, 129 Leishmania, 4, 5, 11, 12, 15, 115 Leishmaniasis, 5, 10, 11, 12, 13, 15, 17, 19, 20, 29, 50, 53, 61, 115 Leprosy, 17, 115 Leptospirosis, 70, 115 Lethal, 8, 16, 52, 115 Leukemia, 14, 103, 115 Life cycle, 11, 115

Ligaments, 105, 115 Ligands, 115, 127 Linkage, 7, 115 Lipid, 99, 100, 115 Lipoprotein, 99, 110, 115 Liver, 101, 106, 108, 110, 111, 115 Localized, 109, 113, 114, 115, 121 Locomotion, 115, 121 Lucida, 114, 115 Lupus, 18, 21, 115 Lymph, 93, 108, 111, 115, 116, 126 Lymph node, 93, 116 Lymphatic, 108, 113, 115, 116, 126, 127 Lymphatic system, 115, 116, 126, 127 Lymphocyte Depletion, 112, 116 Lymphocytes, 32, 37, 99, 112, 116, 126, 127, 130 Lymphocytic, 103, 116 Lymphoid, 99, 116 Lymphoproliferative, 33, 116 Lytic, 34, 37, 43, 62, 116, 125, 130 M Malaria, 11, 17, 51, 69, 84, 116 Malaria, Falciparum, 116 Malaria, Vivax, 116 Malignant, 116, 118 Mannans, 110, 116 Mannosidases, 14, 116 Mannosides, 116 Meatus, 117, 129 MEDLINE, 79, 117 Megacolon, 4, 19, 44, 117 Membrane, 15, 50, 103, 104, 109, 110, 114, 115, 117, 118, 119, 128 Meningitis, 114, 117 Mental, iv, 4, 78, 80, 107, 109, 117, 122 Mental Health, iv, 4, 78, 80, 117, 122 Microbe, 117, 128 Microorganism, 104, 117, 120, 130 Micro-organism, 107, 110, 117 Microscopy, 9, 13, 15, 100, 117 Migration, 23, 49, 117 Mitochondria, 117, 119, 128 Modeling, 10, 33, 107, 117 Modification, 110, 117, 123 Molecular, 5, 8, 10, 11, 12, 13, 14, 17, 19, 47, 79, 81, 101, 105, 106, 107, 109, 111, 117, 128, 129 Molecule, 4, 13, 97, 99, 100, 104, 107, 108, 112, 117, 119, 121, 123, 126, 129 Monitor, 53, 117, 119 Monoclonal, 8, 117, 123

135

Monoclonal antibodies, 8, 117 Monocytes, 32, 118 Mononuclear, 28, 29, 118, 129 Morphological, 108, 110, 118 Mucocutaneous, 115, 118 Mucosa, 115, 118 Muscle Fibers, 118 Mutagenesis, 12, 118 Mutagens, 118 Mydriatic, 106, 118 Myocarditis, 35, 118 Myocardium, 38, 118 Myosin, 18, 22, 38, 118 N Naphthoquinones, 62, 118 NCI, 1, 77, 104, 118 Neonatal, 18, 118 Neopterin, 48, 118 Nervous System, 41, 100, 103, 118, 120, 127 Neural, 14, 111, 118 Neuronal, 14, 103, 118, 120 Neurons, 14, 106, 110, 118, 127 Neurotransmitter, 97, 102, 118 Neutralization, 8, 119 Niche, 33, 119 Nitric Oxide, 51, 119 Nitrogen, 98, 109, 119 Nuclear, 5, 10, 108, 109, 119, 128 Nucleic acid, 97, 112, 118, 119, 123 Nucleus, 103, 106, 109, 116, 118, 119, 125, 126 O Open Reading Frames, 13, 119 Ophthalmology, 109, 119 Organelles, 106, 118, 119 Ovum, 115, 119 Oxidation, 99, 106, 110, 119 P Palliative, 119, 127 Parasite, 3, 6, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18, 21, 24, 34, 35, 37, 44, 49, 119, 120 Parasitic, 4, 5, 6, 11, 12, 15, 16, 84, 109, 111, 113, 119, 124 Parasitism, 15, 120 Pathogen, 9, 120 Pathologic, 105, 120 Peptide, 16, 120, 121, 122 Peptide Fragments, 16, 120 Perennial, 120, 128 Perforation, 120, 130 Peripheral blood, 29, 113, 120

Peripheral Nerves, 115, 120, 126 Peripheral Nervous System, 30, 118, 120 Peritonitis, 120, 130 Pesticides, 62, 113, 120 Phagocytosis, 37, 120 Phallic, 109, 120 Pharmacokinetics, 107, 120 Pharmacologic, 120, 128 Pharynx, 120, 129 Phenotype, 105, 120 Physicochemical, 112, 120 Physiologic, 101, 120, 123 Pilot study, 7, 120 Plant Diseases, 11, 121 Plants, 6, 62, 102, 103, 121, 128 Plasma, 40, 60, 99, 109, 121 Plasma cells, 99, 121 Plasmid, 8, 121, 129 Platelet Activation, 7, 121 Platelet Aggregation, 98, 119, 121 Platelets, 119, 121 Pneumonia, 105, 121 Polymerase, 10, 24, 31, 45, 62, 121 Polymerase Chain Reaction, 24, 31, 62, 121 Polymorphic, 7, 121 Polypeptide, 98, 105, 109, 121 Polysaccharide, 98, 99, 121 Postnatal, 121, 126 Practice Guidelines, 80, 121 Precursor, 107, 108, 118, 121 Prevalence, 38, 40, 46, 50, 122 Progressive, 121, 122 Promoter, 10, 122 Prone, 14, 122 Prophylaxis, 12, 122, 129 Propolis, 63, 122 Protein C, 98, 99, 115, 122 Protein S, 16, 101, 105, 122, 124 Proteins, 11, 12, 13, 15, 18, 21, 49, 98, 99, 103, 104, 117, 119, 120, 121, 122, 123, 125 Proteolytic, 16, 104, 109, 122 Protozoa, 6, 10, 11, 15, 114, 115, 117, 122, 128, 129 Protozoal, 122 Protozoan, 3, 5, 6, 8, 12, 14, 16, 116, 122 Pruritic, 122, 124 Psychiatry, 109, 122 Public Health, 5, 6, 13, 20, 60, 80, 122 Public Policy, 79, 122 Publishing, 18, 122 Pulmonary, 101, 122, 123, 129 Pulmonary Artery, 101, 123, 129

136

Chagas Disease

Pulse, 117, 123 Pupil, 106, 118, 123 Purifying, 16, 123 Purines, 12, 123, 130 Q Quality of Life, 7, 123 R Race, 117, 123 Radiation, 105, 109, 112, 123, 130 Radiation therapy, 109, 123 Radioactive, 112, 117, 119, 123 Radiological, 42, 123 Radiology, 123 Randomized, 107, 123 Reactivation, 32, 46, 123 Receptor, 29, 99, 123 Recombinant, 11, 28, 39, 53, 54, 123, 129 Recombinant Proteins, 11, 54, 123 Rectum, 4, 25, 99, 104, 109, 110, 114, 123, 125 Reductase, 15, 19, 123 Refer, 1, 102, 104, 109, 115, 123, 128 Regeneration, 14, 123 Regimen, 107, 123 Research Design, 10, 124 Respiration, 102, 117, 124 Ribose, 97, 124 Ribosome, 124, 128 Rickettsia, 9, 124 Rickettsiae, 9, 124 Rigidity, 121, 124 Risk factor, 25, 38, 124 Rod, 100, 124 Rodenticides, 120, 124 S Salivary, 106, 124, 126 Salivary glands, 106, 124 Satellite, 10, 124 Scabies, 84, 124 Screening, 4, 39, 47, 54, 69, 104, 124 Secretion, 111, 124 Secretory, 62, 124 Segmental, 43, 124 Segmentation, 124 Selenium, 61, 124 Sequence Analysis, 9, 125 Sequencing, 16, 121, 125 Seroconversion, 7, 125 Serologic, 24, 42, 125 Serology, 47, 62, 125 Serum, 36, 40, 48, 98, 99, 104, 112, 116, 120, 125, 129

Side effect, 97, 125, 128 Sigmoid, 4, 125 Sigmoid Colon, 4, 125 Skeletal, 36, 125 Skeleton, 97, 125 Skull, 125, 127 Social Environment, 123, 125 Soft tissue, 101, 125 Solitary Nucleus, 100, 125 Somatic, 111, 120, 125, 129 Specialist, 85, 106, 125 Species, 4, 15, 56, 63, 65, 105, 107, 111, 115, 116, 117, 119, 123, 124, 125, 126, 127, 128, 129, 130 Specificity, 13, 97, 125 Spectrum, 114, 125 Sphincter, 3, 42, 115, 126 Spinal cord, 103, 118, 120, 126, 127 Spinal Nerves, 120, 126 Spirochete, 126, 127 Spleen, 106, 116, 126 Squalene Synthetase, 15, 126 Stem Cells, 15, 126 Stomach, 109, 110, 111, 120, 126, 130 Stool, 104, 113, 114, 126 Strand, 11, 121, 126 Stress, 100, 126 Stroke, 6, 78, 114, 126 Subacute, 113, 126 Subclinical, 113, 126 Submandibular, 62, 126 Subspecies, 125, 126, 130 Substrate, 12, 14, 126 Substrate Specificity, 14, 126 Supplementation, 61, 126 Suppression, 17, 126 Surface Plasmon Resonance, 13, 127 Symbiosis, 22, 127 Sympathetic Nervous System, 100, 127 Syphilis, 69, 127 Systemic, 7, 99, 101, 113, 123, 127, 128, 130 Systolic, 44, 127 T Temporal, 9, 117, 127 Testosterone, 123, 127 Theophylline, 123, 127 Therapeutics, 4, 15, 127 Thermal, 107, 121, 127 Thrombin, 109, 121, 122, 127 Thrombosis, 122, 126, 127 Thymus, 112, 116, 127 Thyroid, 102, 127

137

Ticks, 9, 113, 127 Titre, 43, 127 Toxic, iv, 5, 11, 15, 102, 106, 112, 120, 124, 128 Toxicity, 15, 107, 128 Toxicology, 80, 128 Toxin, 102, 108, 128 Transfection, 15, 101, 128 Transfer Factor, 112, 128 Transfusion, 50, 52, 69, 128 Transgenes, 5, 128 Translation, 10, 128 Translational, 13, 128 Transplantation, 15, 23, 52, 112, 116, 128 Trans-Splicing, 5, 10, 128 Trees, 34, 44, 128 Triatoma, 9, 30, 33, 35, 45, 46, 49, 60, 61, 62, 63, 65, 67, 128 Triatominae, 22, 33, 46, 63, 128 Trophic, 34, 63, 128 Tropism, 9, 128 Trypanosome, 4, 17, 128 Trypanosomiasis, 3, 6, 9, 11, 17, 18, 20, 26, 27, 45, 46, 50, 60, 69, 72, 129 Tuberculosis, 115, 129 Tumor Necrosis Factor, 40, 129 U Ubiquitin, 53, 129 Urethra, 129 Uric, 98, 123, 129 Urinary, 46, 129, 130 Urine, 15, 101, 129 V Vaccination, 19, 129

Vaccine, 8, 16, 129 Vagus Nerve, 22, 125, 129 Vascular, 108, 113, 119, 129 Vasodilators, 119, 129 Vector, 5, 9, 16, 22, 23, 24, 26, 32, 33, 34, 49, 56, 63, 129 Vein, 119, 124, 129 Venereal, 127, 129, 130 Venous, 122, 129 Ventricle, 43, 112, 123, 127, 129 Ventricular, 44, 47, 129 Ventricular Function, 47, 129 Veterinary Medicine, 79, 129 Viral, 36, 69, 108, 118, 129 Viral Hepatitis, 69, 129 Virulence, 8, 12, 128, 130 Virulent, 34, 130 Virus, 52, 69, 110, 113, 129, 130 Visceral, 11, 15, 100, 115, 129, 130 Visceral Afferents, 100, 129, 130 Vitro, 11, 111, 130 Vivo, 116, 130 Volvulus, 4, 130 W White blood cell, 99, 101, 103, 116, 121, 130 X Xanthine, 98, 130 Xanthine Oxidase, 98, 130 X-ray, 119, 123, 130 Y Yaws, 69, 130 Yeasts, 110, 120, 130 Yellow Fever, 70, 130

138

Chagas Disease

139

140

Chagas Disease