Kegel Exercises: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

KEGEL EXERCISES A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J A...

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KEGEL

EXERCISES A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Kegel Exercises: 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: 0-597-83949-2 1. Kegel Exercises-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 Kegel exercises. 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 KEGEL EXERCISES ..................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Kegel Exercises.............................................................................. 4 The National Library of Medicine: PubMed .................................................................................. 4 CHAPTER 2. ALTERNATIVE MEDICINE AND KEGEL EXERCISES ....................................................... 7 Overview........................................................................................................................................ 7 National Center for Complementary and Alternative Medicine.................................................... 7 Additional Web Resources ........................................................................................................... 10 General References ....................................................................................................................... 11 CHAPTER 3. BOOKS ON KEGEL EXERCISES ...................................................................................... 13 Overview...................................................................................................................................... 13 Book Summaries: Federal Agencies.............................................................................................. 13 Chapters on Kegel Exercises......................................................................................................... 14 CHAPTER 4. MULTIMEDIA ON KEGEL EXERCISES ........................................................................... 19 Overview...................................................................................................................................... 19 Video Recordings ......................................................................................................................... 19 CHAPTER 5. PERIODICALS AND NEWS ON KEGEL EXERCISES ........................................................ 21 Overview...................................................................................................................................... 21 News Services and Press Releases................................................................................................ 21 Newsletter Articles ...................................................................................................................... 23 Academic Periodicals covering Kegel Exercises ........................................................................... 26 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 29 Overview...................................................................................................................................... 29 NIH Guidelines............................................................................................................................ 29 NIH Databases............................................................................................................................. 31 Other Commercial Databases....................................................................................................... 33 APPENDIX B. PATIENT RESOURCES ................................................................................................. 35 Overview...................................................................................................................................... 35 Patient Guideline Sources............................................................................................................ 35 Finding Associations.................................................................................................................... 37 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 39 Overview...................................................................................................................................... 39 Preparation................................................................................................................................... 39 Finding a Local Medical Library.................................................................................................. 39 Medical Libraries in the U.S. and Canada ................................................................................... 39 ONLINE GLOSSARIES.................................................................................................................. 45 Online Dictionary Directories ..................................................................................................... 46 KEGEL EXERCISES DICTIONARY............................................................................................. 47 INDEX ................................................................................................................................................ 63

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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 Kegel exercises 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 Kegel exercises, 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 Kegel exercises, 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 Kegel exercises. 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 Kegel exercises, 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 Kegel exercises. 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 KEGEL EXERCISES Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Kegel exercises.

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

Kegel Exercises Help Kids Overcome Bedwetting, Incontinence Source: NIH News and Features. National Institutes of Health News and Features. p. 12. April 1994. Contact: Available from NIH News and Features. (301) 496-2317. Summary: This article describes recent research that demonstrates the value of Kegel exercises in helping children to overcome urinary incontinence and bedwetting. Topics include the prevalence of urinary incontinence; the potential complications of urinary incontinence, including psychosocial problems and urinary tract infections; methods used to treat urinary incontinence in children; the amount of training in the Kegel technique that was used in the study; and the results. Within 2 months of training, 47 (60 percent) of the children studied were completely cured of daytime incontinence; another

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11 children (14 percent) had a partial reduction in both urinary incontinence frequency and urgency. The author concludes with a brief discussion of the mechanism by which the Kegel technique might operate. •

Kegel Exercises and Childhood Incontinence: A New Role for An Old Treatment Source: Journal of Pediatrics. 124(1): 91-92. January 1994. Summary: This article reports on a study in which Kegel exercises were used to treat urinary incontinence in 79 children. An average of less than 2 hours of professional time was required. Incontinence was eliminated in 60 percent of the patients; children who had both day and night wetting tended to show simultaneous improvements in both problems. The authors call for research that will test the hypothesis that Kegel exercises eliminate involuntary contractions of the detrusor muscle. 9 references. (AA).

Federally Funded Research on Kegel Exercises The U.S. Government supports a variety of research studies relating to Kegel exercises. 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 Kegel exercises. 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 Kegel exercises.

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.

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). 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.

Studies

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To generate your own bibliography of studies dealing with Kegel exercises, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Kegel exercises” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Kegel exercises (hyperlinks lead to article summaries): •

Kegel exercises after warm sitz bath recommended. Author(s): Whalley J. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1990 January-February; 19(1): 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2299436&dopt=Abstract

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Kegel exercises and childhood incontinence: a new role for an old treatment. Author(s): Schneider MS, King LR, Surwit RS. Source: The Journal of Pediatrics. 1994 January; 124(1): 91-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8283381&dopt=Abstract

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Kegel exercises and squatting behavior. Author(s): Robson WL, Leung AK, Mathers MS. Source: The Journal of Pediatrics. 1994 July; 125(1): 169-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8021772&dopt=Abstract

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Kegel exercises enhanced by biofeedback. Author(s): Tries J. Source: J Enterostomal Ther. 1990 March-April; 17(2): 67-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2324385&dopt=Abstract

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Kegel exercises. Author(s): Hooley JS. Source: J Fla Med Assoc. 1993 March; 80(3): 213. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8338537&dopt=Abstract

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Kegel exercises. Strengthening the weak pelvic floor muscles that cause urinary incontinence. Author(s): Kolcaba K, Dowd T, Winslow EH, Jacobson AF. Source: The American Journal of Nursing. 2000 November; 100(11): 59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11103639&dopt=Abstract

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Management of female incontinence with Kegel exercises. Author(s): Kuhns-Hastings J. Source: Aaohn Journal : Official Journal of the American Association of Occupational Health Nurses. 1988 February; 36(2): 78-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3337753&dopt=Abstract

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On call. My wife's problem with urinary leakage has improved with Kegel exercises. I've had dribbling since my TURP operation last month. Can these exercises help me, too? Author(s): Simon HB. Source: Harvard Men's Health Watch. 2001 September; 6(2): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11572833&dopt=Abstract

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Results of the anti-incontinence operations and Kegel exercises in patients with type II anatomic stress incontinence. Author(s): Yalcin OT, Hassa H, Ozalp S, Yildirim A, Sener T. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1998 March; 77(3): 341-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9539284&dopt=Abstract

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Teaching a patient to perform Kegel exercises. Author(s): McConnell EA. Source: Nursing. 1993 August; 23(8): 90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8361706&dopt=Abstract

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The role of biofeedback in Kegel exercise training for stress urinary incontinence. Author(s): Burgio KL, Robinson JC, Engel BT. Source: American Journal of Obstetrics and Gynecology. 1986 January; 154(1): 58-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3946505&dopt=Abstract

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Validation of surface EMG as a measure of intravaginal and intra-abdominal activity: implications for biofeedback-assisted Kegel exercises. Author(s): Workman DE, Cassisi JE, Dougherty MC. Source: Psychophysiology. 1993 January; 30(1): 120-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8416056&dopt=Abstract

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CHAPTER 2. EXERCISES

ALTERNATIVE MEDICINE AND KEGEL

Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Kegel exercises. 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 Kegel exercises 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 “Kegel exercises” (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 Kegel exercises: •

Age as a variable in an exercise program for the treatment of simple urinary stress incontinence. Author(s): Henderson JS, Taylor KH. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1987 July-August; 16(4): 266-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3650327&dopt=Abstract

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Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Author(s): Bump RC, Hurt WG, Fantl JA, Wyman JF. Source: American Journal of Obstetrics and Gynecology. 1991 August; 165(2): 322-7; Discussion 327-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1872333&dopt=Abstract

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Biofeedback for community-dwelling individuals with urinary incontinence. Author(s): Payne CK. Source: Urology. 1998 February; 51(2A Suppl): 35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495734&dopt=Abstract

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Idiopathic Constipation and Fecal Incontinence. Author(s): Krevsky B. Source: Current Treatment Options in Gastroenterology. 1998 December; 1(1): 20-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096560&dopt=Abstract

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Kegel exercises after warm sitz bath recommended. Author(s): Whalley J. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1990 January-February; 19(1): 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2299436&dopt=Abstract

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Kegel exercises enhanced by biofeedback. Author(s): Tries J. Source: J Enterostomal Ther. 1990 March-April; 17(2): 67-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2324385&dopt=Abstract

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Long-term efficacy of simple behavioral therapy for daytime wetting in children. Author(s): Wiener JS, Scales MT, Hampton J, King LR, Surwit R, Edwards CL. Source: The Journal of Urology. 2000 September; 164(3 Pt 1): 786-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10953156&dopt=Abstract

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Managing urinary incontinence in community-residing elderly persons. Author(s): Baigis-Smith J, Smith DA, Rose M, Newman DK. Source: The Gerontologist. 1989 April; 29(2): 229-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2753383&dopt=Abstract

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Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction. Author(s): Harvey MA. Source: J Obstet Gynaecol Can. 2003 June; 25(6): 487-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806450&dopt=Abstract

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Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games. Author(s): McKenna PH, Herndon CD, Connery S, Ferrer FA.

Alternative Medicine

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Source: The Journal of Urology. 1999 September; 162(3 Pt 2): 1056-62; Discussion 1062-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10458431&dopt=Abstract •

Pelvic muscle rehabilitation in males following prostatectomy. Author(s): Moul JW. Source: Urologic Nursing : Official Journal of the American Urological Association Allied. 1998 December; 18(4): 296-301. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9873356&dopt=Abstract

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Physiologic assessment of sexual response in women: the unfulfilled promise. Author(s): Hoon PW. Source: Clinical Obstetrics and Gynecology. 1984 September; 27(3): 767-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6488618&dopt=Abstract

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Rehabilitation principles in the care of gynecologic and obstetric patients. Author(s): Maly BJ. Source: Archives of Physical Medicine and Rehabilitation. 1980 February; 61(2): 78-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7369843&dopt=Abstract

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Sexual dysfunction, Part II: Diagnosis, management, and prognosis. Author(s): Halvorsen JG, Metz ME. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1992 March-April; 5(2): 177-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1575070&dopt=Abstract

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The role of biofeedback in Kegel exercise training for stress urinary incontinence. Author(s): Burgio KL, Robinson JC, Engel BT. Source: American Journal of Obstetrics and Gynecology. 1986 January; 154(1): 58-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3946505&dopt=Abstract

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Urinary incontinence in the aged, Part 2: Management strategies. Author(s): Rousseau P, Fuentevilla-Clifton A. Source: Geriatrics. 1992 June; 47(6): 37-40, 45, 48. Review. Erratum In: Geriatrics 1992 September; 47(9): 87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1592267&dopt=Abstract

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Urinary incontinence. Not a 'normal' part of aging. Author(s): Baum N, Suarez G, Appell RA. Source: Postgraduate Medicine. 1991 August; 90(2): 99-102, 107-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1862054&dopt=Abstract

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Urinary incontinence: the basics. Author(s): Kennedy KL, Steidle CP, Letizia TM. Source: Ostomy Wound Manage. 1995 August; 41(7): 16-8, 20, 22 Passim; Quiz 33-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7662091&dopt=Abstract

•

Validation of surface EMG as a measure of intravaginal and intra-abdominal activity: implications for biofeedback-assisted Kegel exercises. Author(s): Workman DE, Cassisi JE, Dougherty MC. Source: Psychophysiology. 1993 January; 30(1): 120-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8416056&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.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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

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

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

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

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

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

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WebMD®Health: 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 Kegel exercises; 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 Benign Prostatic Hyperplasia Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 11

Endometriosis Source: Integrative Medicine Communications; www.drkoop.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Prostate Enlargement Source: Integrative Medicine Communications; www.drkoop.com Prostate Infection Source: Integrative Medicine Communications; www.drkoop.com Prostatitis Source: Integrative Medicine Communications; www.drkoop.com Urinary Incontinence Source: Integrative Medicine Communications; www.drkoop.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 3. BOOKS ON KEGEL EXERCISES Overview This chapter provides bibliographic book references relating to Kegel exercises. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Kegel exercises include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Instructions for Patients. 5th ed Source: Philadelphia, PA: W.B. Saunders Company. 1994. 598 p. Contact: Available from W.B. Saunders Company. Book Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522. Fax (800) 874-6418. PRICE: $49.95. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This book is a compilation of instructions for patients, published in paperback format. Each fact sheet provides information in three sections: basic

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information, including a description of the condition, frequent signs and symptoms, causes, risk factors, preventive measures, expected outcome, and possible complications; treatment, including general measures, medication, activity guidelines, and diet; and when to contact one's health care provider. Fact sheets are available on kidney and urologic topics including: enuresis; cystitis in women; cystitis in men; bladder or urethra injury; bladder tumor; glomerulonephritis; male impotence; urinary incontinence; stress incontinence; urge incontinence; acute pyelonephritis; chronic kidney infection; polycystic kidney; kidney stones; the nephrotic syndrome; priapism; benign prostatic hyperplasia; prostatitis; acute renal failure; chronic kidney failure; testicular torsion; urethritis; and Kegel exercises. The fact sheets can be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool. The book is available in English or Spanish. •

Profile of Incontinence: Diagnosis and Management Source: Neenah, WI: Kimberly-Clark Corporation. 1996. 36 p. Contact: Available from Kimberly-Clark Corporation. Department M, P.O. Box 349, Neenah, WI 54957-9973. Summary: This continuing education program helps nurses and pharmacists take a more comprehensive role in managing patients with urinary incontinence (UI). The booklet first summarizes the incidence, prevalence, risk factors, and medical and social implications of UI in the adult population. The booklet then classifies the different types of UI and describes the assessment process used to diagnose UI. The following section describes treatment options, including behavioral treatment such as toileting assistance, bladder training, pelvic muscle rehabilitation (Kegel exercises), dietary modification, and environmental modification; and pharmacological therapy. The final section describes adjunctive therapies that may be used in the treatment of UI, including urine collection devices, catheters, and absorbent products. The curriculum concludes that quality of care of individuals with UI may be enhanced by providing reassurance and facts to dispel the myths associated with UI; obtaining a complete medication history, including nonprescription medications; encouraging the completion of a voiding diary prior to initial consult to aid in the diagnosis; providing ongoing patient education and reinforcement of therapy; monitoring for adverse effects throughout the course of therapy; recommending more thorough and advanced testing in the appropriate situations; referring patients with more complex or confusing problems to specialists; and increasing public awareness of the prevention of UI through modification of known risk factors. A posttest with which readers can obtain continuing education credits is included. 5 figures. 4 tables. 50 references.

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

Books

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Pelvic Floor Muscle Exercises Source: in Corcos, J.; Schick, E., eds. Urinary Sphincter. New York, NY: Marcel Dekker, Inc. 2001. p. 443-457. Contact: Available from Marcel Dekker, Inc. Cimarron Road, P.O. Box 5005, Monticello, NY 12701. (800) 228-1160 or (845) 796-1919. Fax (845) 796-1772. E-mail: [email protected]. International E-mail: [email protected]. Website: www.dekker.com. PRICE: $225.00 plus shipping and handling. ISBN: 0824704770. Summary: The urinary sphincter is the key to understanding both normal and abnormal function of the lower urinary tract. Its relationships with the bladder, the pelvic floor, and the bony structures of the pelvis are complex and incompletely understood. This chapter on pelvic floor muscle exercises is from a textbook that presents a detailed and systematic account of the current knowledge on the anatomy, physiology, functional relationships, and range of dysfunctions that affect the urinary sphincter. The author notes that the pelvic floor muscles (PFMs) are one of many factors contributing to the urethral closure mechanism. Strengthening and improving PFM function can compensate for other nonfunctioning factors. PFM exercise, with or without biofeedback, has been effective in treating female genuine stress incontinence (GSI). PFM exercises, also called Kegel exercises, have no known side effects, and women should be motivated to perform intensive PFM exercises as the first choice of treatment for stress incontinence. However, more than 30 percent of women do not contract correctly at their first consultation, and thorough individual instruction is needed. Manual techniques and electrical stimulation can be used to teach women how to contract. Three sets of 8 to 12 close-to-maximum contractions every day or every second day are recommended. Most people need motivation and encouragement to perform hard strength training. This can be achieved in individual training sessions or in specifically designed PFM exercise classes. When sufficient function has been achieved, PFM strength has to be maintained by further training, but with lower frequency. The author concludes that more research is needed to find out how much exercise will maintain sufficient PFM function and to evaluate the effect of PFM exercise in men and in patients with urge incontinence. 6 figures. 50 references.

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Regaining Control with Stress Incontinence Source: in King, B.D. and Harke, J. Coping with Bowel and Bladder Problems. San Diego, CA: Singular Publishing. 1994. p. 45-67. Contact: Available from Singular Publishing Group, Inc. 401 West A Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. PRICE: $18.95. ISBN: 1565930681. Summary: This chapter is from a book in the Coping with Aging Series on managing bowel and bladder problems. The chapter provides a discussion of the strategies used to regain control of stress incontinence. Topics covered include the role of weight loss; estrogen replacement, including estrogen tablets and vaginal estrogen cream; perineal exercises (Kegel exercises) and identifying the pubococcygeal muscle; a perineal muscle exercise program; medications; the use of biofeedback; electrical stimulation used to increase perineal muscle tone; surgical procedures available for women with stress incontinence; considerations for women post-hysterectomy; stress incontinence in men after surgery of the prostate gland; the placement of an artificial sphincter; periurethral injections; and the use of the penile clamp. The authors recommend that patients with stress incontinence begin with the noninvasive methods outlined, before exploring other management options. 11 figures.

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Digestive and Urinary Problems Source: in Mettler, M. and Kemper, D.W. Healthwise for Life: Medical Self Care for Healthy Aging. Boise, ID: Healthwise, Incorporated. 1996. p. 115-141. Contact: Available from Healthwise, Incorporated. P.O. Box 1989, Boise, ID 83701. (800) 706-9646 or (208) 345-1161. Fax (208) 345-1897. E-mail: [email protected]. Website: www.healthwise.com. PRICE: $14.35. ISBN: 1877930385. Summary: This chapter on digestive and urinary problems is from a medical self-care text for older persons interested in maintaining the best possible health for themselves. Designed for readers who are 50 or older, the book discusses prevention, home treatment, and ways to know when to contact one's health care provider. The introductory section of the chapter includes a chart of common symptoms, their possible causes, and the topic in the book under which readers will find information about those symptoms. The chapter then discusses abdominal pain, colorectal cancer, constipation, dehydration, diarrhea, diverticulosis and diverticulitis, gallbladder disease, heartburn, hemorrhoids and anal itching, irritable bowel syndrome, nausea and vomiting, stomach flu and food poisoning, ulcers (peptic ulcer), urinary incontinence, and urinary tract infections. For each condition, the authors provide a brief description, including possible risk factors, strategies to use for prevention, practical home treatments, and how to know when to contact a health care provider. The chapter includes sidebars, which provide information on oral rehydration solution (including a recipe), ways to control intestinal gas, and Kegel exercises. The chapter is written in nontechnical language, with an emphasis on self-care and overall health. 4 figures.

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Products and Devices for Managing Incontinence Source: in Gartley, C. Managing Incontinence: A Guide to Living with Loss of Bladder Control. Ottawa, IL: Jameson Books, Inc. 1985. p. 81-92. Contact: Available from Jameson Books, Inc. 722 Columbus Street, Ottawa, IL 61350. (815) 434-7905. ISBN: 091546313X. PRICE: $12.95; plus shipping and handling. Summary: This chapter on products and devices for managing problems of bladder control is from a book that offers information and practical advice for people with urinary incontinence. The authors of the book offer medical advice, practical help, product information, and conversations with others who have urinary incontinence (because of disease, injuries, operations, or birth anomalies). In this chapter, the authors examine products and procedures that may help readers to cope with incontinence. No single method is recommended as the best for any individual. In fact, many devices work well for some persons and not for others. The authors first offer a checklist of items to consider in any product or system. The products are described in generic terms rather than by brand to give readers a general idea of what types of devices are available. Topics include absorbent products, pad and pant systems, drip collectors (for males), adult undergarments, internal collection devices (Foley catheter and intermittent catheterization), external collection devices, surgical remedies, and muscle conditioners (including Kegel exercises). An appendix of product information by manufacturer is included at the end of the book. 9 figures.

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Management of Incontinence Source: in Horman, R.J., ed. Patient Care in Community Practice. Binghamton, NY: Pharmaceutical Products Press. 2002. p.31-53.

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Contact: Available from Pharmaceutical Products Press. 10 Alice Street, Binghamton, NY 13904-1580. (800)429-6784. E-mail: [email protected]. Website: www.haworthpressinc.com. PRICE: $39.95 plus shipping and handling. ISBN: 0853694508. Summary: This chapter on the management of urinary incontinence is from a text for pharmacists on patient care in community practice. The author notes that in modern society, an inability to regulate urine output from the body is considered a social disadvantage and will frequently result in the person with incontinence feeling outcast and ostracized. The author emphasizes that once the condition is recognized and accepted, there are many constructive ways in which the general practitioner and pharmacist can assist in its management. Topics include a brief description of bladder and allied anatomy, the normal process of micturition (urination), the classification of incontinence, stress incontinence, urge incontinence, overflow incontinence, enuresis (bedwetting), miscellaneous causes of incontinence, appliances and their selection, urethral catheters, pelvic floor muscle exercises (Kegel exercises), and enuresis alarms. The chapter concludes with contact information for organizations in England, for readers wishing more information; web site addresses are also provided. 7 figures. 2 tables. •

Urinary System Source: in Kelly, R.B., ed. Family Health and Medical Guide. Dallas, TX: Word Publishing. 1996. p. 158-168. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $30.00 for members; $35.00 for non-members; plus shipping and handling. ISBN: 0849908396. Summary: This chapter on the urinary system is from a family health and medical guide. The chapter first describes the anatomy and function of the urinary tract, including the kidneys, the ureters, the bladder, and the urethra. The chapter then discusses cancer of the urinary tract, cysts of the kidney, glomerulonephritis (inflammation of the kidney's glomeruli), infections of the urinary tract, pyelonephritis (kidney infection), kidney failure, kidney stones, nephrotic syndrome (a condition in which the kidneys leak large amounts of protein into the urine), and urinary incontinence (the inability to hold urine voluntarily). For each topic, the authors discuss symptoms, diagnostic tests, treatment options, and prevention. One sidebar provides suggestions on how to reduce the risk of bladder infection; another considers the use of bladder retraining for incontinence problems; a third briefly describes how to use Kegel exercises to strengthen pelvic floor muscles. 5 figures.

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Incontinence Source: in Carlson, K.J.; Eisenstat, S.A.; Ziporyn, T. Harvard Guide to Women's Health. Cambridge, MA: Harvard University Press. 1996. p. 317-322. Contact: Available from Harvard University Press. Customer Service Department, 79 Garden Street, Cambridge, MA 02138. (800) 448-2242. Fax (800) 962-4983. PRICE: $24.95 (paperback). ISBN: 0674367693 (paperback). Summary: This chapter on urinary incontinence is from a consumer handbook of women's health. Topics include the incidence of incontinence; the types of incontinence, including stress, urge, overflow, and functional; risk factors; symptoms; diagnostic tests

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and evaluation; and treatment options including Kegel exercises, drug therapy, and surgery. The chapter concludes with a list of other chapters in the book that may be related. The authors emphasize the emotional and social issues that may impact women's health. They also discuss how common diseases and their treatments are different for women than for men. 1 figure. •

Urinary Tract and Pelvic Floor Source: in Byyny, R.L. and Speroff, L. Clinical Guide for the Care of Older Women: Primary and Preventive Care. 2nd ed. Baltimore, MD: Williams and Wilkins. 1996. p. 365-384. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-6423 or (410) 528-8555. Fax (800) 447-8438. PRICE: $69.00. ISBN: 0683011510. Summary: This chapter, from a clinical guide for the care of older women, reviews the changes that occur with aging in the urinary tract as well as in the pelvic floor. The authors offer a program of evaluation and management for the clinical consequences of these changes. Topics include renal function with aging; atrophic mucosal changes; relaxation of the pelvic floor; the different types and uses of vaginal pessaries; the physiology of micturition; the types of urinary incontinence, including urge (detrusor instability), stress, overflow, and functional incontinence; diagnostic tests to classify incontinence; incontinence treatment, including bladder training, surgery, drug therapy, Kegel exercises, vaginal cones, and long-term catheterization; urinary tract infections and their treatment; and asymptomatic bacteriuria. 15 figures. 33 references.

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Childbirth and Incontinence Source: in Parker, W.H., et al. Incontinence Solution: Answers for Women of All Ages. New York, NY: Simon and Schuster. 2002. p.67-88. Contact: Available from Fireside, Rockefeller Center. 1230 Avenue of the Americans, New York, NY 10020. (800) 456-6798. PRICE: $13.00; plus shipping and handling. ISBN: 0743215877. Summary: Urinary incontinence is the uncontrollable loss of enough urine to cause social or sanitary difficulties. This chapter discusses childbirth and urinary incontinence. The chapters is from a book that offers women up to date medical explanations for incontinence and its treatment. The authors first review how childbirth can cause incontinence, noting that there are many factors that can lead to incontinence: the strength of the pelvic supporting structures the woman is born with, the forces these structures have resisted over the years (including childbirth, heavy lifting and straining during bowel movements), the ability to heal if these tissues are injured, and the effect of the aging process on the collagen that gives strength to these structures. Other topics include the impact of long labor on incontinence, vaginal delivery and its consequences, forceps delivery and incontinence, nonmedical reasons to avoid cesarean section deliveries, how childbirth can weaken the bladder, the use of Kegel exercises during and after pregnancy, childbirth as a cause of anal incontinence, complications of episiotomy, and strategies to prevent the incontinence associated with childbirth. The chapter includes the stories of two women who had complications of incontinence after pregnancy. Chapter references are located at the end of the book. 1 figure. 9 references.

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

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

Choice is Yours Source: Wilmette, IL: Simon Foundation for Continence. 1996. (videocassette). Contact: Available from Simon Foundation for Continence. P.O. Box 835, Wilmette, IL 60091. (800) 237-4666 or (847) 864-3913. Fax (847) 864-9758. PRICE: $17.95. Summary: This videotape encourages women to seek help for urinary incontinence problems. After an introductory section in which women with incontinence express their fears and discouragement, the program focuses on positive interactions between physicians and patients as they strive to diagnose and treat urinary incontinence. Topics include the anatomy and physiology of the bladder; the kinds of incontinence, notably stress, urge, and mixed, although other types are briefly mentioned; symptoms and diagnosis, including the use of a voiding diary and specific diagnostic tests; and treatment options, including lifestyle changes, bladder retraining, Kegel exercises, vaginal cones, biofeedback, electrical stimulation, drug therapy, and surgery. The program is narrated by Drs. Linda Brubaker, Rodney Appell, and Neil Resnick.

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Your Bladder and You. Who's Boss? Source: Rockville, MD: Urology Wellness Center. 199x. (videocassette). Contact: Available from Urology Wellness Center. 14820 Physicians Lane, Suite 241, Rockville, MD 20850. (301) 424-5661. Fax (301) 424-3734. PRICE: $23.95 plus shipping and handling. Summary: This videotape presents a slide lecture on urinary incontinence, defined as a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable. Topics include the prevalence of urinary incontinence (UI), the costs of UI in both community and nursing home settings, reasons for the underreporting of UI problems, the anatomy of the female urogenital system, keeping a continence chart to help establish the parameters of a UI problem, stress incontinence and its treatment (including Kegel exercises, biofeedback, electrical stimulation, vaginal cones, pessaries, and surgery), urge incontinence and its causes, treatment options for urge incontinence (including avoiding bladder irritants and constipation), bowel training, nocturia (urinating at night), current drug therapy for overactive bladder, mixed incontinence, overflow incontinence, functional incontinence, and the role of behavior modification strategies in managing UI problems. The lecture stresses that most people do not seek medical help because they are embarrassed and they are not aware that treatment is available. However, these are highly prevalent disorders that can severely diminish the patient's quality of life. Most patients can be adequately assessed with a history, physical examination, determination of postvoid residual (amount of urine left in the bladder after urinating), and urinalysis.

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Management Strategies for the Incontinent Ambulatory Elderly Source: Baltimore, MD: University of Maryland at Baltimore School of Medicine. 1996. (videocassette). Contact: Available from Video Press, University of Maryland at Baltimore School of Medicine. Suite 133, 100 Penn Street, Baltimore, MD 21201-1082. (800) 328-7450 or (410) 706-5497. Fax (410) 706-8471. PRICE: $100.00 for 2-week rental; $300.00 for purchase. Summary: This videotape program outlines basic anatomy of the urogenital system and defines incontinence. Behavioral treatment approaches are presented as they can be taught by staff to the ambulatory elderly. Topics include Kegel exercises, bladder retraining, and education to retrain daily habits and faulty voiding patterns that contribute to incontinence. (AA).

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CHAPTER 5. EXERCISES

PERIODICALS AND NEWS ON KEGEL

Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Kegel exercises.

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

Men can benefit from Kegel exercises, too Source: Reuters Health eLine Date: June 27, 2003

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Kegel exercises offer long-term benefit for some incontinent wome Source: Reuters Medical News Date: May 30, 2000

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Kegel exercises effective after transurethral prostatectomy Source: Reuters Medical News Date: July 29, 1998 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 “Kegel exercises” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “Kegel exercises” (or synonyms). If you know the name of a company that is relevant to Kegel exercises, 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/.

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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 “Kegel exercises” (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 “Kegel exercises” (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 Kegel exercises: •

Incontinence in Elders: A Practical Diagnostic and Management Schema Source: IHS Primary Care Provider. 24(5): 73-78. May 1999. Contact: Available from Indian Health Service Clinical Support Center. Two Renaissance Square, Suite 780, 40 North Central Avenue, Phoenix, AZ 85004. (602) 3647777. Fax (602) 364-7788. E-mail: [email protected]. Website: www.ihs.gov. Summary: This article reminds readers that urinary incontinence (UI) is not an inevitable consequence of aging, rather it is a treatable condition in the majority of patients. The authors focus on a specific population (Native Americans) and provide a scheme for diagnosis and management of UI in this population. The authors note that many elders fear UI, because it is often a primary reason that they may cease community living to be placed in a nursing home. For this reason, health care providers are encouraged to ask their patients specifically about incontinence and to let them know that most incontinence can be successfully treated, so that these elders may regain their dignity and improve their quality of life. The authors summarize the types of incontinence, including stress, urge, functional, overflow, mixed, and transient, then review the diagnostic tests used to evaluate incontinence and determine treatment. The goals of treatment include to preserve the upper urinary tract, to maintain or regain adequate bladder capacity with good compliance, to promote low pressure micturition (urination), to avoid bladder overdistention, to prevent urinary tract infection (UTI), to minimize the use of Foley catheters, and to choose therapy that minimizes the patient's risks while maximizing his or her social, emotional, and vocational acceptability. Treatment options include behavior modification (including Kegel exercises and bladder training), electrostimulation, biofeedback, pharmacotherapy (drugs), surgical procedures, collagen injection, intermittent self catheterization, mechanical plugs and appliances, neuroimplantation (for the spinal cord patient with incontinence), and environmental changes (such as providing a bedside commode). 4 tables. 12 references.

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Pelvic Floor Weakness: When the Bottom Gives Way Source: Mayo Clinic Health Letter. 20(5): 4-5. May 2002. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465.

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Kegel Exercises

Summary: This article, from a health information newsletter, reviews the problem of pelvic floor weakness. The strains of daily life and aging can be factors that weaken and stretch muscles, ligaments, nerves, and other tissues supporting the pelvic organs. Once identified, pelvic floor weakness can sometimes be managed with exercises and noninvasive therapies. Often, though, surgical treatment is preferred and even necessary. The article reviews the physiology and anatomy of the pelvic floor muscles, conditions that may result from weakened pelvic floor muscles (uterine prolapse, cystocele, rectocele, enterocele), the symptoms of those conditions, diagnostic tests that may be done, and treatment options. One sidebar reviews the use of Kegel exercises to strengthen the pelvic floor muscles. 1 figure. •

Understanding Biofeedback Source: Informer, The. 14(1): 2. Fall 2002. Contact: Available from Simon Foundation for Continence. P.O. Box 835-F, Wilmette, IL 60091. (800) 23SIMON or (800) 237-4666 or (847) 864-3913. Fax (847) 864-9758. E-mail: [email protected]. Website: www.simonfoundation.org. Summary: This brief article explains how biofeedback can be useful for patients coping with urinary incontinence. Kegel exercises may be prescribed to strengthen the pelvic floor muscles and help the closure mechanism of the bladder to protect from stress urinary leakage when sneezing, coughing, or lifting. These exercises also help relieve urgency and urge incontinence symptoms. Many people have difficulty learning these exercises successfully, because of weakness, disuse, and injury. Biofeedback can help identify the correct muscles, determine the degree of weakness in order to prescribe an exercise level, and determine that the exercises are being done correctly. Biofeedback measures pelvic muscle activity and translates this activity into images on a computer screen, or into light or sound. This visual or auditory feedback allows the patient to learn to perform pelvic muscle exercises properly. The article covers how biofeedback works, how biofeedback can be used to improve incontinence, biofeedback for stress urinary incontinence, biofeedback for urge incontinence, and when to expect results.

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Urinary Incontinence: Putting an End to the Embarrassment Source: Harvard Health Letter. 24(7): 6-7. May 1999. Contact: Available from Harvard Medical School Health Publications Group. Harvard Health Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail: [email protected]. Summary: This newsletter article encourages readers to learn about urinary incontinence (UI) and seek health care for managing any UI problems. Although UI affects both women and men, it is more common in women, and it is not a problem just in older people. The author stresses that incontinence is not considered normal at any age, and it should not be seen as an inevitable part of growing older. However, many people are too embarrassed to discuss the problem with a doctor, so they resign themselves to wearing adult diapers or pads. Fortunately, incontinence can be treated or even cured in most people by strengthening the pelvic muscles, taking medication, or both. The article briefly reviews the anatomy of the urinary tract, then defines three types of incontinence: stress, urge, and overflow. Individuals may be asked to keep a diary during the week prior to the doctor's visit to keep track of how much and how often they urinated or leaked urine. Tests performed in the office may include a pelvic or rectal exam, a urinalysis to test for infection, and a noninvasive imaging scan to check for residual urine in the bladder. Strengthening pelvic floor muscles with Kegel

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25

exercises has been shown to reduce urine leakage in 50 to 75 percent of women and cure it in 20 percent with stress incontinence. Other treatment options covered include bladder retraining, biofeedback, drug therapy, dietary changes (cutting back on alcohol and caffeine), and surgery. The author concludes that surgery is generally considered a last resort and is mainly used to strengthen pelvic muscles or lift the bladder to alleviate stress incontinence. 1 figure. •

Pelvic Muscle Rehabilitation Source: Quality Care. 16(3): 1-2. Summer 1998. Contact: Available from National Association for Continence. P.O. Box 8310, Spartanburg, SC 29305-8310. (800) 252-3337 or (864) 579-7900. Fax (864) 579-7902. Summary: This newsletter article reviews the use of pelvic floor muscle exercises (Kegel exercises) to prevent or treat urinary incontinence. The author notes that exercising the muscles of the pelvic floor on a regular basis should be as much a part of a woman's preventive health care routine as an annual Pap smear and monthly breast self examination. Pelvic muscles are frequently damaged during childbirth and sometimes by surgery in the pelvic area (hysterectomy or prolapse surgeries for women and prostatectomy for men). The author describes the purpose of pelvic muscle rehabilitation and then details how the exercises are done. The author notes that some people may only need written directions to undertake these exercises, but some people may need help from a health care professional to locate and exercise the pelvic muscles. Biofeedback, electrical stimulation, and vaginal weights are the most common methods used to help individuals locate and begin to use their pelvic muscles. The author concludes that, whichever method is prescribed, successful pelvic muscle rehabilitation depends on a consistent effort by the individual. 1 figure.

•

Incontinence: Ways to Help You Stay Dry Source: Mayo Clinic Health Letter. 16(1): 1-3. January 1998. Contact: Available from Mayo Foundation for Medical Education and Research. 200 First Street SW, Rochester, MN 55905. Summary: This patient education article from the Mayo Clinic newsletter reviews self care strategies for people with urinary incontinence (UI). The author emphasizes that most UI can be treated, with resulting cure or improvement. The author first outlines the urinary system and how the urinary sphincter and urethra work. The author then defines four types of UI: stress, urge, overflow, and mixed. A number of factors can lead to UI, including excess weight, frequent constipation, a chronic cough, or childbirth (all of which can stress and weaken the pelvic floor muscles). Other causes include urinary related infections, overactive bladder muscles, a malfunction of the urinary sphincter, and high fluid intake. In addition, diseases such as diabetes, stroke, and Parkinson's disease can damage the nerves that control the bladder. In men, UI can also stem from noncancerous enlargement of the prostate gland (benign prostatic hyperplasia), prostate cancer, and prostate surgery. The author describes some of the treatments available, including behavior modification (bladder retraining), avoiding alcohol and caffeine, pelvic floor exercises, medications, bulking agents (injected into the lining of the urethra), urethral plug, urethral patch, pessary, and surgery. The author concludes that most people treated for incontinence can see a significant reduction in urine leakage. One sidebar details how to perform Kegel exercises to strengthen pelvic floor muscles. 1 figure.

26

Kegel Exercises

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

27

APPENDICES

29

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 Institute4: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

4

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

30

Kegel Exercises

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

31

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 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:6 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

5

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

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•

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

•

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

The NLM Gateway7 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.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Kegel exercises” (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 47 1 490 0 0 538

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 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.11 Simply search by “Kegel exercises” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

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

8

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). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 11

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

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

33

Coffee Break: Tutorials for Biologists12 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.13 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.14 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/.

12 Adapted 13

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 14 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.

35

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 Kegel exercises 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 Kegel exercises. 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 Kegel exercises. 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 “Kegel exercises”:

36

Kegel Exercises

•

Other guides Exercise for Children http://www.nlm.nih.gov/medlineplus/exerciseforchildren.html Exercise for Seniors http://www.nlm.nih.gov/medlineplus/exerciseforseniors.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on Kegel exercises. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Kegel Exercises Source: in Griffith, H.W. Instructions for Patients. 5th ed. Philadelphia, PA: W.B. Saunders Company. 1994. p. 559. Contact: Available from W.B. Saunders Company. Book Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522. Fax (800) 874-6418. PRICE: $49.95. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This brief fact sheet on Kegel exercises is from a compilation of instructions for patients, published in book format. The fact sheet notes that Kegel exercises can strengthen the muscles around the vagina and increase the patient's ability to control and relax these muscles. Keeping these muscles strong can help prevent a prolapsed uterus or poor bladder control. The fact sheet lists three steps in performing the exercises and provides recommendations for how often to practice the exercises. The fact sheet can be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool. The book in which the fact sheet appears is available in English or Spanish.

•

Continence Facts: Pelvic Muscle Exercises: Kegel Exercises for Urinary Incontinence Source: Westmount, Quebec: Canadian Continence Foundation. 2000. 2 p. Contact: Canadian Continence Foundation. B.P/P.O. 30, Succ. Victoria Branch, Westmount, Quebec, Canada, H3Z 2V4. (514) 488-8379. Email: [email protected]. Website: www.continence-fdn.ca. PRICE: $2.00; bulk copies available.

Patient Resources

37

Summary: Urinary incontinence (UI) is the loss of bladder control. This fact sheet helps readers who are experiencing urine leakage to learn about the use of pelvic floor muscle exercises (Kegel exercises) that may be used for treating incontinence in both women and men of all ages. The fact sheet describes how pelvic muscle exercises may help and stresses the importance of working with a health care professional for UI concerns, as incontinence can almost always be cured, treated, or managed successfully. The fact sheet then outlines exactly how to do the pelvic muscle exercises (for men and for women), as well as a recommended schedule. Readers are encouraged to contact their health care provider if they are needing assistance with identifying the correct pelvic floor muscles; biofeedback can be used to identify and exercise the pelvic muscles. The brochure includes the contact information for the Canadian Continence Foundation (TCCF). 3 figures. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to Kegel exercises. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

38

Kegel Exercises

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 Kegel exercises. 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 “Kegel exercises” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “Kegel exercises”. 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 “Kegel exercises” (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 “Kegel exercises” (or a synonym) into the search box, and click “Submit Query.”

39

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.15

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

15

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

40

Kegel Exercises

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)16: •

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/

16

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

Finding Medical Libraries

41

•

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

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

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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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/

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

Finding Medical Libraries

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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

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

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

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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

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

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

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

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

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

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

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

Basic Guidelines for Kegel Exercises Kegel exercises Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003975.htm

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Signs & Symptoms for Kegel Exercises Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Incontinence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003142.htm Incontinent Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003142.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm

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Background Topics for Kegel Exercises Biofeedback Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002241.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Vagina Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002342.htm

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

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

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

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

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

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KEGEL EXERCISES DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [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] Adverse Effect: An unwanted side effect of treatment. [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] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] 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] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Anomalies: Birth defects; abnormalities. [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] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anuria: Inability to form or excrete urine. [NIH]

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Anus: The opening of the rectum to the outside of the body. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Auditory: Pertaining to the sense of hearing. [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] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [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]

Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bulking Agents: Laxatives that make bowel movements soft and easy to pass. [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]

Dictionary 49

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] Cardiac: Having to do with the heart. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [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] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH]

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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] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Continence: The ability to hold in a bowel movement or urine. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU]

Dictionary 51

Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystitis: Inflammation of the urinary bladder. [EU] Cystocele: Fallen bladder. When the bladder falls or sags from its normal position down to the pelvic floor, it can cause either urinary leakage or urinary retention. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Dehydration: The condition that results from excessive loss of body water. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Diuresis: Increased excretion of urine. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Drip: The continuous slow introduction of a fluid containing nutrients or drugs. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and

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the movement of wastes out of cells. [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] Enterocele: A hernia in the intestine. [NIH] Enuresis: Involuntary discharge of urine after the age at which urinary control should have been achieved; often used alone with specific reference to involuntary discharge of urine occurring during sleep at night (bed-wetting, nocturnal enuresis). [EU] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Episiotomy: An incision of the posterior vaginal wall and a portion of the pudenda which enlarges the vaginal introitus to facilitate delivery and prevent lacerations. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excrete: To get rid of waste from the body. [NIH] Fallopian Tubes: Two long muscular tubes that transport ova from the ovaries to the uterus. They extend from the horn of the uterus to the ovaries and consist of an ampulla, an infundibulum, an isthmus, two ostia, and a pars uterina. The walls of the tubes are composed of three layers: mucosal, muscular, and serosal. [NIH] Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members. [NIH]

Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Flatus: Gas passed through the rectum. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH]

Dictionary 53

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]

General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [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] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Hormones: Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various endocrine glands and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU]

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Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hysterectomy: Excision of the uterus. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear

Dictionary 55

gases and mustard gases are also irritants. [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 Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Lacerations: Torn, ragged, mangled wounds. [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] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micturition: The passage of urine; urination. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH]

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Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mustard Gas: Severe irritant and vesicant of skin, eyes, and lungs. It may cause blindness and lethal lung edema and was formerly used as a war gas. The substance has been proposed as a cytostatic and for treatment of psoriasis. It has been listed as a known carcinogen in the Fourth Annual Report on Carcinogens (NTP-85-002, 1985) (Merck, 11th ed). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] 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] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nocturia: Excessive urination at night. [EU] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Overactive bladder: A condition in which the patient experiences two or all three of the following conditions: [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] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH]

Dictionary 57

Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Pessary: 1. An instrument placed in the vagina to support the uterus or rectum or as a contraceptive device. 2. A medicated vaginal suppository. [EU] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Photoreceptors: Cells specialized to detect and transduce light. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [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] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] 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] 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]

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Priapism: Persistent abnormal erection of the penis, usually without sexual desire, and accompanied by pain and tenderness. It is seen in diseases and injuries of the spinal cord, and may be caused by vesical calculus and certain injuries to the penis. [EU] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [NIH]

Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] 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] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Prostatitis: Inflammation of the prostate. [EU] 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] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] 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] 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] Reassurance: A procedure in psychotherapy that seeks to give the client confidence in a favorable outcome. It makes use of suggestion, of the prestige of the therapist. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH]

Dictionary 59

Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [EU] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Sanitary: Relating or belonging to health and hygiene; conductive to the restoration or maintenance of health. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Seminal vesicles: Glands that help produce semen. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH]

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Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sitz Bath: A special plastic tub. A person sits in a few inches of warm water to help relieve discomfort of hemorrhoids or anal fissures. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress incontinence: An involuntary loss of urine that occurs at the same time that internal abdominal pressure is increased, such as with laughing, sneezing, coughing, or physical activity. [NIH] Stress urinary: Leakage of urine caused by actions--such as coughing, laughing, sneezing, running, or lifting--that place pressure on the bladder from inside the body. Stress urinary incontinence can result from either a fallen bladder or weak sphincter muscles. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU]

Dictionary 61

Symphysis: A secondary cartilaginous joint. [NIH] Systemic: Affecting the entire body. [NIH] Tear Gases: Gases that irritate the eyes, throat, or skin. Severe lacrimation develops upon irritation of the eyes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [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] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Traction: The act of pulling. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethritis: Inflammation of the urethra. [EU] Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH]

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Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital System: All the organs involved in reproduction and the formation and release of urine. It includes the kidneys, ureters, bladder, urethra, and the organs of reproduction ovaries, uterus, fallopian tubes, vagina, and clitoris in women and the testes, seminal vesicles, prostate, seminal ducts, and penis in men. [NIH] Uterine Prolapse: Downward displacement of the uterus. It is classified in various degrees: in the first degree the cervix is within the vaginal orifice; in the second degree the cervix is outside the orifice; in the third degree the entire uterus is outside the orifice. [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] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Venous: Of or pertaining to the veins. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH]

63

INDEX A Abdominal, 6, 10, 16, 47, 49, 54, 56, 60 Abdominal Pain, 16, 47, 54 Acute renal, 14, 47 Adenosine, 47, 48 Adverse Effect, 14, 47, 60 Alertness, 47, 48 Algorithms, 47, 48 Alimentary, 47, 57 Alternative medicine, 22, 47 Anal, 16, 18, 47, 60 Anal Fissure, 47, 60 Anomalies, 16, 47 Antagonism, 47, 48 Antibody, 47, 50, 54 Antigen, 47, 50, 54 Anuria, 47, 55 Anus, 47, 48, 57, 58 Arteries, 48, 51, 55 Articular, 48 Asymptomatic, 18, 48 Auditory, 24, 48 B Bacteria, 47, 48, 52, 55, 62 Bacteriuria, 18, 48, 61 Base, 48, 55 Benign, 10, 14, 25, 48, 53 Benign prostatic hyperplasia, 14, 25, 48 Biotechnology, 4, 22, 31, 48 Bladder, 14, 15, 16, 17, 18, 19, 20, 23, 24, 25, 36, 37, 48, 51, 54, 58, 59, 60, 61, 62 Bloating, 48, 54 Blood vessel, 48, 49, 53, 58, 60, 61, 62 Bowel, 15, 18, 20, 47, 48, 50, 54, 60 Bowel Movement, 18, 48, 50, 60 Branch, 36, 43, 48, 53, 60, 61 Breakdown, 48, 51, 52 Bulking Agents, 25, 48 C Caffeine, 25, 48 Calcium, 48, 49, 50, 51 Cardiac, 48, 49, 52, 56 Catecholamine, 49, 57 Catheterization, 16, 18, 23, 49, 54 Catheters, 14, 17, 23, 49 Cell, 48, 49, 50, 54, 56, 59 Central Nervous System, 48, 49, 53, 59 Cervix, 49, 59, 62

Cesarean Section, 18, 49 Chronic, 14, 25, 49, 52, 54, 55, 57, 60 Chronic renal, 49, 57 Clamp, 15, 49 Clinical trial, 4, 31, 49, 58 Cloning, 48, 49 Colitis, 49, 54 Collagen, 18, 23, 49, 58 Colorectal, 16, 49 Colorectal Cancer, 16, 49 Complement, 50 Complementary and alternative medicine, 7, 11, 50 Complementary medicine, 7, 50 Computational Biology, 31, 50 Cones, 18, 19, 20, 50 Connective Tissue, 49, 50 Constipation, 8, 16, 20, 25, 50, 54 Consultation, 15, 50 Continence, 19, 20, 24, 25, 36, 37, 50 Contraceptive, 50, 57 Contraindications, ii, 51 Coronary, 51, 55 Coronary Thrombosis, 51, 55 Curative, 51, 61 Cutaneous, 51, 54 Cyclic, 48, 51 Cystitis, 14, 51 Cystocele, 24, 51 D Databases, Bibliographic, 31, 51 Dehydration, 16, 51 Diagnostic procedure, 22, 51 Diarrhea, 16, 51, 54 Digestion, 47, 48, 51, 54, 55, 57, 60 Direct, iii, 51, 59 Diuresis, 48, 51 Diverticula, 51 Diverticulitis, 16, 51 Diverticulum, 51 Drip, 16, 51 Drug Interactions, 51 Duct, 49, 51 Duodenum, 51, 60 E Edema, 51, 56 Efficacy, 8, 51 Elastin, 49, 51

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Electrolytes, 51, 55 End-stage renal, 49, 52, 57 Enterocele, 24, 52 Enuresis, 14, 17, 52 Environmental Health, 30, 32, 52 Episiotomy, 18, 52 Erection, 52, 58 Esophagus, 52, 53, 60 Estrogen, 15, 52 Evacuation, 50, 52 Excrete, 47, 52, 55 F Fallopian Tubes, 52, 59, 62 Family Health, 17, 52 Family Planning, 31, 52 Feces, 50, 52, 60 Fetus, 49, 52, 62 Flatus, 52 G Gallbladder, 16, 47, 52 Gas, 16, 52, 54, 56, 62 Gastric, 52, 53, 57 Gastric Juices, 52, 57 Gastric Mucosa, 52, 57 Gene, 48, 53, 59 General practitioner, 17, 53 Genital, 53, 62 Genitourinary, 53, 62 Gland, 53, 56, 58, 59 Glomerular, 53, 55 Glomeruli, 17, 53, 58 Glomerulonephritis, 14, 17, 53 Glomerulus, 53 Governing Board, 53, 57 H Headache, 48, 53 Health Status, 52, 53 Heartburn, 16, 53 Hemodialysis, 53, 55 Hemorrhage, 53, 60 Hemorrhoids, 16, 53, 60 Hernia, 52, 53 Hormones, 52, 53, 61 Hydroxylysine, 49, 53 Hydroxyproline, 49, 53 Hygienic, 20, 53 Hypertrophy, 48, 54 Hysterectomy, 15, 25, 54 Hysterotomy, 49, 54 I Id, 10, 37, 42, 44, 54 Impotence, 14, 54

Incision, 52, 54, 58 Incontinence, 3, 4, 5, 6, 8, 9, 10, 11, 14, 15, 16, 17, 18, 19, 20, 23, 24, 25, 36, 37, 45, 54, 60 Infarction, 51, 54, 55 Infection, 11, 14, 17, 24, 54, 55, 58, 60 Infiltration, 53, 54 Inflammation, 17, 49, 51, 54, 58, 61 Ingestion, 54, 57 Inhalation, 54, 57 Intermittent, 16, 23, 54 Intestinal, 16, 54 Intestine, 48, 49, 51, 52, 54, 55 Intracellular, 48, 54 Intubation, 49, 54 Involuntary, 4, 20, 52, 54, 56, 60 Irritable Bowel Syndrome, 16, 54 Irritants, 20, 54 K Kb, 30, 55 Kidney Failure, 14, 17, 52, 55 Kidney Failure, Acute, 55 Kidney Failure, Chronic, 55 Kidney stone, 14, 17, 55 L Lacerations, 52, 55 Large Intestine, 49, 54, 55, 58, 59 Library Services, 42, 55 Ligament, 55, 58 Liver, 47, 52, 55 Localized, 54, 55 Lymphatic, 54, 55 M MEDLINE, 31, 55 Membranes, 55, 60 MI, 46, 55 Microbiology, 48, 55 Micturition, 17, 18, 23, 55 Modification, 14, 20, 23, 25, 55, 58 Molecular, 31, 33, 48, 50, 56 Motion Sickness, 56 Mustard Gas, 55, 56 Myocardium, 55, 56 N Nausea, 16, 56, 61 Necrosis, 54, 55, 56 Need, 3, 13, 14, 15, 19, 23, 25, 38, 49, 56 Nephrosis, 56 Nephrotic, 14, 17, 56 Nephrotic Syndrome, 14, 17, 56 Nocturia, 20, 56

Index 65

O Oliguria, 55, 56 Ovaries, 52, 56, 59, 62 Overactive bladder, 20, 25, 56 P Palliative, 56, 61 Pancreas, 47, 56 Patch, 25, 56 Patient Education, 14, 25, 36, 40, 42, 46, 56 Pelvic, 5, 7, 8, 9, 14, 15, 17, 18, 23, 24, 25, 36, 37, 51, 56, 58 Penis, 56, 58, 59, 62 Pepsin, 56, 57 Pepsin A, 57 Peptic, 16, 57 Peptic Ulcer, 16, 57 Perineal, 15, 57 Perineum, 57 Pessary, 25, 57 Pharmacist, 17, 57 Pharmacologic, 57, 61, 62 Pharmacotherapy, 23, 57 Photoreceptors, 50, 57 Physical Examination, 20, 57 Physiology, 15, 18, 19, 24, 57 Plasma, 55, 57, 59 Poisoning, 16, 56, 57 Polycystic, 14, 57 Polypeptide, 49, 57 Polyposis, 49, 57 Posterior, 47, 52, 56, 57 Practice Guidelines, 32, 57 Prevalence, 3, 14, 20, 57 Priapism, 14, 58 Prolapse, 25, 58 Proline, 49, 53, 58 Prostate, 11, 15, 25, 48, 58, 59, 61, 62 Prostate gland, 15, 25, 58 Prostatectomy, 9, 22, 25, 58 Prostatic Hyperplasia, 10, 58 Prostatitis, 11, 14, 58 Protein S, 48, 58 Proteins, 47, 49, 50, 56, 57, 58, 61 Proteinuria, 56, 58 Psychotherapy, 58 Public Policy, 31, 58 Pulmonary, 55, 58 Pulmonary Edema, 55, 58 Pyelonephritis, 14, 17, 58 Q Quality of Life, 20, 23, 58

R Randomized, 51, 58 Reassurance, 14, 58 Rectal, 24, 58 Rectum, 48, 49, 52, 54, 55, 57, 58, 59 Refer, 1, 50, 59 Regimen, 51, 57, 59 Regurgitation, 53, 59 Rehydration, 16, 59 Renal pelvis, 55, 59 Reproductive system, 58, 59 Restoration, 59 Retina, 50, 59 Retropubic, 58, 59 Risk factor, 14, 16, 17, 59 Rod, 49, 59 S Sanitary, 18, 59 Screening, 49, 59, 61 Sebaceous, 54, 59 Sebaceous gland, 54, 59 Sediment, 59, 61 Segregation, 48, 59 Self Care, 16, 25, 59 Semen, 58, 59 Seminal vesicles, 59, 62 Serotonin, 57, 59, 61 Side effect, 15, 47, 60, 61 Signs and Symptoms, 14, 60 Sitz Bath, 5, 8, 60 Skeletal, 49, 60 Smooth muscle, 48, 60 Sneezing, 24, 60 Social Environment, 58, 60 Spastic, 54, 60 Specialist, 38, 60 Sphincter, 15, 25, 60 Spinal cord, 23, 49, 58, 60 Steel, 49, 60 Stimulant, 48, 60 Stomach, 16, 47, 52, 56, 60 Stool, 54, 55, 60 Stress, 6, 7, 9, 14, 15, 17, 18, 19, 20, 23, 24, 25, 49, 54, 56, 60 Stress incontinence, 6, 7, 14, 15, 17, 20, 25, 60 Stress urinary, 6, 9, 24, 60 Stroke, 25, 30, 60 Subacute, 54, 60 Subclinical, 54, 60 Symphysis, 58, 61 Systemic, 54, 61

66

Kegel Exercises

T Tear Gases, 55, 61 Testicular, 14, 61 Testis, 61 Therapeutics, 61 Thrombosis, 58, 60, 61 Tissue, 47, 48, 50, 51, 52, 53, 54, 55, 56, 57, 59, 60, 61 Torsion, 14, 54, 61 Toxic, iv, 61 Toxicity, 51, 61 Toxicology, 32, 61 Toxins, 47, 54, 61 Traction, 49, 61 Transfection, 48, 61 Transurethral, 22, 58, 61 Transurethral Resection of Prostate, 58, 61 Tryptophan, 49, 59, 61 U Unconscious, 54, 61 Uremia, 55, 61 Ureters, 17, 55, 61, 62 Urethra, 14, 17, 25, 48, 56, 58, 61, 62

Urethritis, 14, 61 Urinalysis, 20, 24, 61 Urinary Retention, 51, 62 Urinary tract, 3, 15, 16, 17, 18, 23, 24, 48, 62 Urinary tract infection, 3, 16, 18, 23, 48, 62 Urine, 14, 17, 18, 20, 24, 25, 37, 47, 48, 50, 51, 52, 54, 55, 56, 58, 59, 60, 61, 62 Urogenital, 20, 53, 62 Urogenital System, 20, 62 Uterine Prolapse, 24, 62 Uterus, 36, 49, 52, 54, 56, 57, 59, 62 V Vagina, 36, 46, 49, 54, 57, 59, 62 Vaginal, 15, 18, 19, 20, 25, 52, 57, 62 Vascular, 54, 62 VE, 6, 62 Venous, 53, 58, 62 Vertebrae, 60, 62 Veterinary Medicine, 31, 62 Volition, 54, 62 W Womb, 59, 62

Index 67

68

Kegel Exercises

Kegel Exercises: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

Hepatitis A Vaccine: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

Butternut Squash: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Facial Paralysis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

Breast Augmentation - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Premenstrual Dysphoric Disorder - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Anagrelide: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Peanut Allergy: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Cauda Equina Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Magnesium Citrate: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

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

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

Body Dysmorphic Disorder: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

Dermabrasion: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Septra: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

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

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Female Infertility - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Living Will - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hip Pain: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

Marburg Virus: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Erythema Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Alopecia Areata - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

Kegel Exercises: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

Hepatitis A Vaccine: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

Butternut Squash: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Facial Paralysis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

Breast Augmentation - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Premenstrual Dysphoric Disorder - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Anagrelide: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Peanut Allergy: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Cauda Equina Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Magnesium Citrate: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

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

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

Body Dysmorphic Disorder: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

Dermabrasion: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Septra: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

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

Glioblastoma Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Female Infertility - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Living Will - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hip Pain: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

Marburg Virus: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Erythema Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Alopecia Areata - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

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