Cluster Headaches - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

LUSTER EADACHES A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J AM...

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LUSTER EADACHES A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright Ó2004 by ICON Group International, Inc. Copyright Ó2004 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., 1961 Parker, Philip M., 1960 Cluster Headaches: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0 597 84378 3 1. Cluster Headaches Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on cluster headaches. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications.

Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON CLUSTER HEADACHES.............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Cluster Headaches......................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. NUTRITION AND CLUSTER HEADACHES .................................................................... 21 Overview...................................................................................................................................... 21 Finding Nutrition Studies on Cluster Headaches ....................................................................... 21 Federal Resources on Nutrition ................................................................................................... 24 Additional Web Resources ........................................................................................................... 24 CHAPTER 3. ALTERNATIVE MEDICINE AND CLUSTER HEADACHES.............................................. 27 Overview...................................................................................................................................... 27 National Center for Complementary and Alternative Medicine.................................................. 27 Additional Web Resources ........................................................................................................... 31 General References ....................................................................................................................... 32 CHAPTER 4. CLINICAL TRIALS AND CLUSTER HEADACHES .......................................................... 33 Overview...................................................................................................................................... 33 Recent Trials on Cluster Headaches ............................................................................................ 33 Keeping Current on Clinical Trials ............................................................................................. 34 CHAPTER 5. PATENTS ON CLUSTER HEADACHES .......................................................................... 37 Overview...................................................................................................................................... 37 Patents on Cluster Headaches...................................................................................................... 37 Patent Applications on Cluster Headaches.................................................................................. 41 Keeping Current .......................................................................................................................... 43 CHAPTER 6. BOOKS ON CLUSTER HEADACHES .............................................................................. 45 Overview...................................................................................................................................... 45 Book Summaries: Online Booksellers ........................................................................................... 45 Chapters on Cluster Headaches ................................................................................................... 46 CHAPTER 7. PERIODICALS AND NEWS ON CLUSTER HEADACHES ................................................ 47 Overview...................................................................................................................................... 47 News Services and Press Releases................................................................................................ 47 Newsletter Articles ...................................................................................................................... 51 Academic Periodicals covering Cluster Headaches ...................................................................... 51 CHAPTER 8. RESEARCHING MEDICATIONS..................................................................................... 53 Overview...................................................................................................................................... 53 U.S. Pharmacopeia....................................................................................................................... 53 Commercial Databases ................................................................................................................. 54 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 59 Overview...................................................................................................................................... 59 NIH Guidelines............................................................................................................................ 59 NIH Databases............................................................................................................................. 61 Other Commercial Databases....................................................................................................... 63 The Genome Project and Cluster Headaches................................................................................ 63 APPENDIX B. PATIENT RESOURCES ................................................................................................. 67 Overview...................................................................................................................................... 67 Patient Guideline Sources............................................................................................................ 67 Finding Associations.................................................................................................................... 73 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 75 Overview...................................................................................................................................... 75 Preparation................................................................................................................................... 75

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Finding a Local Medical Library.................................................................................................. 75 Medical Libraries in the U.S. and Canada ................................................................................... 75 ONLINE GLOSSARIES .................................................................................................................. 81 Online Dictionary Directories ..................................................................................................... 83 CLUSTER HEADACHES DICTIONARY ................................................................................... 85 INDEX .............................................................................................................................................. 113

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading." 1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with cluster headaches 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 cluster headaches, 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 cluster headaches, 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 cluster headaches. 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 cluster headaches, 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 cluster headaches. The Editors

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

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CHAPTER 1. STUDIES ON CLUSTER HEADACHES Overview In this chapter, we will show you how to locate peer-reviewed references and studies on cluster headaches.

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

Retrospective Study of Patients With Cluster Headaches Source: Oral Surgery, Oral Medicine, Oral Pathology. 73(5): 519-525. May 1992. Summary: Referred pain in the midface and teeth is a common clinical feature of cluster headache and cluster headache-like disorders. This article reports on 33 cases of cluster headache that met the International Headache Society classification criteria, and that were seen by the authors during a 2-year period. Fourteen (42 percent) of 33 patients who were seen by dental practitioners and who received some form of ineffective dental or pharmalogical treatment are described in the article. Almost 50 percent of the cluster headache patients described received inappropriate dental treatment. The authors hope that this review and retrospective assessment will make the dental practitioner aware of this disorder and provide a broader perspective in the treatment of pain in the orofacial

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region. The authors also discuss clinical presentation, pathogenesis, and treatment of cluster headaches.

Federally Funded Research on Cluster Headaches The U.S. Government supports a variety of research studies relating to cluster headaches. 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 cluster headaches. 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 cluster headaches. The following is typical of the type of information found when searching the CRISP database for cluster headaches: ·

Project Title: RACE, PSYCHIATRIC DISORDERS, AND HEADACHE Principal Investigator & Institution: Heckman, Bernadette D.; Psychology; Ohio University Athens Athens, Oh 45701 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): This application requests five years of support for a Mentored Research Scientist Development Award (K01) for a new minority investigator. The objectives of the planned training program are two-fold. The first objective is to provide the minority candidate with contemporary training in the areas of statistics, research methodology, research ethics, the pathophysiology of headache disorders, cross-cultural psychology, and health disparities. Formal coursework in these areas will facilitate the successful conduct of the planned study and prepare the candidate for future research endeavors throughout her career. The second objective is to examine how race and psychiatric co-morbid conditions are related to headache severity, quality of life, treatment adherence, and ability to respond favorably to treatments in people with episodic migraines, chronic migraines, episodic tension-type headaches, chronic tension-type headaches, substance abuse headaches, or cluster headaches. Using a quasi-experimental prospective research design, 400 patients presenting at outpatient medical centers in four urban areas of Ohio (Cincinnati, Cleveland, Columbus, and Toledo) will complete self-administered assessments, telephone-based interviews, and daily headache diaries that elicit data on headache severity, quality of life, social support, treatment self-efficacy, locus of control, treatment adherence, and treatment outcome. Guided by Social Cognitive Theory (SCT; Bandura, 1986), the planned study will employ structural equation modeling path analysis to determine whether SCT constructs, such as social support, health-related locus of control, and treatment selfefficacy, mediate associations between race and the presence of a co-morbid psychiatric

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

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disorder and key outcome measures, such as quality of life and treatment outcome. If successful, the candidate will obtain extramural funding prior to the completion of the training program that will enable her to conceptualize, implement, and evaluate a culturally-contextualized intervention to reduce headache pain and improve the life quality of people who experience severe headache characteristics. Website: http://crisp.cit.nih.gov/crisp/Crisp Query.Generate Screen

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

A cluster headache family with possible autosomal recessive inheritance. Author(s): De Simone R, Fiorillo C, Bonuso S, Castaldo G. Source: Neurology. 2003 August 26; 61(4): 578-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12939449&dopt=Abstract

·

A note on cluster headache in a population-based twin register. Author(s): Svensson D, Ekbom K, Pedersen NL, Traff H, Waldenlind E. Source: Cephalalgia : an International Journal of Headache. 2003 June; 23(5): 376-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12780768&dopt=Abstract

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A patient with cluster headache responsive to indomethacin: any relationship with chronic paroxysmal hemicrania? Author(s): Buzzi MG, Formisano R. Source: Cephalalgia : an International Journal of Headache. 2003 June; 23(5): 401-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12780773&dopt=Abstract

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

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A peculiar case of bilateral cluster headaches. Author(s): Split W, Durko A. Source: Headache. 1983 July; 23(4): 197. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6411656&dopt=Abstract

·

A retrospective study of patients with cluster headaches. Author(s): Bittar G, Graff-Radford SB. Source: Oral Surg Oral Med Oral Pathol. 1992 May; 73(5): 519-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1518633&dopt=Abstract

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A study of the activity of platelet monoamine oxidase in patients with migraine headaches or with 'cluster headaches'. Author(s): Bussone G, Giovannini P, Boiardi A, Boeri R. Source: European Neurology. 1977; 15(3): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=852472&dopt=Abstract

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Abnormal 5-HT1D receptor function in cluster headache: a neuroendocrine study with sumatriptan. Author(s): Pinessi L, Rainero I, Valfre W, Lo Giudice R, Ferrero M, Rivoiro C, Arvat E, Gianotti L, Del Rizzo P, Limone P. Source: Cephalalgia : an International Journal of Headache. 2003 June; 23(5): 354-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12780765&dopt=Abstract

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Abnormal neuromuscular transmission in cluster headache. Author(s): Ertas M, Baslo MB. Source: Headache. 2003 June; 43(6): 616-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12786920&dopt=Abstract

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Biochemical studies in cluster headaches. Author(s): D'Andrea G, Cadaldini M. Source: Italian Journal of Neurological Sciences. 1999 April; 20(2 Suppl): S10-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=10662929&dopt=Abstract

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Cerebral arterial occlusion and cluster headaches in neurofibromatosis. Author(s): Vannucci RC, Solomon GE, Deck MD. Source: Am J Dis Child. 1974 March; 127(3): 422-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=4205497&dopt=Abstract

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Cerebral hyperemia during spontaneous cluster headaches with excessive cerebral vasoconstriction to hyperoxia. Author(s): Kawamura J, Meyer JS, Terayama Y, Weathers S. Source: Headache. 1991 April; 31(4): 222-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2050516&dopt=Abstract

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Childhood onset cluster headaches. Author(s): Maytal J, Lipton RB, Solomon S, Shinnar S. Source: Headache. 1992 June; 32(6): 275-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1399546&dopt=Abstract

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Cigarette smoking and cluster headaches. Author(s): Millac P, Akhtar N. Source: Headache. 1985 June; 25(4): 223. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=4019184&dopt=Abstract

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Clinical effectiveness of calcium entry blockers in prophylactic treatment of migraine and cluster headaches. Author(s): Meyer JS, Hardenberg J. Source: Headache. 1983 November; 23(6): 266-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6358126&dopt=Abstract

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Clinical observations on familial cluster headache. Author(s): Torelli P, Manzoni GC. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 June; 24(2): 61-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12827540&dopt=Abstract

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Cluster headache as a manifestation of intracranial inflammatory myofibroblastic tumour: a case report with pathophysiological considerations. Author(s): Bigal ME, Rapoport AM, Camel M. Source: Cephalalgia : an International Journal of Headache. 2003 March; 23(2): 124-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12603369&dopt=Abstract

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Cluster headache associated with sleep apnoea. Author(s): Nobre ME, Filho PF, Dominici M. Source: Cephalalgia : an International Journal of Headache. 2003 May; 23(4): 276-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12716345&dopt=Abstract

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Cluster headache in women: evidence of hypofertility(?) Headaches in relation to menstruation and pregnancy. Author(s): Ekbom K, Waldenlind E. Source: Cephalalgia : an International Journal of Headache. 1981 September; 1(3): 167-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=7346185&dopt=Abstract

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Cluster headache-like headaches: a symptomatic feature? A report of three patients with intracranial pathologic findings. Author(s): Greve E, Mai J. Source: Cephalalgia : an International Journal of Headache. 1988 June; 8(2): 79-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=3401920&dopt=Abstract

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Cluster headaches and sleep disorders. Author(s): Weintraub JR. Source: Current Pain and Headache Reports. 2003 April; 7(2): 150-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12628058&dopt=Abstract

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Cluster headaches associated with vascular malformations. Author(s): Herzeberg L, Lenman JA, Victoratos G, Fletcher F. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1975 July; 38(7): 648-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1159435&dopt=Abstract

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Cluster headaches from isosorbide dinitrate. Author(s): Bernat JL. Source: Annals of Neurology. 1979 December; 6(6): 554-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=533253&dopt=Abstract

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Cluster headaches in childhood. Author(s): D'Cruz OF. Source: Clinical Pediatrics. 1994 April; 33(4): 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8013173&dopt=Abstract

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Cluster headaches in childhood. Author(s): Curless RG. Source: The Journal of Pediatrics. 1982 September; 101(3): 393-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=7108660&dopt=Abstract

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Cluster headaches simulating parasomnias. Author(s): Isik U, D'Cruz OF. Source: Pediatric Neurology. 2002 September; 27(3): 227-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12393135&dopt=Abstract

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Cluster headaches. Author(s): Skinner RJ. Source: Aust Fam Physician. 1991 April; 20(4): 510. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1824029&dopt=Abstract

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Cluster headaches. Author(s): Ryan RE Jr, Ryan RE Sr. Source: Otolaryngologic Clinics of North America. 1989 December; 22(6): 1131-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2513546&dopt=Abstract

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Cluster headaches. Author(s): McKenna JP. Source: American Family Physician. 1988 April; 37(4): 173-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=3358342&dopt=Abstract

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Cluster headaches. Author(s): Bickerstaff ER. Source: Nurs Times. 1977 September 29; 73(39): 1518-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=917865&dopt=Abstract

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Cluster headaches. How to recognize and treat them. Author(s): Green MW. Source: Postgraduate Medicine. 1983 June; 73(6): 67-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6406993&dopt=Abstract

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Cluster headaches: association with anxiety disorders and memory deficits. Author(s): Jorge RE, Leston JE, Arndt S, Robinson RG. Source: Neurology. 1999 August 11; 53(3): 543-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=10449118&dopt=Abstract

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Cluster headaches--central or peripheral in origin? Author(s): Schoenen J. Source: Lancet. 1998 July 25; 352(9124): 253-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=9690402&dopt=Abstract

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Delayed diagnosis of cluster headache in African-American women. Author(s): Wheeler SD, Carrazana EJ. Source: Journal of the National Medical Association. 2001 January; 93(1): 31-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12653378&dopt=Abstract

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Diagnosis and management of cluster headaches. Author(s): Gabai IJ, Spierings EL. Source: The Nurse Practitioner. 1990 October; 15(10): 32-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2234557&dopt=Abstract

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Diminished nocturnal lipolysis in cluster headache: a sign of central sympathetic dysregulation? Author(s): Meyer EL, Waldenlind E, Marcus C. Source: Neurology. 2003 November 11; 61(9): 1250-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=14610129&dopt=Abstract

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Divalproex sodium in the treatment of migraine and cluster headaches. Author(s): Gallagher RM, Mueller LL, Freitag FG. Source: J Am Osteopath Assoc. 2002 February; 102(2): 92-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=11866398&dopt=Abstract

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Drug management of adult vascular headaches (migraine and cluster headache): Part II--Prevention and attacks. Author(s): Damasio H. Source: Iowa Med. 1984 December; 74(12): 536, 538-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6440873&dopt=Abstract

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Drug management of adult vascular headaches (migraine and cluster headache): Part I--Treatment of the acute attack. Author(s): Damasio H. Source: Iowa Med. 1984 November; 74(11): 490-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6511281&dopt=Abstract

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Epidemiology of cluster headache. Author(s): Finkel AG. Source: Current Pain and Headache Reports. 2003 April; 7(2): 144-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12628057&dopt=Abstract

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Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. Author(s): Sarlani E, Schwartz AH, Greenspan JD, Grace EG. Source: J Orofac Pain. 2003 Summer; 17(3): 262-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=14558496&dopt=Abstract

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Features involved in the diagnostic delay of cluster headache. Author(s): van Vliet JA, Eekers PJ, Haan J, Ferrari MD; Dutch RUSSH Study Group. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 August; 74(8): 1123-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12876249&dopt=Abstract

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For cluster headaches: cryosurgery. Author(s): Chadduck WM, Madonia EC. Source: Va Med. 1981 September; 108(9): 622-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=7293391&dopt=Abstract

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Greater occipital nerve blockade for cluster headache. Author(s): Vijayan N. Source: Cephalalgia : an International Journal of Headache. 2003 May; 23(4): 323; Author Reply 323. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12716355&dopt=Abstract

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Heart rate variability in cluster headache. Author(s): Tubani L, Baratta L, Giorgino F, Delfino M, Fiore G, Golluscio V, Giacovazzo M. Source: Ann Ital Med Int. 2003 January-March; 18(1): 42-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12739428&dopt=Abstract

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Hemicrania continua with contralateral episodic cluster headache: a case report. Author(s): Lisotto C, Mainardi F, Maggioni F, Zanchin G. Source: Cephalalgia : an International Journal of Headache. 2003 November; 23(9): 92930. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=14616936&dopt=Abstract

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Hyperbaric oxygen in chronic cluster headaches: influence on serotonergic pathways. Author(s): Di Sabato F, Rocco M, Martelletti P, Giacovazzo M. Source: Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc. 1997 June; 24(2): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=9171470&dopt=Abstract

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Hypothalamic deep brain stimulation for intractable chronic cluster headache: a 3year follow-up. Author(s): Leone M, Franzini A, Broggi G, Bussone G. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 May; 24 Suppl 2: S143-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12811614&dopt=Abstract

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Impairment of trigeminal sensory pathways in cluster headache. Author(s): van Vliet JA, Vein AA, Le Cessie S, Ferrari MD, van Dijk JG; Dutch RUSSH Research Group. Source: Cephalalgia : an International Journal of Headache. 2003 July; 23(6): 414-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12807520&dopt=Abstract

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Incidence of cluster headaches: a population-based study in Olmsted County, Minnesota. Author(s): Swanson JW, Yanagihara T, Stang PE, O'Fallon WM, Beard CM, Melton LJ 3rd, Guess HA. Source: Neurology. 1994 March; 44(3 Pt 1): 433-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8145911&dopt=Abstract

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Increased prevalence of sensing types in men with cluster headaches. Author(s): Mueller L, Gallahger RM, Steer RA, Ciervo CA. Source: Psychological Reports. 2000 October; 87(2): 555-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=11086604&dopt=Abstract

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Internal resorption and cluster headaches. Author(s): Connolly JB, D'Andrea R. Source: J Conn State Dent Assoc. 1980 Winter; 54(1): 15-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6776168&dopt=Abstract

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Intractable cluster headaches in a migraineur. Author(s): Rothrock JF, Mathew NT, Kaup AO, Evans RW. Source: Headache. 2002 September; 42(8): 831-3; Discussion 832-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12390651&dopt=Abstract

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Intranasal civamide for the treatment of episodic cluster headaches. Author(s): Saper JR, Klapper J, Mathew NT, Rapoport A, Phillips SB, Bernstein JE. Source: Archives of Neurology. 2002 June; 59(6): 990-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12056936&dopt=Abstract

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Intranasal lidocaine for migraine and cluster headaches. Author(s): Mills TM, Scoggin JA. Source: The Annals of Pharmacotherapy. 1997 July-August; 31(7-8): 914-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=9220056&dopt=Abstract

Studies

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Intravenous magnesium sulfate relieves cluster headaches in patients with low serum ionized magnesium levels. Author(s): Mauskop A, Altura BT, Cracco RQ, Altura BM. Source: Headache. 1995 November-December; 35(10): 597-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8550360&dopt=Abstract

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Letter: Cluster headaches--a new treatment. Author(s): Giampaoli AV. Source: The Western Journal of Medicine. 1974 April; 120(4): 326. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=4821713&dopt=Abstract

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Lithium carbonate has no measurable effect on cerebral hemodynamics in cluster headaches. Author(s): Okayasu H, Meyer JS, Mathew NT, Amano T, Hardenberg J. Source: Headache. 1984 January; 24(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6423567&dopt=Abstract

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Lithium carbonate in the treatment of cluster headaches. Author(s): Damasio H, Lyon L. Source: Journal of Neurology. 1980; 224(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6157794&dopt=Abstract

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Lithium treatment of chronic cluster headaches. Author(s): Lieb J, Zeff A. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1978 December; 133: 556-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=737393&dopt=Abstract

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Long-term follow-up of chronic cluster headache treated surgically with trigeminal tractotomy. Author(s): Green MW. Source: Headache. 2003 May; 43(5): 479-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12752753&dopt=Abstract

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Monozygotic twin sisters suffering from cluster headache and migraine without aura. Author(s): Schuh-Hofer S, Meisel A, Reuter U, Arnold G. Source: Neurology. 2003 June 10; 60(11): 1864-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12796556&dopt=Abstract

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Nasal plug as an aid for cluster headaches. Author(s): Dalessio DJ. Source: Headache. 1987 October; 27(9): 522-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=3692837&dopt=Abstract

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Nasal plug as an aid for cluster headaches: relevance of the nasal cycle. Author(s): Backon J. Source: Headache. 1989 January; 29(1): 60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2925376&dopt=Abstract

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Neuro-ophthalmic complications of migraine and cluster headaches. Author(s): Corbett JJ. Source: Neurologic Clinics. 1983 November; 1(4): 973-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6390159&dopt=Abstract

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Nitric oxide pathway and response to nitroglycerin in cluster headache patients: plasma nitrite and citrulline levels. Author(s): Costa A, Ravaglia S, Sances G, Antonaci F, Pucci E, Nappi G. Source: Cephalalgia : an International Journal of Headache. 2003 July; 23(6): 407-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12807519&dopt=Abstract

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Ocular migraine in a patient with cluster headaches. Author(s): Kline LB, Kelly CL. Source: Headache. 1980 September; 20(5): 253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=7451120&dopt=Abstract

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Oculosympathetic paresis associated with cluster headaches. Author(s): Riley FC Jr, Moyer NJ. Source: American Journal of Ophthalmology. 1971 October; 72(4): 763-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=5110867&dopt=Abstract

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Orbital phlebography: a comparison between cluster headache and other headaches. Author(s): Bovim G, Jenssen G, Ericson K. Source: Headache. 1992 September; 32(8): 408-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1399563&dopt=Abstract

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Outcome of trigeminal nerve section in the treatment of chronic cluster headache. Author(s): Jarrar RG, Black DF, Dodick DW, Davis DH. Source: Neurology. 2003 April 22; 60(8): 1360-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12707445&dopt=Abstract

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Oxygen for cluster headaches. Author(s): Janks JF. Source: Jama : the Journal of the American Medical Association. 1978 January 16; 239(3): 191. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=579383&dopt=Abstract

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Parenteral indomethacin (the INDOTEST) in cluster headache. Author(s): Antonaci F, Costa A, Ghirmai S, Sances G, Sjaastad O, Nappi G. Source: Cephalalgia : an International Journal of Headache. 2003 April; 23(3): 193-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12662186&dopt=Abstract

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Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Author(s): Goadsby PJ. Source: Lancet. Neurology. 2002 August; 1(4): 251-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12849458&dopt=Abstract

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Percutaneous retrogasserian glycerol rhizolysis for treatment of chronic intractable cluster headaches: long-term results. Author(s): Pieper DR, Dickerson J, Hassenbusch SJ. Source: Neurosurgery. 2000 February; 46(2): 363-8; Discussion 368-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=10690725&dopt=Abstract

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Platelet aggregation profiles in cluster headache. Author(s): D'Andrea G, Granella F, Cadaldini M. Source: Headache. 2003 March; 43(3): 272-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12603647&dopt=Abstract

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Prescribing oxygen for cluster headaches. Author(s): Sands GH. Source: Jama : the Journal of the American Medical Association. 1986 December 26; 256(24): 3349. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=3783883&dopt=Abstract

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Prophylactic therapy of cluster headaches. Author(s): Solomon SS, Lipton RB, Newman LC. Source: Clinical Neuropharmacology. 1991 April; 14(2): 116-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1901762&dopt=Abstract

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Recent advances in the acute management of migraine and cluster headaches. Author(s): Kumar KL. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1994 June; 9(6): 339-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8078000&dopt=Abstract

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Recurrence of cluster headaches presenting with a virtually painless Horner's syndrome. Author(s): Peatfield RC. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1995 August; 59(2): 196-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=7629545&dopt=Abstract

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Refractory episodic cluster headache responsive to percutaneous cervical zygapophyseal radiofrequency ablation: a case report. Author(s): Vaisman J, Nimgade A. Source: Headache. 2003 March; 43(3): 279-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12603649&dopt=Abstract

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Regional cerebral hemodynamics during migraine and cluster headaches measured by the 133Xe inhalation method. Author(s): Sakai F, Meyer JS. Source: Headache. 1978 July; 18(3): 122-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=669942&dopt=Abstract

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Reversible cognitive decline accompanies migraine and cluster headaches. Author(s): Meyer JS, Thornby J, Crawford K, Rauch GM. Source: Headache. 2000 September; 40(8): 638-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=10971660&dopt=Abstract

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Sexual headaches occurring in cluster headache patients. Author(s): Maliszewski M, Diamond S, Freitag FG. Source: The Clinical Journal of Pain. 1989; 5(1): 45-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2520385&dopt=Abstract

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Soluble interleukin-2 receptors increase during the active periods in cluster headache. Author(s): Empl M, Forderreuther S, Schwarz M, Muller N, Straube A. Source: Headache. 2003 January; 43(1): 63-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12864761&dopt=Abstract

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Somatostatin infusion withdrawal: a study of patients with migraine, cluster headache and healthy volunteers. Author(s): Levy MJ, Matharu MS, Bhola R, Lightman S, Goadsby PJ. Source: Pain. 2003 April; 102(3): 235-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12670664&dopt=Abstract

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Stimulation of the posterior hypothalamus for treatment of chronic intractable cluster headaches: first reported series. Author(s): Franzini A, Ferroli P, Leone M, Broggi G. Source: Neurosurgery. 2003 May; 52(5): 1095-9; Discussion 1099-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12699552&dopt=Abstract

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Symptomatic cluster headache in internal carotid artery dissection--consider anhidrosis. Author(s): Frigerio S, Buhler R, Hess CW, Sturzenegger M. Source: Headache. 2003 September; 43(8): 896-900. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12940812&dopt=Abstract

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The clinical link between migraine and cluster headaches. Author(s): Medina JL, Diamond S. Source: Archives of Neurology. 1977 August; 34(8): 470-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=889478&dopt=Abstract

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The influence of the pineal gland on migraine and cluster headaches and effects of treatment with picoTesla magnetic fields. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1992 November-December; 67(1-4): 145-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1305631&dopt=Abstract

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The management of migraine and cluster headaches. Author(s): Diamond S. Source: Compr Ther. 1995 September; 21(9): 492-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8565436&dopt=Abstract

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The spectrum of cluster headaches: a case report. Author(s): Rosich Pla AR. Source: Neurologia (Barcelona, Spain). 1996 February; 11(2): 76-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8652196&dopt=Abstract

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The treatment of cluster headaches with prednisone. Author(s): Jammes JL. Source: Dis Nerv Syst. 1975 July; 36(7): 375-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1097222&dopt=Abstract

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Timing patterns of cluster headaches and association with symptoms of obstructive sleep apnea. Author(s): Chervin RD, Zallek SN, Lin X, Hall JM, Sharma N, Hedger KM. Source: Sleep Res Online. 2000; 3(3): 107-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=11382908&dopt=Abstract

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Topical agents in the treatment of cluster headache. Author(s): Markley HG. Source: Current Pain and Headache Reports. 2003 April; 7(2): 139-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12628056&dopt=Abstract

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Topiramate in the prophylactic treatment of cluster headache. Author(s): Lainez MJ, Pascual J, Pascual AM, Santonja JM, Ponz A, Salvador A. Source: Headache. 2003 July-August; 43(7): 784-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12890134&dopt=Abstract

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Topiramate in the treatment of cluster headache. Author(s): McGeeney BE. Source: Current Pain and Headache Reports. 2003 April; 7(2): 135-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12628055&dopt=Abstract

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Treatment of cluster headaches. Author(s): Agnew DC. Source: The Western Journal of Medicine. 1991 July; 155(1): 66-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1877236&dopt=Abstract

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Trigeminal cisternal injection of glycerol for treatment of chronic intractable cluster headaches. Author(s): Hassenbusch SJ, Kunkel RS, Kosmorsky GS, Covington EC, Pillay PK. Source: Neurosurgery. 1991 October; 29(4): 504-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1944829&dopt=Abstract

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Update on cluster headache. Author(s): May A, Leone M. Source: Current Opinion in Neurology. 2003 June; 16(3): 333-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12858070&dopt=Abstract

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Weakening the grip of cluster headache. Author(s): Reed S, DeAsa CR. Source: Rn. 2003 September; Suppl: 14-20; Quiz 22-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=14533304&dopt=Abstract

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What are cluster headaches and how are they treated? Author(s): Mathew NT. Source: Health News. 2000 July; 6(7): 10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=10932653&dopt=Abstract

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CHAPTER 2. NUTRITION AND CLUSTER HEADACHES Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and cluster headaches.

Finding Nutrition Studies on Cluster Headaches 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.4 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 “cluster headaches” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

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

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

A pharmacological approach to the analgesizing mechanism of somatostatin in cluster headache. Source: Caleri, D Marabini, S Panconesi, A Pietrini, U Ric-Clin-Lab. 1987 Apr-June; 17(2): 155-62 0390-5748

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A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic feature, including new cases. Author(s): Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK. Source: Goadsby, P J Lipton, R B Brain. 1997 January; 120 ( Pt 1)193-209 0006-8950

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Chronic cluster headache managed by nervus intermedius section. Author(s): Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada. Source: Rowed, D W Headache. 1990 June; 30(7): 401-6 0017-8748

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Chronic paroxysmal hemicrania. XIII. The pupillometric pattern. Author(s): Department of Neurology, Regionsykehuset, Trondheim University Hospital, Norway. Source: Souza Souza Carvalho, D Salvesen, R Sand, T Smith, S E Sjaastad, O Cephalalgia. 1988 September; 8(3): 219-26 0333-1024

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Clinical experiences from Sweden on the use of subcutaneously administered sumatriptan in migraine and cluster headache. Author(s): Gothenburg Migraine Clinic, Sociala Huset, Uppg D, Sweden. Source: Dahlof, C Ekbom, K Persson, L Arch-Neurol. 1994 December; 51(12): 1256-61 0003-9942

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Cluster headache in black patients. A report of 7 cases. Author(s): Department of Neurology, Medical University of Southern Africa, Pretoria. Source: Joubert, J S-Afr-Med-J. 1988 May 7; 73(9): 552-4 0038-2469

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Cluster headaches. Author(s): Barnes Hospital, Washington University School of Medicine, St. Louis, Missouri. Source: Ryan, R E Ryan, R E Otolaryngol-Clin-North-Am. 1989 December; 22(6): 1131-44 0030-6665

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Diagnosis and management of cluster headaches. Author(s): Kaiser Permanente, Placentia, Calif. Source: Gabai, I J Spierings, E L Nurse-Pract. 1990 October; 15(10): 32-6 0361-1817

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Differential changes in receptor-mediated transduction in migraine and cluster headache: studies on polymorphonuclear leucocytes. Source: de Belleroche, J Morris, R Davies, P T Rose, F C Headache. 1988 July; 28(6): 40913 0017-8748

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Divalproex sodium in the treatment of migraine and cluster headaches. Author(s): University Headache Center, Moorestown, NJ 08057-1550, USA. Source: Gallagher, R Michael Mueller, Loretta L Freitag, Frederick G J-Am-OsteopathAssoc. 2002 February; 102(2): 92-4 0098-6151

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Double blind comparison of lithium and verapamil in cluster headache prophylaxis. Author(s): Headache Centre, C. Besta Neurological Institute of Milan, Italy. Source: Bussone, G Leone, M Peccarisi, C Micieli, G Granella, F Magri, M Manzoni, G C Nappi, G Headache. 1990 June; 30(7): 411-7 0017-8748

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Episodic cluster headache: short and long term results of prophylactic treatment. Source: de Carolis, P de Capoa, D Agati, R Baldrati, A Sacquegna, T Headache. 1988 August; 28(7): 475-6 0017-8748

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Intranasal civamide for the treatment of episodic cluster headaches. Author(s): Michigan Headache Pain and Neurological Institute, 3120 Professional Dr, Ann Arbor, MI 48104, USA. Source: Saper, Joel R Klapper, Jack Mathew, Ninan T Rapoport, Alan Phillips, Scott B Bernstein, Joel E Arch-Neurol. 2002 June; 59(6): 990-4 0003-9942

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Melatonin as adjunctive therapy in the prophylaxis of cluster headache: a pilot study. Author(s): Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada. Source: Pringsheim, T Magnoux, E Dobson, C F Hamel, E Aube, M Headache. 2002 September; 42(8): 787-92 0017-8748

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Methylergonovine maleate as a cluster headache prophylactic: a study and review. Author(s): University Headache Center, University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, Moorestown 08057, USA. Source: Mueller, L Gallagher, R M Ciervo, C A Headache. 1997 Jul-August; 37(7): 437-42 0017-8748

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Nerves and vessels in the pterygopalatine fossa and symptoms of cluster headache. Source: Hardebo, J E Elner, A Headache. 1987 November; 27(10): 528-32 0017-8748

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Prophylactic therapy of cluster headaches. Author(s): Department of Neurology, Montefiore Medical Center, Bronx, New York 10467. Source: Solomon, S S Lipton, R B Newman, L C Clin-Neuropharmacol. 1991 April; 14(2): 116-30 0362-5664

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Recent advances in the acute management of migraine and cluster headaches. Author(s): Headache Clinic, Veterans Affairs Medical Center, Portland, OR 97207. Source: KuMarch, K L J-Gen-Intern-Med. 1994 June; 9(6): 339-48 0884-8734

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Secondary cluster headache responsive to sumatriptan. Author(s): Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia. Source: Cremer, P D Halmagyi, G M Goadsby, P J J-Neurol-Neurosurg-Psychiatry. 1995 December; 59(6): 633-4 0022-3050

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Sodium valproate in the treatment of cluster headache: an open clinical trial. Author(s): Department of Neurology, Beilinson Medical Center, Petah Tiqva, Israel. Source: Hering, R Kuritzky, A Cephalalgia. 1989 September; 9(3): 195-8 0333-1024

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Substance P theory: a unique focus on the painful and painless phenomena of cluster headache. Author(s): Institute of Internal Medicine and Therapy, IV, University of Florence, Italy. Source: Sicuteri, F Fanciullacci, M Nicolodi, M Geppetti, P Fusco, B M Marabini, S Alessandri, M Campagnolo, V Headache. 1990 January; 30(2): 69-79 0017-8748

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The chronic paroxysmal hemicrania concept expanded. Source: Spierings, E L Headache. 1988 October; 28(9): 597-8 0017-8748

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

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

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

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

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

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

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

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

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

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

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

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Family Village: http://www.familyvillage.wisc.edu/med nutrition.html

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

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

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

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

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WebMDÒHealth: http://my.webmd.com/nutrition

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

Nutrition

25

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

Minerals Magnesium Source: Healthnotes, Inc.; www.healthnotes.com

27

CHAPTER 3. ALTERNATIVE MEDICINE AND CLUSTER HEADACHES Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to cluster headaches. 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 cluster headaches 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 “cluster headaches” (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 cluster headaches: ·

A headache clinic's experience: Diamond Headache Clinic, Ltd. Author(s): Medina JL, Diamond S. Source: Nida Res Monogr. 1981 May; 36: 130-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6791022&dopt=Abstract

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A review of nonvalidated and complementary therapies for cluster headache. Author(s): Bilchik TR. Source: Current Pain and Headache Reports. 2004 April; 8(2): 157-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=14980151&dopt=Abstract

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Autogenic biofeedback treatment for migraine. Author(s): Fahrion SL.

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Source: Mayo Clinic Proceedings. 1977 December; 52(12): 776-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=339010&dopt=Abstract ·

Behavioral treatment approaches to chronic headache. Author(s): Andrasik F. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 May; 24 Suppl 2: S80-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12811599&dopt=Abstract

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Behavioral treatment of chronic cluster headache in a geriatric patient. Author(s): King AC, Arena JG. Source: Biofeedback Self Regul. 1984 June; 9(2): 201-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6509110&dopt=Abstract

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Blood volume pulse biofeedback treatment of chronic cluster headache. Author(s): Hoelscher TJ, Lichstein KL. Source: Biofeedback Self Regul. 1983 December; 8(4): 533-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6675728&dopt=Abstract

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Chronic and recurrent headaches in children and adolescents. Author(s): Gascon GG. Source: Pediatric Clinics of North America. 1984 October; 31(5): 1027-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6384900&dopt=Abstract

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Classification, mechanisms, and management of headache. Author(s): Repschlaeger BJ, McPherson MA. Source: Clin Pharm. 1984 March-April; 3(2): 139-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6373100&dopt=Abstract

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Cluster-like signs and symptoms respond to myofascial/craniomandibular treatment: a report of two cases. Author(s): Vargo CP, Hickman DM. Source: Cranio. 1997 January; 15(1): 89-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=9586493&dopt=Abstract

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Effect of hyperbaric oxygen on the immunoreactivity to substance P in the nasal mucosa of cluster headache patients. Author(s): Di Sabato F, Giacovazzo M, Cristalli G, Rocco M, Fusco BM. Source: Headache. 1996 April; 36(4): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8675426&dopt=Abstract

Alternative Medicine 29

·

Foods, and food and drug combinations, responsible for head and neck pain. Author(s): Seltzer S. Source: Cephalalgia : an International Journal of Headache. 1982 June; 2(2): 111-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6751553&dopt=Abstract

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Headaches. Author(s): Sutherland JE. Source: American Family Physician. 1983 February; 27(2): 137-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6829368&dopt=Abstract

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Hyperbaric oxygen in chronic cluster headaches: influence on serotonergic pathways. Author(s): Di Sabato F, Rocco M, Martelletti P, Giacovazzo M. Source: Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc. 1997 June; 24(2): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=9171470&dopt=Abstract

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Hyperbaric oxygen therapy in cluster headache. Author(s): Di Sabato F, Fusco BM, Pelaia P, Giacovazzo M. Source: Pain. 1993 February; 52(2): 243-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8455970&dopt=Abstract

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Hyperbaric oxygen treatment of active cluster headache: a double-blind placebocontrolled cross-over study. Author(s): Nilsson Remahl AI, Ansjon R, Lind F, Waldenlind E. Source: Cephalalgia : an International Journal of Headache. 2002 November; 22(9): 730-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12421159&dopt=Abstract

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Low CSF met-enkephalin levels in cluster headache are elevated by acupuncture. Author(s): Hardebo JE, Ekman R, Eriksson M. Source: Headache. 1989 September; 29(8): 494-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2529227&dopt=Abstract

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Migraine. Author(s): Spector RH. Source: Survey of Ophthalmology. 1984 November-December; 29(3): 193-207. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6440302&dopt=Abstract

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Monoamine oxidase activities in patients with migraine or with cluster headache during the acute phases and after treatment with L-5-hydroxytryptophan. Author(s): Bussone G, Boiardi A, Cerrati A, Girotti F, Merati B, Rivolta G.

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Source: Riv Patol Nerv Ment. 1979 September-October; 100(5): 269-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=318025&dopt=Abstract ·

Preventive effects of hyperbaric oxygen in cluster headache. Author(s): Pascual J, Peralta G, Sanchez U. Source: Headache. 1995 May; 35(5): 260-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=7775187&dopt=Abstract

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Primary care for women. Assessment and management of headache. Author(s): Barrett E. Source: Journal of Nurse-Midwifery. 1996 March-April; 41(2): 117-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=8691273&dopt=Abstract

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Substance P theory: a unique focus on the painful and painless phenomena of cluster headache. Author(s): Sicuteri F, Fanciullacci M, Nicolodi M, Geppetti P, Fusco BM, Marabini S, Alessandri M, Campagnolo V. Source: Headache. 1990 January; 30(2): 69-79. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1689282&dopt=Abstract

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The influence of the pineal gland on migraine and cluster headaches and effects of treatment with picoTesla magnetic fields. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1992 November-December; 67(1-4): 145-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1305631&dopt=Abstract

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The new science of headaches. Author(s): Gorman C, Park A. Source: Time. 2002 October 7; 160(15): 76-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=12389453&dopt=Abstract

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The treatment of cluster headache with relaxation and thermal biofeedback. Author(s): Blanchard EB, Andrasik F, Jurish SE, Teders SJ. Source: Biofeedback Self Regul. 1982 June; 7(2): 185-91. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=6753952&dopt=Abstract

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The treatment of headaches employing acupuncture. Author(s): Cheng AC. Source: The American Journal of Chinese Medicine. 1975 April; 3(2): 181-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=1124734&dopt=Abstract

Alternative Medicine 31

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Treatment of a cluster headache patient in a hyperbaric chamber. Author(s): Weiss LD, Ramasastry SS, Eidelman BH. Source: Headache. 1989 February; 29(2): 109-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2708039&dopt=Abstract

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Unilateral impairment of pupillary response to trigeminal nerve stimulation in cluster headache. Author(s): Fanciullacci M, Fusco BM, Alessandri M, Campagnolo V, Sicuteri F. Source: Pain. 1989 February; 36(2): 185-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list uids=2783997&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: ·

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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

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

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

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Family Village: http://www.familyvillage.wisc.edu/med altn.htm

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

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

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MedWebPlus: http://medwebplus.com/subject/Alternative and Complementary Medicine

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

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

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WebMDÒHealth: http://my.webmd.com/drugs and herbs

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

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Yahoo.com: http://dir.yahoo.com/Health/Alternative Medicine/

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

General Overview Cluster Headache Source: Healthnotes, Inc.; www.healthnotes.com

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Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Pain Source: Healthnotes, Inc.; www.healthnotes.com ·

Herbs and Supplements Cayenne Alternative names: Capsicum annuum, Capsicum frutescens Source: Healthnotes, Inc.; www.healthnotes.com Cayenne Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances view/0,1525,765,00.html Melatonin Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. CLINICAL TRIALS AND CLUSTER HEADACHES Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning cluster headaches.

Recent Trials on Cluster Headaches The following is a list of recent trials dedicated to cluster headaches.5 Further information on a trial is available at the Web site indicated. ·

Intranasal Civamide for Episodic Cluster Headache Condition(s): Episodic Cluster Headache Study Status: This study is no longer recruiting patients. Sponsor(s): Winston Laboratories Purpose - Excerpt: This is a 49-day study to evaluate the effectiveness of Intranasal Civamide (Zucapsaicin) in the treatment of an episodic cluster headache period compared to placebo (medically inactive substance which does not contain any active ingredients). Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00069082

·

A Phase III Study of Civamide Nasal Solution (Zucapsaicin) for the Treatment of Episodic Cluster Headache Condition(s): Episodic Cluster Headache Study Status: This study is completed. Sponsor(s): Winston Laboratories

5

These are listed at www.ClinicalTrials.gov.

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Cluster Headaches

Purpose - Excerpt: This is a 49-day study to evaluate the effectiveness of Intranasal Civamide (Zucapsaicin) in the treatment of an episodic cluster headache period compared to placebo (medically inactive substance which does not contain any active ingredients). Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033839

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

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

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

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

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

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

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

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

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

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

Clinical Trials 35

·

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

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

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

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

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

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

37

CHAPTER 5. PATENTS ON CLUSTER HEADACHES Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.6 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “cluster headaches” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on cluster headaches, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Cluster Headaches By performing a patent search focusing on cluster headaches, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 6Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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Cluster Headaches

The following is an example of the type of information that you can expect to obtain from a patent search on cluster headaches: ·

Anticonvulsant derivatives useful in treating cluster headaches Inventor(s): Carrazana; Enrique J. (Key Biscayne, FL), Wheeler; Steve D. (Miami, FL) Assignee(s): Ortho-mcneil Pharmaceutical, Inc. (skillman, Nj) Patent Number: 6,319,903 Date filed: January 13, 2000 Abstract: Anticonvulsant derivatives useful in treating cluster headaches are disclosed. Excerpt(s): are structurally novel antiepileptic compounds that are highly effective anticonvulsants in animal tests (Maryanoff, B. E, Nortey, S. O., Gardocki, J. F., Shank, R. P. and Dodgson, S. P. J Med. Chem. 30, 880-887, 1987; Maryanoff, B. E., Costanzo, M. J., Shank, R. P., Schupsky, J. J., Ortegon, M. E., and Vaught J. L. Bioorganic & Medicinal Chemistry Letters 3, 2653-2656, 1993). These compounds are covered by U.S. Pat. No.4,513,006. One of these compounds 2,3:4,5-bis-O-(1-methylethylidene)-.beta.-Dfructopyranose sulfamate known as topiramate has been demonstrated in clinical trials of human epilepsy to be effective as adjunctive therapy or as monotherapy in treating simple and complex partial seizures and secondarily generalized seizures (E. FAUGHT, B. J. WILDER, R. E. RAMSEY, R. A. REIFE, L D. KRAMER, G. W. PLEDGER, R. M. KARIM et. al., Epilepsia 36 (S4) 33, 1995; S. K. SACHDEO, R. C. SACHDEO, R. A. REIFE, P. LIM and G. PLEDGER, Epilepsia 36 (S4) 33, 1995), and is currently marketed for the treatment of simple and complex partial seizure epilepsy with or without secondary generalized seizures in approximately twenty countries including the United States, and applications for regulatory approval are presently pending in several additional countries throughout the world. Compounds of Formula I were initially found to possess anticonvulsant activity in the traditional maximal electroshock seizure (MES) test in mice (SHANK, R. P., GARDOCKI, J. F., VAUGHT, J. L., DAVIS, C. B., SCHUPSKY, J. J., RAFFA, R. B., DODGSON, S. J., NORTEY, S. O., and MARYANOFF, B. E., Epilcpsia 35 450-460, 1994). Subsequent studies revealed that Compounds of Formula I were also highly effective in the MES test in rats. More recently topiramate was found to effectively block seizures in several rodent models of epilepsy (J. NAKAMURA, S. TAMURA, T. KANDA, A. ISHII, K. ISHIHARA, T. SERIKAWA, J. YAMADA, and M. SASA, Eur. J. Pharmacol. 254 83-89, 1994), and in an animal model of kindled epilepsy (A. WAUQUIER and S. ZHOU, Epilepsy Res. 24, 73-77, 1996). Cluster headache is an excruciating painful disorder associated with considerable suffering which is characterized by severe, short duration, unilateral orbital-temporal pain, Ipsilateral autonomic dysfunction and chronobiological disturbances. (A. Kudrow, The pathogenesis of a cluster headache, Curr. Opin. Neurol. 7:278-282, 1994; Headache Classification Committee of the International Headache Society, Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain, Cephalgia S7:1-96, 1988). Although treatment is often successful, some patients have intractable pain. Thus, a need remains for effective treatments for cluster headaches. Web site: http://www.delphion.com/details?pn=US06319903

Patents 39

·

Compositions and methods for relieving headache symptoms in aspirin-sensitive headache sufferers Inventor(s): Frank-Kollman; Mary Theresa (173 Egrets Way, Richmond Hill, GA 31324) Assignee(s): None Reported Patent Number: 6,440,983 Date filed: December 21, 2000 Abstract: The treatment of migraine and/or cluster headaches in human beings in need of such treatment includes oral administration of a composition containing acetaminophen, ibuprofen, caffeine and magnesium as the active ingredients. The inclusion of an additional active ingredient, guaifenesin, further provides treatment for severe sinus headaches. Compositions and methods for alleviating the symptoms of these headache conditions are disclosed. Excerpt(s): The present invention relates broadly to the field of healthcare, and in particular, to the treatment of severe headaches in human beings. More specifically, this invention relates to compositions and methods for providing relief from the symptoms of migraine headaches and/or cluster headaches and/or headaches related to sinus congestion, in affected individuals who also have a low tolerance for aspirin due to digestive disorders. Migraine is a particularly painful headache, which recurs and can be physically debilitating to sufferers. In many respects, cluster headaches are similar to migraine headaches, and all references herein to migraine and/or migraine headaches shall be considered as also including, and as references to, cluster headaches. There is no single cause or remedy for migraine headaches, and the incidence of migraine appears to be increasing in the general population. Although sufferers, on average, experience only one attack per month, each attack can last between four and seventytwo hours. In some cases, sufferers experience a pre-onset "warning" which may indicate that a migraine is imminent, and which may be termed an "aura." An "aura" is a disruption of brain function characterized by visual disturbances like flashing lights and blurred vision. These "disruptions" occur twenty to thirty minutes before an attack. About twenty percent of migraine suffers experience "aura" symptoms. Other attacks can be preceded by a "prodrome" several hours before the onset of a migraine. These "prodrome" symptoms may include, but are not limited to, fatigue, yawning, sensory sensitivity, mood changes, and food cravings. Prescription medications have previously been developed to alleviate the severity of migraine pain, but prescription migraine medications generally contain some type of narcotic, which, over time, may become addictive. Although over-the-counter remedies also exist, marketed under the EXCEDRIN.RTM. and ADVIL.RTM. brands, the EXCEDRIN.RTM. Migraine Formula contains aspirin, acetaminophen, and caffeine as its active ingredients, while the only active ingredient of the ADVIL.RTM. Migraine product is ibuprofen. Many migraine sufferers cannot take aspirin, due to digestive disorders, such as acid reflux disease, ulcers, and acid indigestion, and for many such sufferers, ibuprofen alone is not sufficient to lessen the pain or to reduce it to a manageable level. It would therefore be desirable to provide a non-prescription remedy which alleviates migraine symptoms in a manner not accomplished by the currently available "over-the-counter" remedies. Web site: http://www.delphion.com/details?pn=US06440983

40

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Cluster Headaches

Pharmaceutical composition for the intranasal administration of hydroxocobalamin Inventor(s): Merkus; Franciscus W. H. M. (Grootreesdijk 26, B-2460 Kasterlee, BE) Assignee(s): None Reported Patent Number: 5,925,625 Date filed: December 30, 1997 Abstract: A method and composition are disclosed for the prophylaxis and treatment of vascular headaches such as migraine headaches and cluster headaches. The method comprises the intranasal administration of a pharmaceutical composition comprising one or more hydroxocobalamin compounds in a total concentration above 1% (w/w), said composition having a viscosity less than 1000 cP. Excerpt(s): The invention is related to a pharmaceutical composition for the intranasal administration of hydroxocobalamin, a substance from the vitamin B12 family. Vitamin B12 has been first isolated in 1948 and since that time it is widely used in therapeutically active drugs in the treatment of pernicious anemia and other vitamin B12 deficiency disorders. These diseases are mainly caused by an inadequate absorption of vitamin B12 from the gastrointestinal tract. Vitamin B12 occurs in the human body as methylcobalamin, adenosylcobalamin, hydroxocobalamin and cyanocobalamin. Only cyanocobalamin and hydroxocobalamin are used in the treatment of patients. Web site: http://www.delphion.com/details?pn=US05925625

·

Prevention and treatment of migraine, cluster and other recurrent headaches using leukotriene antagonist drugs Inventor(s): Kevorkian; Robert C. (West Granby, CT), Sheftell; Fred D. (778 Long Ridge Rd., Stamford, CT) Assignee(s): Sheftell; Fred D. (stamford, Ct) Patent Number: 6,194,432 Date filed: December 23, 1998 Abstract: A method is disclosed for using leukotriene (LT) antagonist drugs to prevent and treat recurrent primary headaches, which includes migraine headaches and cluster headaches. LT antagonist drugs (such as montelukast and zafirlukast) are commercially available, and they are safe for long-term chronic use without problems of tolerance or dependence. These drugs, taken daily in pill form, are conventionally used for treating asthma. In a clinical trial, LT antagonists taken orally each day reduced the frequency, duration, and severity of migraines, and reduced sensitivity to perfume as a triggering factor. LT antagonists were also found to increase the effectiveness of "triptan" drugs (such as sumatriptan) when used to treat acute migraine headaches. Excerpt(s): This invention is in the field of pharmacology, and relates to drugs that can help reduce the frequency, duration, and/or severity of certain types of headaches that are classified as "recurrent primary headaches", including migraine headaches and cluster headaches. The treatment disclosed herein involves daily or other chronic administration of "leukotriene antagonist" drugs, which previously have been used for treating asthma. As is well-known, migraine headaches (also referred to simply as migraines, for convenience) are severe types of headaches. Typically, migraines are distinguished from ordinary headaches by several factors. Migraines with aura (referred to in the past as "classic" migraines) affect approximately 20% of migraine sufferers, and

Patents 41

are usually preceded or accompanied by some type of visual, sensory or motor disturbance, known as an aura. Migraines without aura (previously known as "common" migraines) usually affect one side of head only, last between 4 and 72 hours, and are usually accompanied by nausea, vomiting, or similar symptoms. To establish a diagnosis of migraine without aura, there must have been at least 5 previous episodes; organic factors which may mimic migraine must have been ruled out; and, the attack must last 4 to 72 hours. In cluster headaches, the rain is almost always one-sided, and typically involves the eye and temple region. As opposed to migraine, which may he a throbbing type of pain, the pain of a cluster headache is almost always non-throbbing, and is often likened by the patient to a red hot poker being driven into the affected eye, with immense force. Attacks generally last about 45 to 90 minutes, and may occur several times a day. They also fairly often awaken a sufferer from sleep, when in cycle. Symptoms accompanying such attacks generally include a red and tearing eye, stuffed and running nostril, and drooping of the eyelid, all on the side of the attack. As opposed to migraine patients, who must retreat to a dark and quiet environment, the pain of cluster headaches is usually so intense that the sufferer often paces, rocks, walks about, or does anything else that may help distract him from the pain (including, in many cases, banging his head or fists against the wall, ground, or other object). Web site: http://www.delphion.com/details?pn=US06194432

Patent Applications on Cluster Headaches As of December 2000, U.S. patent applications are open to public viewing.7 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to cluster headaches: ·

Prevention and treatment of migraine and other recurrent headaches using leukotriene LTD4 receptor blocker drugs Inventor(s): Kevorkian, Robert C.; (West Granby, CT), Sheftell, Fred D.; (Stamford, CT) Correspondence: Patrick D. Kelly; 11939 Manchester #403; ST. Louis; MO; 63131; US Patent Application Number: 20040019080 Date filed: February 27, 2001 Abstract: Receptor blocker (antagonist) drugs which suppress the binding of the D4 class of leukotriene molecules to leukotriene receptors can reduce the frequency and severity of recurrent primary headaches, including migraine and cluster headaches. Various LTD4 receptor blockers are commercially available, including montelukast and zafirlukast. In the past, these drugs have been used to treat asthma. During human clinical trials on asthma patients, headaches were one of the most commonly reported side effects of those two drugs; therefore, they apparently were never tested as agents which might prevent or reduce migraine or cluster headaches. However, it has been shown that in at least some patients who suffer from acute recurrent migraines, LTD4 receptor blockers can greatly reduce the frequency, duration, and/or severity of their headaches, when taken chronically on a daily basis. Tests also indicate that LTD4 receptor blockers can be combined with a triptan drug to achieve a synergistic effect against acute headaches.

7

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

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Excerpt(s): This application is a continuation-in-part of application Ser. No. 09/221,015, filed Dec. 23, 1998, issued as U.S. Pat. No. 6,194,432 on Feb. 27, 2001. That application claimed priority based on provisional application 60/103,933, filed Oct. 13, 1998. This invention is in the field of pharmacology, and relates to drugs that can help reduce the frequency, duration, and/or severity of certain types of headaches classified as "recurrent primary headaches" (including migraine headaches and cluster headaches). This treatment involves daily or other chronic administration of certain types of "leukotriene antagonist" drugs which can suppress activation of the "D4" subtype of receptor that is normally activated by leukotrienes. Several such leukotriene D4-receptor antagonist drugs are known; previously, they have been used for treating asthma, as discussed below. Migraine headaches (also referred to simply as migraines, for convenience) and cluster headaches are discussed in numerous journal articles and in various full-length medical texts, such as Headache in Clinical Practice (edited by S. Silberstein et al., Oxford Univ. Press, 1998); Headache Classification and Epidemiology by J. Olesen (Raven Press 1994), and Headache Disorders: A Management Guide for Practitioners, by A. Rapoport and F. Sheftell (W. B. Saunders, Philadelphia, 1996). In addition, various definitions, categories, and diagnostic standards have been approved and issued by the International Headache Society (IHS), and were published as a supplement to the journal Cephalalgia in 1988. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Use of BIBN4096 in combination with other antimigraine drugs for the treatment of migraine Inventor(s): Doods, Henri; (Warthausen, DE), Eberlein, Wolfgang; (Biberach, DE), Rudolf, Klaus; (Warthausen, DE) Correspondence: Boehringer Ingelheim Corporation; 900 Ridgebury Road; P. O. Box 368; Ridgefield; CT; 06877; US Patent Application Number: 20030181462 Date filed: August 13, 2002 Abstract: A method of treatment or prevention of headache, migraine or cluster headaches, which method comprises co-administration of a therapeutically effective amount of the compound 1-[N.sup.2-[3,5-dibromo-N-[[4-(3,4-dihyd- ro-2(1H)oxochinazolin-3-yl)-1-piperidinyl]-carbonyl]-D-tyrosyl]-L-lysyl]-4-(4-pyridinyl)piperazine[BIBN4096BS] or a physiologically acceptable salt thereof and a therapeutically effective amount of a second active antimigraine drug, particularly sumatriptan, zolmitriptan or dihydroergotamin or a physiologically acceptable salt thereof, as well as to the corresponding pharmaceutical compositions and the preparation thereof. Excerpt(s): Benefit of U.S. provisional application Ser. No. 60/315,321, filed Aug. 28, 2001 is hereby claimed. This is a continuation-in-part of Attorney Docket No. 1/1248 filed on Aug. 9, 2002. The invention relates to a method for the treatment or prevention of headache, migraine and cluster headaches, which comprises the co-administration of the agent BIBN4096BS and another antimigraine drug. Migraine is one of the most common neurological disorders, involving periodical attacks of headache and nausea as well as a plethora of other symptoms. Although considerable progress has been made, the pathophysiology of migraine is still not understood. However, several observations point to an involvement of Calcitonin Gene-Related Peptide (CGRP). Migraine headache involves the activation of the trigeminal system and dilatation of cranial vessels. CGRP

Patents 43

is localized to neurons in the trigeminal ganglia and CGRP levels are increased during a migraine attack, presumably causing the vasodilation observed. Accordingly, it is conceivable that inhibition of CGRP-evoked dilatation of the cranial vessels may provide a novel treatment for migraine headache. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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

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CHAPTER 6. BOOKS ON CLUSTER HEADACHES Overview This chapter provides bibliographic book references relating to cluster headaches. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on cluster headaches 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: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in PrintÒ). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “cluster headaches” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “cluster headaches” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “cluster headaches” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): ·

Cluster Headaches: Treatment and Relief for Cluster, Cluster Migraine, and Recurring Eyestab Pain by Michael E. Goldstein; ISBN: 1881217183; http://www.amazon.com/exec/obidos/ASIN/1881217183/icongroupinterna

·

Headache Survival: The Holistic Medical Treatment Program for Migraine, Tension, and Cluster Headaches by Robert S. Ivker, et al; ISBN: 1585421413; http://www.amazon.com/exec/obidos/ASIN/1585421413/icongroupinterna

·

The Magnesium Solution for Migraine Headaches: How to Use Magnesium to Prevent and Relieve Migraine and Cluster Headaches Naturally by Jay S. Cohen; ISBN: 0757002560; http://www.amazon.com/exec/obidos/ASIN/0757002560/icongroupinterna

46

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Cluster Headaches

Treating Sinus, Migraine, and Cluster Headaches, My Way : An allergist's approach to headache treatment by William E. Walsh MD; ISBN: 0963154451; http://www.amazon.com/exec/obidos/ASIN/0963154451/icongroupinterna

Chapters on Cluster Headaches In order to find chapters that specifically relate to cluster headaches, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and cluster headaches using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “cluster headaches” (or synonyms) into the “For these words:” box.

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CHAPTER 7. PERIODICALS AND NEWS ON CLUSTER HEADACHES Overview In this chapter, we suggest a number of news sources and present various periodicals that cover cluster headaches.

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

Trigeminal nerve sectioning may be a valid option for chronic cluster headache Source: Reuters Medical News Date: May 09, 2003

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·

Parenteral indomethacin does not prevent cluster headache Source: Reuters Industry Breifing Date: May 02, 2003

·

Botox may relieve cluster headaches Source: Reuters Health eLine Date: November 28, 2002

·

Melatonin ineffective for cluster headache patients who fail conventional therapy Source: Reuters Industry Breifing Date: November 22, 2002

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Greater occipital nerve blockade is effective treatment for cluster headache Source: Reuters Medical News Date: October 24, 2002

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Implanted device wipes out cluster headaches Source: Reuters Health eLine Date: September 26, 2002

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Woman's dislodged filling causes cluster headaches Source: Reuters Health eLine Date: September 10, 2002

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Intranasal capsaicin isomer may prevent episodic cluster headaches Source: Reuters Industry Breifing Date: July 18, 2002

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New subtype of cluster headache identified Source: Reuters Medical News Date: June 12, 2002

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Male preponderance in cluster headache has decreased since 1970 Source: Reuters Medical News Date: June 07, 2002

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Cluster headache symptoms without the headache reported Source: Reuters Industry Breifing Date: April 12, 2002

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Chronic cluster headache may resolve with melatonin treatment Source: Reuters Industry Breifing Date: February 04, 2002

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Cluster headache patients in community experience long delay before diagnosis Source: Reuters Medical News Date: January 19, 2001

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"Abortive cluster headache" may present without pain Source: Reuters Medical News Date: August 08, 2000

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Zolmitriptan useful in treating cluster headache Source: Reuters Industry Breifing Date: July 25, 2000

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Sleep disordered breathing common in cluster headache patients Source: Reuters Medical News Date: June 28, 2000

Periodicals and News

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New-onset cluster headache in older women may resemble migraine Source: Reuters Medical News Date: May 11, 2000

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Cluster headaches not just in young men Source: Reuters Health eLine Date: May 10, 2000

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Aura may accompany cluster headache Source: Reuters Medical News Date: January 17, 2000

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"Thrashing around" suggestive of cluster headache-like disorder in children Source: Reuters Medical News Date: December 27, 1999

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Premonitory symptoms may occur in cluster headache patients Source: Reuters Medical News Date: November 30, 1999

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Anxiety disorders, memory deficits associated with cluster headache Source: Reuters Medical News Date: September 28, 1999

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Structural brain abnormality identified in cluster headache patients Source: Reuters Medical News Date: June 29, 1999

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Zolmitriptan effective oral treatment for episodic cluster headache Source: Reuters Medical News Date: June 03, 1999

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Gender variations in cluster headache reported Source: Reuters Medical News Date: June 02, 1999

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Hypothalamic irregularities implicated in cluster headache Source: Reuters Medical News Date: April 09, 1999

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Refractory cluster headache relieved by methylphenidate Source: Reuters Medical News Date: December 07, 1998

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Cluster headache with migrainous features may respond to divalproex Source: Reuters Medical News Date: September 15, 1998

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Cluster headache pathophysiology requires reappraisal Source: Reuters Medical News Date: August 13, 1998

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Neurovascular pathophysiology of cluster headaches demonstrated Source: Reuters Medical News Date: July 24, 1998

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Cause of cluster headache questioned Source: Reuters Health eLine Date: July 24, 1998

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·

Methylprednisolone Relieves Cluster Headache Symptoms Source: Reuters Medical News Date: April 02, 1998

·

Methylergonovine Maleate Efficacious For Prevention Of Cluster Headaches Source: Reuters Medical News Date: January 05, 1998

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Methysergide Derivative Reduces Frequency, Intensity Of Cluster Headaches Source: Reuters Medical News Date: September 10, 1997

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Migrainous Women Less Likely To Smoke Than Those With Cluster Headache Source: Reuters Medical News Date: July 21, 1997

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Carotid Artery Dissection Symptoms Mimic Migraine, Cluster Headache Source: Reuters Medical News Date: June 02, 1997

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Migraine And Cluster Headache May Have Similar Pathogenesis Source: Reuters Medical News Date: April 09, 1997

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 “cluster headaches” (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.

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51

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 “cluster headaches” (or synonyms). If you know the name of a company that is relevant to cluster headaches, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “cluster headaches” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “cluster headaches” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on cluster headaches: ·

A Bushel and a Peck of Peppers Source: University of California, Berkeley, Wellness Letter. 17(3):3. December 2000. Contact: Health Letter Associates. P.O. Box 412, Prince Street Station, New York, NY 10012-0007. www.wellnessletter.com. Summary: Peppers, whether hot or sweet, are a diverse and nutritious food. Peppers contain vitamin C, beta carotene, potassium, folic acid, calcium, and fiber, along with other phytochemicals. Most peppers start out green; as they ripen and become more vivid in color, they contain more nutrients. The hotness of hot peppers comes from a phytochemical called capsaicin. Capsaicin is used as a component of ointments for relieving arthritis pain, cluster headaches, and other health problems, and may also have other pharmacological uses.

Academic Periodicals covering Cluster Headaches Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to cluster headaches. In addition to these sources, you can search for articles covering cluster headaches that have been published by any of the periodicals listed in previous chapters. To find the latest

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studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to cluster headaches: Antihistamines ·

Systemic - U.S. Brands: Aller-Chlor; AllerMax Caplets; Aller-med; Atarax; Banophen; Banophen Caplets; Benadryl; Benadryl Allergy; Bromphen; Calm X; Chlo-Amine; Chlorate; Chlor-Trimeton; Chlor-Trimeton Allergy; Chlor-Trimeton Repetabs; Claritin; Claritin Reditabs; Compoz http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202060.html

Caffeine ·

Systemic - U.S. Brands: Cafcit; Caffedrine Caplets; Dexitac Stay Alert Stimulant; Enerjets; Keep Alert; Maximum Strength SnapBack Stimulant Powders; NoDoz Maximum Strength Caplets; Pep-Back; Quick Pep; Ultra Pep-Back; Vivarin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html

Ergotamine, Belladonna Alkaloids, and Phenobarbital ·

Systemic - U.S. Brands: Bellergal-S http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202217.html

Headache Medicines, Ergot Derivative-Containing ·

Systemic - U.S. Brands: Cafergot; Cafertine; Cafetrate; D.H.E. 45; Ercaf; ErgoCaff; Ergomar; Ergostat; Gotamine; Migergot; Wigraine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202216.html

Lithium ·

Systemic - U.S. Brands: Cibalith-S; Eskalith; Lithane; Lithobid; Lithonate; Lithotabs http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202330.html

Methysergide ·

Systemic - U.S. Brands: Sansert http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202363.html

Sumatriptan ·

Systemic - U.S. Brands: Imitrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202665.html

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

Mosby’s Drug ConsultÔ Mosby’s Drug ConsultÔ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing

Researching Medications

55

information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug info/index.html.

Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

59

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

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

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

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

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

8

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

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

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

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

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

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

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

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

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

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

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

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

·

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

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

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

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

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

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

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

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

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

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

·

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

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

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

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

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.

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·

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

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

The NLM 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 “cluster headaches” (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 1388 17 977 2 7 2391

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 “cluster headaches” (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.

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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/.

The Genome Project and Cluster Headaches In the following section, we will discuss databases and references which relate to the Genome Project and cluster headaches.

Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).19 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 16 Adapted from 17

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. 19 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “cluster headaches” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for cluster headaches: ·

Cluster Headache, Familial Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=119915

Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: ·

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

·

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

·

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

·

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

·

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

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·

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

·

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html

Entrez Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: ·

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

·

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

·

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

·

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

·

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

·

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

·

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

·

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

·

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

·

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

·

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

·

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “cluster headaches” (or synonyms) into the search box and click “Go.”

Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database20 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome toc/toc a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome db.html.

The Genome Database21 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “cluster headaches” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

20 Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about syndrome.html. 21 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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

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Other guides Asthma http://www.nlm.nih.gov/medlineplus/asthma.html Bell's Palsy http://www.nlm.nih.gov/medlineplus/bellspalsy.html Cerebral Palsy http://www.nlm.nih.gov/medlineplus/cerebralpalsy.html Cerebral Palsy http://www.nlm.nih.gov/medlineplus/tutorials/cerebralpalsyloader.html Common Cold http://www.nlm.nih.gov/medlineplus/commoncold.html Dizziness and Vertigo http://www.nlm.nih.gov/medlineplus/dizzinessandvertigo.html Food Allergy http://www.nlm.nih.gov/medlineplus/foodallergy.html Heat Illness http://www.nlm.nih.gov/medlineplus/heatillness.html Infant and Toddler Health http://www.nlm.nih.gov/medlineplus/infantandtoddlerhealth.html Interstitial Cystitis http://www.nlm.nih.gov/medlineplus/interstitialcystitis.html Meniere's Disease http://www.nlm.nih.gov/medlineplus/menieresdisease.html Migraine http://www.nlm.nih.gov/medlineplus/migraine.html Migraine Headache http://www.nlm.nih.gov/medlineplus/tutorials/headacheandmigraineloader.htm l Neurologic Diseases http://www.nlm.nih.gov/medlineplus/neurologicdiseases.html Peripheral Nerve Disorders http://www.nlm.nih.gov/medlineplus/peripheralnervedisorders.html Shingles http://www.nlm.nih.gov/medlineplus/shingles.html Sinusitis http://www.nlm.nih.gov/medlineplus/sinusitis.html Trigeminal Neuralgia http://www.nlm.nih.gov/medlineplus/trigeminalneuralgia.html

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Within the health topic page dedicated to cluster headaches, the following was listed: ·

General/Overviews What You Should Know about Headache Source: American Council for Headache Education http://www.achenet.org/understanding/

·

Diagnosis/Symptoms Headaches Source: American Academy of Family Physicians http://familydoctor.org/502.xml

·

Treatment Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=PN00038

·

Alternative Therapy Have a Splitting Headache? Chiropractic Care Can Help Source: American Chiropractic Association http://www.acatoday.com/media/tips/headache.shtml

·

Nutrition Diet and Headache Source: National Headache Foundation http://www.headaches.org/consumer/topicsheets/diet headache.html

·

Specific Conditions/Aspects Cluster Headache Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00487 Early Morning Awakening Headaches Source: National Headache Foundation http://www.headaches.org/consumer/topicsheets/earlymorning.html Headache and Sinus Disease Source: American Rhinologic Society http://american-rhinologic.org/cgibin/menu.cgi?m=main.menu&state=1001125555100000001000000&citem=7&f=patie ntinfo.headache.phtml Headaches and Allergies Source: American College of Allergy, Asthma & Immunology http://www.medem.com/MedLB/article detaillb.cfm?article ID=ZZZ4H568I6C& sub cat=129

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Headaches Caused by Viral Infections Source: National Headache Foundation http://www.headaches.org/consumer/topicsheets/viralinfections.html Hemicrania Continua Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health and medical/disorders/hemicrania continua.h tm Paroxysmal Hemicrania Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health and medical/disorders/paroxysmal hemicrani a.htm Rebound Headache Source: Beth Israel Medical Center, Dept. of Pain Medicine and Palliative Care http://stoppain.org/pain medicine/rebound.html Sexual Benign Headaches Source: National Headache Foundation http://www.headaches.org/consumer/topicsheets/sexual.html SUNCT Headache (Short-Lasting, Unilateral, Neuralgiform with Conjunctival Injection and Tearing) Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health and medical/disorders/sunct.htm Tension-Type Headache Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00304 Unusual Headaches Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01574 Vision Problems Causing Headaches? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=BN00009 ·

Children Chronic Headaches in Kids: Medication and Behavior Modifications May Help Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00428 Headache Triggers Source: American Council for Headache Education http://www.achenet.org/kids/triggers.php Headaches in Children Source: American Council for Headache Education http://www.achenet.org/kids/children.php Kids and Headache: Treatment Source: American Council for Headache Education http://www.achenet.org/kids/treatment.php

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Oooh, Your Aching Head! Source: Nemours Foundation http://kidshealth.org/kid/ill injure/sick/headache.html Why Does Eating Ice Cream Give Me a Headache? Source: Nemours Foundation http://kidshealth.org/kid/talk/qa/ice cream headache.html ·

From the National Institutes of Health Headache Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health and medical/disorders/headache.htm Headache: Hope through Research Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health and medical/pubs/headache htr.htm

·

Organizations American Council for Headache Education http://www.achenet.org/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

·

Women Headache, Stress and “Moods” Source: American Council for Headache Education http://www.achenet.org/women/stress/ Taking Control of Headache Source: American Council for Headache Education http://www.achenet.org/women/control.php Will Using Oral Contraceptives Make My Headaches Worse? Source: American Council for Headache Education http://www.achenet.org/women/oral/worse.php

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

The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on cluster headaches. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to

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http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: ·

Headaches and Biofeedback Source: Dallas, TX: MyoData-TMJ and Stress Center. 1990. 30 p. Contact: Available from MyoData-TMJ and Stress Center. P.O. Box 803394, Dallas, TX 75380. (800) 533-5121 or (214) 416-7676. PRICE: $6.95 plus shipping and handling; bulk orders available. Item Number B103. Summary: This booklet provides a guide to headaches and how they can be helped with biofeedback. Topics covered include common types of headaches and how they occur, including tension headaches, migraines, cluster headaches, headache of cervical (neck) origin, headaches of dental origin, and other headache types; the role of emotional anxiety and stress in muscle tension; evaluating the cause of headaches, including the interview, the use of a headache diary, physical examination, and the use of biofeedback for diagnosis; treatment strategies, including relaxation training, postural training, stretching, the generalization technique; what patients can do, including nutrition and exercise; and non-biofeedback approaches to headache treatment, including physical therapy, dental treatment, and psychology. The brochure begins with a pre-test and concludes with a brief reading list. 6 references.

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

Cluster Headaches Summary: A cluster headache is a rare type of headache that is more common in men. Cluster headaches start suddenly. The pain is usually behind or around one eye and is very severe. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6312

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 cluster headaches. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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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/

·

WebMDÒHealth: 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 cluster headaches. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with cluster headaches.

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 cluster headaches. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797.

Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “cluster headaches” (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

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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 “cluster headaches”. 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 “cluster headaches” (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 “cluster headaches” (or a synonym) into the search box, and click “Submit Query.”

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

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

22

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

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: ·

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/

23

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

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·

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

·

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

·

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

·

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids families/fam resources/fam res lib/frl.htm

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

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·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

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·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

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·

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

·

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

·

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

·

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

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

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

·

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

·

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

·

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

·

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

·

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

·

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

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

Basic Guidelines for Cluster Headaches Cluster headaches Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000786.htm

·

Signs & Symptoms for Cluster Headaches Decreased sensation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Excessive tears Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003036.htm Eyelid drooping Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003035.htm

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Flushed face Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm Head pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Headaches Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Muscle weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Nasal congestion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003049.htm Nausea/vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Red eye Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003031.htm Rhinorrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003051.htm Runny nose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003051.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm ·

Diagnostics and Tests for Cluster Headaches Serotonin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003562.htm

·

Background Topics for Cluster Headaches Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Analgesic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm

Online Glossaries 83

Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm

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

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

·

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

85

CLUSTER HEADACHES DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-Hydroxytryptophan: Precursor of serotonin used as antiepileptic and antidepressant. [NIH] Ablation: The removal of an organ by surgery. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] 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] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out

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into deep cavities for the teeth. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antiepileptic: An agent that combats epilepsy. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apnoea: Cessation of breathing. [EU] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical

Dictionary

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environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Aura: A subjective sensation or motor phenomenon that precedes and marks the of a paroxysmal attack, such as an epileptic attack on set. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta carotene: A vitamin A precursor. Beta carotene belongs to the family of fat-soluble vitamins called carotenoids. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived

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constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bupivacaine: A widely used local anesthetic agent. [NIH] 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] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the

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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] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotenoids: Substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. May reduce the risk of developing cancer. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamines: A general class of ortho-dihydroxyphenylalkylamines derived from tyrosine. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] 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] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] 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] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH]

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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] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] 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] 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] 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] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the

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anterior part of the sclera. [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] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [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] Contralateral: Having to do with the opposite side of the body. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cryosurgery: The use of freezing as a special surgical technique to destroy or excise tissue. [NIH]

Curative: Tending to overcome disease and promote recovery. [EU] 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] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of

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data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [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] Dilator: A device used to stretch or enlarge an opening. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the

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effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] 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] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electroshock: Induction of a stress reaction in experimental subjects by means of an electrical shock; applies to either convulsive or non-convulsive states. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [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] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Extracellular: Outside a cell or cells. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are

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referred to as facial pain syndromes. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] 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]

Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Fossa: A cavity, depression, or pit. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] 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]

Geriatric: Pertaining to the treatment of the aged. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and

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immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemicrania: An ache or a pain in one side of the head, as in migraine. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU]

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Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxocobalamin: A B12 vitamin. It has been used therapeutically in the treatment and prevention of vitamin B12 deficiency. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperoxia: An abnormal increase in the amount of oxygen in the tissues and organs. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] 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] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH]

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Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isosorbide: 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma. [NIH] Isosorbide Dinitrate: A vasodilator used in the treatment of angina. Its actions are similar to nitroglycerin but with a slower onset of action. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] 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] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH]

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Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipid: Fat. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

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] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manic: Affected with mania. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU]

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Maxillary Nerve: The intermediate sensory division of the trigeminal (5th cranial) nerve. The maxillary nerve carries general afferents from the intermediate region of the face including the lower eyelid, nose and upper lip, the maxillary teeth, and parts of the dura. [NIH]

Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] 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,

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can be made up of many thousands of atoms. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [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] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH]

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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] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [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] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Nitroglycerin: A highly volatile organic nitrate that acts as a dilator of arterial and venous smooth muscle and is used in the treatment of angina. It provides relief through improvement of the balance between myocardial oxygen supply and demand. Although total coronary blood flow is not increased, there is redistribution of blood flow in the heart when partial occlusion of coronary circulation is effected. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Ophthalmic: Pertaining to the eye. [EU]

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Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Orofacial: Of or relating to the mouth and face. [EU] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Pelvic: Pertaining to the pelvis. [EU]

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Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] 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] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phlebography: Radiographic visualization or recording of a vein after the injection of contrast medium. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

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

Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pineal Body: A small conical midline body attached to the posterior part of the third ventricle and lying between the superior colliculi, below the splenium of the corpus callosum. [NIH] Pineal gland: A tiny organ located in the cerebrum that produces melatonin. Also called pineal body or pineal organ. [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] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU]

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Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Post-traumatic: Occurring as a result of or after injury. [EU] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring

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secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein 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] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [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] Pulmonary: Relating 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]

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] Radiofrequency ablation: The use of electrical current to destroy tissue. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [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] 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] Rectum: The last 8 to 10 inches of the large intestine. [NIH]

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Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] 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] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino

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acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH]

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Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [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] Sumatriptan: A serotonin agonist that acts selectively at 5HT1 receptors. It is used in the treatment of migraines. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] 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] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include

Dictionary 109

cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [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] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] 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] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the trigeminal ganglion and project to the trigeminal nucleus of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU]

110

Cluster Headaches

Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Headaches: A group of disorders characterized by recurrent headaches associated with abnormal dilation and constriction of cerebral blood vessels. Representative disorders from this category include migraine, cluster headache, and paroxysmal hemicrania. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens 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] 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] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [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] 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] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the

Dictionary 111

cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Yawning: An involuntary deep inspiration with the mouth open, often accompanied by the act of stretching. [NIH]

113

INDEX 5 5-Hydroxytryptophan, 29, 85 A Ablation, 85 Acetaminophen, 39, 85 Adenosine, 85, 88, 103 Adjunctive Therapy, 23, 38, 85 Adverse Effect, 85, 107 Affinity, 85, 87, 107 Agonist, 85, 92, 108 Airway, 85, 107 Alertness, 85, 88 Algorithms, 85, 88 Alkaline, 85, 88 Alkaloid, 85, 88, 100 Alternative medicine, 50, 85 Alveolar Process, 85, 106 Analgesic, 82, 85, 86, 96, 100 Anatomical, 86, 91, 92, 96, 106 Anemia, 65, 86, 94, 103 Aneurysm, 86, 110 Angina, 86, 97, 101 Animal model, 38, 86 Antagonism, 86, 88 Antibacterial, 86, 108 Antibiotic, 86, 108 Anticonvulsant, 38, 86 Antidepressant, 85, 86 Antiepileptic, 38, 85, 86 Anti-inflammatory, 85, 86, 94, 96, 104 Anti-Inflammatory Agents, 86 Antipyretic, 85, 86 Anxiety, 9, 49, 72, 86 Anxiety Disorders, 9, 86 Apnea, 86 Apnoea, 7, 86 Arachidonic Acid, 86, 98, 104 Arrhythmia, 86, 110 Arterial, 6, 86, 96, 101, 105 Arteries, 86, 88, 91, 99 Aspirin, 39, 86 Astrocytes, 86, 100 Ataxia, 64, 65, 87, 96, 108 Atmospheric Pressure, 87, 96 Atrophy, 64, 87 Aura, 13, 39, 40, 49, 87 Autacoids, 87, 96 Autonomic, 15, 22, 38, 87, 94, 103

B Bacteria, 86, 87, 108, 109 Bacteriophage, 87, 109 Basal Ganglia, 87, 94 Basal Ganglia Diseases, 87 Base, 87, 97, 108 Benign, 70, 87, 94, 95, 101 Beta carotene, 51, 87 Bilateral, 6, 87, 102 Biopsy, 87, 103 Biotechnology, 5, 50, 61, 63, 64, 65, 87 Bladder, 88, 105, 110 Bloating, 88, 96 Blood Cell Count, 88, 103 Blood Coagulation, 88 Blood pressure, 88, 96, 107 Blood vessel, 88, 89, 97, 107, 108, 109, 110 Body Fluids, 88, 107 Bowel, 88, 92 Bowel Movement, 88, 92 Brain Stem, 88, 109 Branch, 79, 88, 102, 108, 109 Bupivacaine, 88, 98 C Caffeine, 39, 54, 88 Calcium, 7, 51, 88, 90, 110 Calcium channel blocker, 88, 110 Capsaicin, 48, 51, 88 Carbohydrate, 88, 95 Carcinogens, 89, 101 Cardiac, 88, 89, 98, 100 Cardiovascular, 89, 98, 107 Carotene, 87, 89 Carotenoids, 87, 89 Case report, 7, 11, 16, 17, 89 Catecholamines, 89, 92, 100 Caudal, 89, 92, 96, 104 Cell, 64, 65, 85, 87, 89, 90, 92, 93, 94, 97, 98, 99, 101, 102, 103, 105, 108, 109 Cell Division, 64, 87, 89, 103 Central Nervous System, 88, 89, 92, 94, 95, 96, 98, 99, 100, 107 Central Nervous System Infections, 89, 95, 96 Cerebellar, 87, 89, 106 Cerebral, 6, 7, 13, 16, 68, 87, 88, 89, 91, 96, 109, 110 Cerebrum, 89, 103, 109

114

Cluster Headaches

Cervical, 16, 72, 89, 101 Cervix, 89 Chronic, 4, 5, 11, 13, 14, 15, 17, 18, 22, 23, 28, 29, 40, 42, 47, 48, 64, 70, 83, 89, 93, 97, 103, 107, 108 Chronic renal, 89, 103 Clinical trial, 4, 23, 33, 34, 38, 40, 41, 61, 90, 105 Cloning, 88, 90 Cofactor, 90, 105 Collapse, 90, 107 Complement, 90 Complementary and alternative medicine, 27, 32, 90 Complementary medicine, 27, 90 Computational Biology, 61, 63, 90 Congestion, 39, 82, 90 Conjunctiva, 90, 109 Connective Tissue, 91, 94, 98, 106 Constriction, 91, 97, 110 Constriction, Pathologic, 91, 110 Contraindications, ii, 91 Contralateral, 11, 91, 102, 106 Conventional therapy, 48, 91 Conventional treatment, 91 Convulsions, 86, 91 Convulsive, 91, 93 Coronary, 91, 99, 101 Coronary Thrombosis, 91, 99 Cortex, 87, 91, 106 Cortical, 91, 106, 108 Cortisone, 91, 104 Cranial, 38, 42, 91, 94, 95, 99, 102, 103, 109 Craniocerebral Trauma, 87, 91, 95, 96, 109 Cryosurgery, 11, 91 Curative, 91, 109 Cyclic, 88, 91 D Databases, Bibliographic, 61, 91 Deamination, 92, 100 Dendrites, 92, 101 Depressive Disorder, 92, 98 Dextroamphetamine, 92, 99 Diagnostic procedure, 37, 50, 92 Diencephalon, 92, 96, 109 Digestion, 88, 92, 93, 96, 98, 108 Digestive system, 35, 92 Dilatation, 42, 86, 92, 110 Dilatation, Pathologic, 92, 110 Dilation, 92, 96, 110 Dilator, 92, 101 Direct, iii, 53, 92, 106

Dissection, 17, 50, 92 Diuresis, 88, 92 Diuretic, 92, 97 Dopamine, 92, 100 Dorsal, 92, 104 Drug Interactions, 55, 92 Drug Tolerance, 92, 109 Dyspepsia, 93, 96 Dysplasia, 65, 93 Dystrophy, 64, 93 E Efficacy, 4, 93, 109 Electrolyte, 93, 104, 107 Electroshock, 38, 93 Emollient, 93, 95, 101 Endocrine System, 93, 101 End-stage renal, 89, 93, 103 Enkephalin, 29, 93 Environmental Exposure, 93, 101 Environmental Health, 60, 62, 93 Enzymatic, 88, 89, 90, 93 Enzyme, 93, 96, 98, 100 Erythrocytes, 86, 88, 93 Esophagus, 92, 93, 95, 106, 108 Essential Tremor, 64, 93 Extracellular, 86, 91, 93, 107 Extremity, 93, 102 F Facial, 10, 38, 93 Facial Pain, 38, 93 Family Planning, 61, 94 Fat, 86, 87, 89, 94, 98, 106 Fatigue, 39, 94 Fibrosis, 65, 94, 106 Folate, 94 Fold, 4, 94 Folic Acid, 51, 94 Fossa, 23, 94 G Gallbladder, 92, 94 Ganglia, 43, 87, 94, 101, 103 Ganglion, 94, 109 Gas, 94, 96 Gastrointestinal, 40, 94, 98, 107 Gastrointestinal tract, 40, 94, 98, 107 Gene, 42, 65, 66, 88, 94, 101 Geriatric, 28, 94 Gland, 91, 94, 98, 102, 105 Glossopharyngeal Nerve, 93, 94 Glucocorticoid, 94, 104 Glucose, 64, 95 Glutamic Acid, 94, 95

Index 115

Glycerol, 15, 18, 95 Governing Board, 95, 104 Grasses, 94, 95 Growth, 64, 86, 95, 98, 101, 103, 107, 109 H Headache Disorders, 4, 38, 42, 95 Heartburn, 95, 96 Hemicrania, 5, 11, 22, 23, 70, 95, 110 Hemodynamics, 13, 16, 95 Hemoglobin, 86, 88, 93, 95 Hemoglobinuria, 64, 95 Hemorrhage, 91, 95, 108 Hereditary, 95, 106 Heredity, 94, 95 Hormonal, 87, 95 Hormone, 91, 95, 96, 107 Host, 87, 96, 98 Hydrocephalus, 96, 97 Hydrolysis, 96, 98, 103 Hydroxocobalamin, 40, 96 Hyperbaric, 11, 28, 29, 30, 31, 96 Hyperbaric oxygen, 11, 28, 29, 30, 96 Hyperoxia, 7, 96 Hypersensitivity, 96, 98 Hypertension, 95, 96 Hypothalamus, 17, 92, 93, 96, 107, 109 I Ibuprofen, 39, 96 Id, 24, 31, 64, 69, 70, 73, 78, 80, 96 Immune system, 96, 98 Immunodeficiency, 64, 96 Impairment, 12, 31, 87, 96, 99 Indicative, 45, 96, 102, 110 Indigestion, 39, 96 Indomethacin, 5, 15, 48, 96 Infarction, 91, 96, 97, 99 Infection, 96, 97, 98, 108 Inflammation, 86, 94, 97, 98, 106 Infusion, 17, 97 Inhalation, 16, 97, 103 Interleukin-2, 16, 97 Intestinal, 89, 97, 98 Intestines, 94, 97 Intoxication, 97, 111 Intracellular, 88, 97, 104 Intravenous, 13, 97 Involuntary, 87, 93, 97, 100, 111 Ischemia, 87, 97 Isosorbide, 8, 97 Isosorbide Dinitrate, 8, 97 K Kb, 60, 97

Kidney Disease, 35, 60, 65, 97 L Large Intestine, 92, 97, 105 Leukemia, 64, 97 Leukocytes, 88, 96, 97 Leukotrienes, 42, 86, 98 Library Services, 78, 98 Lidocaine, 12, 98 Ligament, 98, 105 Lipid, 95, 98 Lipolysis, 10, 98 Lipoxygenase, 98 Lithium, 13, 22, 54, 98 Liver, 85, 86, 92, 94, 98, 100, 104 Localized, 43, 97, 98, 100, 101, 103 Lymph, 89, 98 Lymph node, 89, 98 Lymphoid, 98 Lymphoma, 64, 98 M Malabsorption, 64, 98 Malignant, 64, 98, 101 Malnutrition, 87, 98, 100 Mandible, 85, 98, 106 Manic, 98 Mastication, 98, 109 Maxillary, 98, 99, 102, 109 Maxillary Nerve, 99, 109 Mediate, 4, 92, 99 Mediator, 97, 99, 107 Medical Records, 99, 106 MEDLINE, 61, 63, 65, 99 Megaloblastic, 94, 99 Melanocytes, 99 Melanoma, 64, 99 Membrane, 86, 90, 99, 100, 102 Memory, 9, 49, 99 Menstruation, 8, 99 Mental Disorders, 35, 99, 105 Mental Processes, 99, 105 Methylphenidate, 49, 99 MI, 23, 83, 99 Modeling, 4, 99 Modification, 99, 105 Molecular, 61, 63, 88, 90, 99 Molecule, 87, 90, 96, 99, 105, 110 Monoamine, 6, 29, 92, 100, 110 Monoamine Oxidase, 6, 92, 100, 110 Monotherapy, 38, 100 Morphine, 100 Motility, 96, 100, 107 Motion Sickness, 100

116

Cluster Headaches

Mucociliary, 100, 107 Muscle Fibers, 100 Muscle tension, 72, 100 Muscular Atrophy, 64, 100 Muscular Dystrophies, 93, 100 Myocardium, 99, 100 Myotonic Dystrophy, 64, 100 N Narcolepsy, 92, 99, 100 Narcosis, 100 Narcotic, 39, 100 Nasal Cavity, 100, 102 Nasal Mucosa, 28, 100 Nausea, 41, 42, 82, 96, 100 NCI, 1, 34, 59, 101 Neck Pain, 29, 101 Necrosis, 97, 99, 101 Need, 3, 38, 39, 46, 51, 74, 89, 101, 109 Neoplasia, 64, 101 Neoplasm, 101, 109 Neoplastic, 93, 98, 101 Nephropathy, 97, 101 Nerve, 11, 47, 48, 68, 87, 92, 94, 99, 100, 101, 104, 106, 109 Nervous System, 64, 89, 99, 101, 103, 110 Neural, 100, 101 Neuroendocrine, 6, 101 Neuromuscular, 6, 101 Neurons, 43, 92, 94, 101 Neurosyphilis, 101, 102 Nitroglycerin, 14, 97, 101 Nucleus, 87, 91, 101, 108, 109 O Ointments, 51, 101 Oncogene, 64, 101 Ophthalmic, 14, 101, 109 Optic Chiasm, 96, 102 Orbit, 102 Orbital, 14, 38, 102 Orofacial, 3, 93, 102 Osmotic, 97, 102 Outpatient, 4, 102 Oxidative metabolism, 98, 102 P Palliative, 70, 102, 109 Pancreas, 92, 102, 107 Pancreatic, 64, 102 Pancreatic cancer, 64, 102 Paralysis, 102 Paranasal Sinuses, 102, 107 Paresis, 14, 102

Paroxysmal, 5, 22, 23, 64, 70, 87, 95, 102, 110 Particle, 102, 109 Pathogenesis, 4, 38, 50, 102 Pathologic, 8, 87, 91, 96, 102, 106 Pathophysiology, 4, 15, 42, 49, 102 Patient Education, 71, 76, 78, 83, 102 Pelvic, 102, 105 Percutaneous, 15, 16, 103 Peripheral Nervous System, 103, 107 Pernicious, 40, 99, 103 Pernicious anemia, 40, 103 Pharmacologic, 87, 103, 109 Phlebography, 14, 103 Phosphorus, 88, 103 Physical Examination, 72, 103 Physical Therapy, 72, 103 Physiologic, 85, 99, 103, 105, 106 Pigment, 99, 103 Pilot study, 23, 103 Pineal Body, 103 Pineal gland, 17, 30, 103 Plants, 85, 95, 103 Plasma, 14, 95, 103, 106 Poisoning, 97, 100, 103 Polycystic, 65, 103 Polypeptide, 103, 107 Posterior, 17, 87, 92, 94, 101, 102, 103, 104 Post-traumatic, 95, 104 Postural, 72, 104 Potassium, 51, 104 Practicability, 104, 109 Practice Guidelines, 62, 104 Precipitating Factors, 95, 104 Precursor, 85, 86, 87, 92, 93, 104 Prednisolone, 104 Prednisone, 18, 104 Prevalence, 12, 104 Procaine, 98, 104 Progression, 86, 104 Progressive, 89, 92, 95, 100, 101, 104, 109 Prophylaxis, 22, 23, 40, 104 Prostaglandins, 86, 96, 104 Prostaglandins A, 96, 104 Prostate, 64, 105 Protein S, 65, 88, 105 Proteins, 90, 99, 103, 105, 107 Psychiatric, 4, 99, 105 Psychiatry, 8, 11, 13, 16, 23, 105, 108 Psychic, 105, 106 Psychology, 4, 72, 105 Public Policy, 61, 105

Index 117

Pulmonary, 88, 98, 105, 110 Pulse, 28, 105 Q Quality of Life, 4, 105 R Race, 4, 105 Radiation, 93, 96, 105 Radiation therapy, 96, 105 Radiofrequency ablation, 16, 105 Radiological, 103, 105 Randomized, 93, 105 Receptor, 6, 22, 41, 42, 92, 105, 107 Rectum, 88, 92, 94, 97, 105 Red Nucleus, 87, 106 Refer, 1, 90, 106 Reflux, 39, 106 Refraction, 106, 108 Regimen, 93, 106 Research Design, 4, 106 Resorption, 12, 96, 106 Restoration, 103, 106 Retinoblastoma, 64, 106 Retrospective, 3, 6, 106 Retrospective study, 6, 106 Rheumatism, 96, 106 S Salivary, 92, 102, 106 Salivary glands, 92, 106 Schizoid, 106, 110 Schizophrenia, 106, 110 Schizotypal Personality Disorder, 106, 110 Sclerosis, 64, 106 Screening, 90, 106 Seizures, 38, 82, 102, 106 Semen, 105, 106 Serotonin, 82, 85, 100, 106, 108 Serum, 13, 90, 107 Sex Determination, 65, 107 Shock, 93, 107 Side effect, 41, 53, 85, 107, 109 Signs and Symptoms, 28, 107 Sinusitis, 68, 107 Skull, 91, 102, 107, 108 Sleep apnea, 18, 107 Smooth muscle, 87, 88, 100, 101, 107 Social Environment, 105, 107 Social Support, 4, 107 Sodium, 10, 22, 23, 107 Solvent, 95, 102, 107 Somatostatin, 17, 22, 107 Specialist, 73, 92, 108 Species, 88, 105, 108, 111

Spectrum, 17, 108 Sporadic, 106, 108 Stimulant, 54, 88, 92, 99, 108 Stomach, 92, 93, 94, 96, 97, 100, 106, 108 Stress, 71, 72, 82, 93, 100, 108 Stroke, 35, 60, 70, 71, 108 Stupor, 100, 108 Subacute, 97, 107, 108 Subarachnoid, 95, 108 Subclinical, 97, 106, 108 Sumatriptan, 6, 22, 23, 40, 42, 54, 108 Symphysis, 105, 108 Symptomatic, 8, 17, 108 Synergistic, 41, 108 Systemic, 54, 88, 95, 97, 104, 105, 108 T Telangiectasia, 65, 108 Temporal, 38, 95, 108 Thalamic, 87, 108 Thalamic Diseases, 87, 108 Therapeutics, 55, 100, 109 Thermal, 30, 109 Third Ventricle, 96, 103, 109 Thrombosis, 105, 108, 109 Tissue, 87, 91, 93, 97, 98, 99, 100, 101, 103, 105, 107, 108, 109 Tolerance, 39, 40, 109 Toxic, iv, 93, 95, 109 Toxicity, 92, 109 Toxicology, 62, 109 Transduction, 22, 109 Transfection, 88, 109 Treatment Outcome, 4, 109 Trigeminal, 12, 13, 14, 15, 18, 31, 42, 47, 68, 93, 99, 109 Trigeminal Nerve, 14, 31, 109 Tuberous Sclerosis, 65, 109 Tumour, 7, 94, 109 Tyramine, 100, 110 U Unconscious, 96, 110 Urethra, 105, 110 Urine, 88, 92, 95, 110 Uterus, 89, 99, 110 V Vagina, 89, 99, 110 Vascular, 8, 10, 40, 95, 97, 110 Vascular Headaches, 10, 40, 110 Vasoconstriction, 7, 110 Vasodilation, 43, 110 Vasodilator, 92, 97, 110 Vector, 109, 110

118

Cluster Headaches

Vein, 12, 86, 97, 103, 110 Venous, 88, 101, 105, 110 Ventricle, 105, 109, 110 Verapamil, 22, 110 Veterinary Medicine, 61, 110 Viral, 70, 109, 110 Virus, 87, 89, 109, 110

Viscosity, 40, 110 W Withdrawal, 17, 110 X Xenograft, 86, 111 Y Yawning, 39, 111

Index 119

120

Cluster Headaches

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