PANIC ATTACKS 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., 1960Panic Attacks: 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: 0-597-84150-0 1. Panic Attacks-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on panic attacks. 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 PANIC ATTACKS ....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Panic Attacks ................................................................................ 4 The National Library of Medicine: PubMed ................................................................................ 16 CHAPTER 2. NUTRITION AND PANIC ATTACKS ............................................................................. 59 Overview...................................................................................................................................... 59 Finding Nutrition Studies on Panic Attacks ............................................................................... 59 Federal Resources on Nutrition ................................................................................................... 61 Additional Web Resources ........................................................................................................... 61 CHAPTER 3. ALTERNATIVE MEDICINE AND PANIC ATTACKS ....................................................... 63 Overview...................................................................................................................................... 63 National Center for Complementary and Alternative Medicine.................................................. 63 Additional Web Resources ........................................................................................................... 68 General References ....................................................................................................................... 70 CHAPTER 4. DISSERTATIONS ON PANIC ATTACKS ......................................................................... 73 Overview...................................................................................................................................... 73 Dissertations on Panic Attacks.................................................................................................... 73 Keeping Current .......................................................................................................................... 74 CHAPTER 5. PATENTS ON PANIC ATTACKS .................................................................................... 75 Overview...................................................................................................................................... 75 Patents on Panic Attacks ............................................................................................................. 75 Patent Applications on Panic Attacks ......................................................................................... 88 Keeping Current .......................................................................................................................... 92 CHAPTER 6. BOOKS ON PANIC ATTACKS ....................................................................................... 93 Overview...................................................................................................................................... 93 Book Summaries: Online Booksellers........................................................................................... 93 The National Library of Medicine Book Index ............................................................................. 96 Chapters on Panic Attacks........................................................................................................... 97 CHAPTER 7. MULTIMEDIA ON PANIC ATTACKS ............................................................................. 99 Overview...................................................................................................................................... 99 Bibliography: Multimedia on Panic Attacks................................................................................ 99 CHAPTER 8. PERIODICALS AND NEWS ON PANIC ATTACKS ........................................................ 101 Overview.................................................................................................................................... 101 News Services and Press Releases.............................................................................................. 101 Academic Periodicals covering Panic Attacks ........................................................................... 104 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 107 Overview.................................................................................................................................... 107 NIH Guidelines.......................................................................................................................... 107 NIH Databases........................................................................................................................... 109 Other Commercial Databases..................................................................................................... 111 APPENDIX B. PATIENT RESOURCES ............................................................................................... 113 Overview.................................................................................................................................... 113 Patient Guideline Sources.......................................................................................................... 113 Finding Associations.................................................................................................................. 115 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 117 Overview.................................................................................................................................... 117 Preparation................................................................................................................................. 117 Finding a Local Medical Library................................................................................................ 117 Medical Libraries in the U.S. and Canada ................................................................................. 117
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ONLINE GLOSSARIES................................................................................................................ 123 Online Dictionary Directories ................................................................................................... 123 PANIC ATTACKS DICTIONARY ............................................................................................. 125 INDEX .............................................................................................................................................. 171
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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 panic attacks 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 panic attacks, 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 panic attacks, 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 panic attacks. 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 panic attacks, 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 panic attacks. 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 PANIC ATTACKS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on panic attacks.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and panic attacks, 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 “panic attacks” (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: •
When Your Patient Complains of Dizziness: Part 2 Source: IM. Internal Medicine. 20(7): 28-35. July 1999. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Summary: In this article, the second of two parts, the author guides physicians in the diagnosis of the cause of spells of dizziness. The author notes that determining the average duration of a dizzy spell is crucial to the diagnosis. Spells that last for only a few seconds are characteristic of benign paroxysmal positional vertigo (BPPV), perilymphatic fistula, orthostatic hypotension (low blood pressure), and panic attacks with hyperventilation. Spells that last for minutes may be caused by migraine or transient ischemic attacks (TIAs). Meniere's disease, hydrops, and vestibular neuritis can
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induce dizzy spells that last for hours. Also, the circumstances that seem to provoke dizziness will also offer clues to the diagnosis. The author provides an illustrative case report and discusses each of these potential diagnoses. All patients should be checked for BPPV with the Hallpike Dix test. A battery of bedside tests should be conducted to test for vestibular hypofunction. Patients with acute vertigo also need to be checked for spontaneous nystagmus. If the physical exam is completely normal and the patient complains of spells of dizziness, he or she should be asked to return to the clinic the next time a spell occurs. Appended to the article is a recertification review self test (with the answers). 2 figures. 2 tables. 5 references. •
Gastroesophageal Reflux Disease: Under the Surface of Heartburn Lies a Potentially Serious Disease Source: AJN. American Journal of Nursing. 100(9): 24D, 24F, 24H. September 2000. Contact: Available from Lippincott Williams and Wilkins. AJN, P.O. Box 50480, Boulder, CO 80322-0480. (800) 627-0484 or (303) 604-1464. Summary: This article familiarizes nurses with gastroesophageal reflux disease (GERD), a potentially serious disease that can be the cause of many patient's symptoms of heartburn. Heartburn is the most common symptom of GERD, which is caused by a weakened or inappropriately relaxed lower esophageal sphincter (the ring of muscle between the stomach and the esophagus). GERD is the most prevalent of the acid related disorders, which also include dyspepsia, gastritis, and peptic ulcer disease. The primary symptom of GERD is heartburn, which typically occur two to three hours after ingestion of a large or fatty meal or when lying down. When the gastric acid is in contact with the esophagus repeatedly or for long periods of time, the esophagus can become damaged and irritated; this can also cause the development of precancerous cells. A careful history can help differentiate between cardiac chest pain, panic attacks, other sources of esophagitis, and GERD. Diagnostic tests can include barium swallow test, esophageal manometry or esophageal pH, esophagoscopy, and the Bernstein test. These diagnostic studies assess esophageal motility (movement of contents through the esophagus), clearance, and the causes of gastroesophageal reflux. Treatment goals for patients with GERD are to eliminate the symptoms, decrease the reflux, and make the refluxed material less irritating to the esophagus. Treatment includes dietary and lifestyle changes, drug therapy, and sometimes surgery. 1 figure. 15 references.
Federally Funded Research on Panic Attacks The U.S. Government supports a variety of research studies relating to panic attacks. 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 panic attacks. 2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore panic attacks. The following is typical of the type of information found when searching the CRISP database for panic attacks: •
Project Title: A NOVEL THERAPY FOR DEPRESSION WITH CO-OCCURRING PANIC Principal Investigator & Institution: Frank, Ellen; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: Complication of major depression by the co-occurrence of panic attacks or panic disorder is both common and clinically significant. Patients with this condition show more severe symptom profiles, greater risk of suicidality, poorer psychosocial functioning, and a poorer response to traditional depression treatments. The primary aim of the current proposal is to develop an effective yet efficient psychotherapeutic intervention for patients with major depression complicated by panic symptoms. This new treatment, interpersonal psychotherapy for depression with panic symptoms (I PTPS), will adapt and integrate components of cognitive behavior therapy (CBT) for panic and anxiety (Barlow & Craske, 1989) into the therapeutic framework of interpersonal psychotherapy for depression (IPT, Kierman et al., 1984) to treat this clinically severe yet treatment-resistant condition. Conceptually, this integrated treatment approach will seek to promote active resolution of interpersonal problems while concurrently addressing symptoms of panic and anxiety that interfere with active interpersonal problem solving. In Phase I of the proposed study, 12 patients with major depression complicated by panic symptoms will be treated with a 16-session course of the newly developed treatment. Specific aims of Phase I include the development, elaboration, and iterative refinement of a treatment manual for IPT-PS; development of therapist training procedures; and the development of measures of treatment adherence, competence, and satisfaction. In Phase II, 24 patients with depression complicated by panic symptoms will be randomly assigned to treatment using IPT-PS, and will be compared with 12 patients randomly assigned to receive standard IPT. Specific aims of this pilot study include: finalizing the treatment manual and measures of treatment adherence, competence, and satisfaction; testing treatment satisfaction with IPT-PS; evaluating characteristics of treatment responders and non-responders; and generating treatment effect size estimates for use in planning a larger efficacy/effectiveness study of IPT-PS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AMYGDALA PLASTICITY DURING FEAR LEARNING Principal Investigator & Institution: Blair, Hugh T.; Center for Neural Science; New York University 15 Washington Place New York, Ny 10003 Timing: Fiscal Year 2001; Project Start 01-DEC-2000 Summary: The brain contains specialized for systems that govern emotions and behavior in the presence of danger. Dysfunction of these systems may be responsible for many common psychiatric disorders, including phobia, panic attacks, post-traumatic stress disorders, obsessive-compulsive disorder, and generalized anxiety disorder. A better understanding of the brain's fear systems may lead to more effective tretments for such disorders. The amygdala is well known to be an essential component of the brain's fear systems. The research proposed here will investigate the amygdala's role in two processes: (1) learning to recognize danger, and () learning to respond to danger
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appropriately. Rats will be trained in auditory fear conditioning, an amygdaladependent memory task in which an innocuous auditory tone is paired with electric shock. During this task, rats learn that the tone predicts danger (the shock). The activity of neurons in the amygdala will be recorded as rats learn this task, to test whether emotional memories are stored in the amygdala by a process of Hebbian synaptic plasticity. After rats have learned the task, they will be taught to escape from the tone (which now predicts danger) by navigating through an open doorway. Neural activity will be recorded in the amygdala as rats learn to escape from the tone, to investigate how the amygdala participates in learning new responses to danger. This research may provide new insights into the neural mechanisms for emotional learning and memory. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AMYGDALA PRIMING MECHANISM UNDERLYING THE PANIC RESPONSE Principal Investigator & Institution: Thielen, Shelley K.; Psychiatry; Indiana UnivPurdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2001; Project Start 23-FEB-2001; Project End 31-JAN-2003 Summary: Anxiety disorders are the most common of all mental health illnesses. Panic disorder (PD), a DSM recognized anxiety disorder, has a lifetime prevalence of 3.5%. The delay of treatment of this illness is further complicated by comorbidity with alcohol abuse or depression. These patients are also at increased risk of suicide. Rats bilaterally implanted with guide cannulae into the basolateral nucleus of the amygdala and injected for a maximum of 6 days with a subthreshold dose of the GABAA antagonist bicuculline methiodide exhibit an increase in heart rate (> 50 beats per minute), blood pressure, respiratory rate, and anxiety- like behavior, measured using the social interaction test on day 4 to 6 of drug treatment. The response exhibited by these rats is reminiscent of the symptoms experienced by panic disorder patients. Further, the BLA nucleus has been identified to be involved in the defense reaction as well as in conditioned fear- both responses are relevant to the development of the panic response. The objective of this research is utilize the primed rat to study the mechanisms underlying the panic response. Specifically, this research is aimed to: 1) determine the whether the panic-provoking agents yohimbine and fenfluramine are able to provoke similar responses in the BLA- primed rat; 2) determine if drugs effective in treating human panic attacks attenuate the panic response in the primed rat; and, 3) determine if the primed rat exhibits conditioned place avoidance. The methods used to explore the first aim will involve quantitating any change in heart rate, blood pressure, or respiratory rate during and after intravenous infusion of the panic provoking agent. Infusion of the drugs will be randomized and behavior will be measured after the monitoring period using the social interaction test. In this test the experimental rat will be paired with an untreated weight-matched (within 10 grams) rat in a 91 square cm arena for five minutes. Each rat will have been habituated to the arena and the lighting conditions prior to testing. Test duration will be 5 minutes. For the second aim, a Pavlovian conditioning test called conditioned place avoidance will be used to determine whether repeated intra- amygdala injections of BMI are aversive and therefore possibly indicative of the development of avoidance of the floor associated with the stimulus. Animals will be conditioned using tactile cues- floors constructed from perforated stainless steel or from stainless steel rods. For the third aim, BLAprimed rats will be treated twice daily for seven days with a prototypical SSRI or TCA and then challenged with an intra- amygdala injection of BMW. Treatments will be administered intraperitoneally, both acutely and chronically. The animal will be
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assessed for changes in response to the intra- amygdala injection of BMI. These three points will be used to study the underlying mechanism of the panic response. This mechanism of provoking the panic response is potentially beneficial in further understanding the neurobiology of the panic response on both the behavioral and cellular level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CBT TREATMENT OF PANIC DISORDER IN COMORBID ALCOHOLICS Principal Investigator & Institution: Kushner, Matt G.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Alcohol use disorders are among the most serious and costly health problems of our time. Studies have been consistent in finding an increased risk of alcohol use disorder among those suffering with the anxiety syndrome, panic disorder "comorbidity". Further, studies suggest that panic disorder can contribute to risk for a new onset of alcohol disorder and to risk for relapse following alcoholism treatment. Both theory and research suggests that relapse in comorbid individuals stems, in part, from the tendency to drink as a means of coping with persistent anxiety and panic symptoms. These findings led us to hypothesize that addressing the panic symptoms of comorbid patients would improve the outcome of comorbid individuals undergoing alcoholism treatment Cognitive behavioral therapy (CBT) for panic disorder would appear to be an ideal intervention for testing this nypothesis; however, the effect of CBT treatment on panic disorder in comorbid individuals remains unknown. Further, conventional CBT treatments do not address the inter-relationship of panic symptoms and pathological alcohol use that is potentially relevant to the persistence of both disorders in comorbid individuals. Therefore, we are proposing an experimental/developmental program (P.21) with a series of research stages aimed at testing the value of CBT for panic among comorbid patients. In stage 1 (conducted in year 1), we will use approximately 4-6 comorbid alcoholism treatment patients as subjects in four separate pilot tests, each focused on one of the four core elements of the panic treatment program, Master your Anxiety and Panic (MAP), along with supplemental material pertinent to comorbidity. Pre- and post-tests along with expert consensus will be used to evaluate whether the material and techniques are working properly, with any problematic materials being modified as needed. In the stage 2 study (year 2 and 3), thirty comorbid patients undergoing a community-based alcoholism treatment will receive either the 10-session MAP program as modified in stage 1 (MMAP) or a 10-session control treatment (progressive muscle relaxation training; PMRT). (Note that PMRT is structured and credible but has been shown to have minimal effects on either alcoholism treatment outcome or panic disorder symptoms.) We hypothesize that those receiving fix MMAP program will demonstrate fewer panic attacks and less intense panic attacks following the study treatments. We also hypothesize that at a 3-month follow-up assessment, subjects in the MMAP group will demonstrate a lower overall rate of several standard alcohol use outcomes as well as time to those outcomes when present. Beyond these directional hypotheses, an important goal of the stage 2 study is to provide effect size parameters indicating the clinical importance of the MMAP intervention. It is expected that the stage 1 and 2 studies proposed here will provide the foundation for an RO1 application to conduct a larger-scale stage 3 study to confirm the value of supplementing standard alcoholism treatment with the MMAP program for comorbid patients.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CELLULAR AND NEUROCHEMICAL MECHANISMS OF REM SLEEP Principal Investigator & Institution: Datta, Subimal; Professor; Psychiatry; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 01-APR-1999; Project End 31-MAR-2008 Summary: (provided by applicant): The long-term objective of this application is to further our understanding of cellular and neurochemical mechanisms of REM sleep. More specifically, the goal is to identify Pedunculo Pontine Tegmentum (PPT) intracellular signal transduction pathways involved in the receptor activation-mediated regulation of REM sleep in the freely moving rat. Recent evidence indicates that novel compounds designed to modify intracellular transduction pathways have therapeutic potential for endogenous depression, cancer, hypothermia, and pathological aggregation of platelets, thus the identification of the intracellular molecules involved in normal regulation of REM sleep may lead to the design of the future generation of drugs to treat REM sleep disorders in humans (e.g. endogenous depression, schizophrenia, panic attacks, bipolar disorders, narcolepsy, excessive daytime sleepiness).The central hypothesis of this proposal is that the activity of REM sleep generating cells in the PPT cholinergic cell compartment is regulated by the activation of specific glutamate and GABA receptors. These particular receptors convey their message via cAMP-dependent protein kinase A (PKA) to regulate normal and glutamate-induced REM sleep. To test this hypothesis systematically, there are four specific aims: 1. Test the hypothesis that cAMP-PKA intracellular signaling molecules in the PPT cholinergic cell compartment are involved in natural and glutamate-microinjection-induced REM sleep. Microinjecting cAMP and PKA inhibitors directly into the PPT to block spontaneous and glutamate-induced REM sleep will achieve this goal. 2. Test the hypothesis that the activation of specific GABA-receptors in the PPT cholinergic cell compartment suppresses REM sleep. This goal will be achieved by microinjecting selective GABA receptor agonists into the PPT to block REM sleep. 3. Test the hypothesis that the induction of GABA-receptor-mediated suppression of REM sleep is due to the inhibition of the cAMP-PKA signal transduction pathway. Microinjecting selective cAMP-PKA activator into the PPT to block the REM sleep suppressing effect of GABA receptor agonist will achieve this goal. 4. Test the hypothesis that the activation of specific GABA receptors suppresses REM sleep by suppressing the activity of REM-on and Wake-REMon cells in the PPI. This aim will be achieved by applying the REM sleep suppressing GABA receptor agonist to identified REM-on and Wake-REM-on PPT cells while recording single cell activity in freely moving rats. These studies are relevant not only to questions about the basic neurobiology of sleep but also to questions of sleep disorders and mental illness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CENTRAL MODULATION OF RHYTHMS Principal Investigator & Institution: Garcia-Rill, Edgar E.; Professor and Director; Anatomy; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2002; Project Start 01-MAR-1984; Project End 30-JUN-2007 Summary: (provided by applicant): The pedunculopontine nucleus (PPN) helps control sleep/wake rhythms and modulates posture and locomotion. The proposed research will address three critical functional aspects (ascending, local and descending) of the
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PPN, the cholinergic arm of the Reticular Activating System (RAS). DESCENDING: Stimulation of the PPN using parameters which are known to induce locomotion in the decerebrate animal produced prolonged responses in caudal pontine (PnC) neurons. This mechanism has the property of switching target neurons from one state to another without the need for continuous driving. This may be a way for the PPN to induce changes in state, for example, from standing into locomotion. LOCAL: During a period of 10-30 days there is a dramatic decrease in the percent of REM sleep in the rat. Preliminary results suggest that there is an increase across this stage in the number of PPN neurons with low threshold spike (LTS) properties, a mechanism which alters the dynamic pattern of activity (bursting) in this area. There also appears to be a switch in the polarity of serotonergic input to intracellularly recorded PPN neurons, which is both excitatory and inhibitory before, but purely inhibitory after, 17 days of age. The proposed studies will characterize these modifications in order to understand how such local reorganization is manifested in the control of changes in state across this critical stage in development. ASCENDING: We will investigate the manner in which ascending projections of the RAS modulate the intralaminar thalamus to promote changes in arousal state, specifically, of PPN projections to parafascicular (Pf) neurons. Most PPN neurons project to intralaminar thalamus; however, there is little information on the synaptic relationships between the PPN and Pf, especially during development, an important gap to be bridged by these studies. We hypothesize that certain sleep pathologies have a developmental etiology. For example, disturbances in the process of decreasing REM sleep in development may lead to a number of disorders characterized by increased REM sleep drive in the adult. The proposed research, therefore, addresses an important problem with significant implications for certain neurological and psychiatric disorders which share increased REM sleep as a symptom with developmental etiology (e.g., schizophrenia, panic attacks, bipolar disorder, depression), and will provide a more integrated view of the concepts in this field. The proposed rat brainstem slice recording studies involve tracing intrinsic membrane properties, neurochemical control mechanisms and anatomical characteristics during a time in which PPN neurons undergo significant hypertrophy and changes in cellular properties and synaptic relationships, which might explain such developmental transformations into the adult form of the RAS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHILDHOOD SOCIAL PHOBIA: LONG-TERM FOLLOW-UP Principal Investigator & Institution: Beidel, Deborah C.; Professor; Psychology; University of Maryland College Pk Campus College Park, Md 20742 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2004 Summary: Social phobia affects approximately 3-5 percent of children, and the prevalence rises as age increases. Youth with social phobia have significant fear of public speaking, reading or writing in public, going to parties, interacting with authority figures, using public restrooms and interacting in informal social gatherings. Clinical correlates include headaches or stomach aches, panic attacks, crying, avoidance, general anxiety, dysphoria, a sense of loneliness, and a very restricted range of social relationships. In extreme cases, school refusal or other behavioral problems may result. These children are deficient in the social skills necessary for normal social development. The disorder is chronic and onset prior to age 11 predicts non- recovery in adulthood. Also, other disorders frequently occur concurrently, most often generalized anxiety disorder, separation anxiety disorder and specific phobia. Recent findings indicate that a new psychosocial treatment (Social Effectiveness Therapy for Children; SET-C) is
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efficacious for children ages 8-12, resulting in reduction in emotional distress and improvement in social functioning, and the treatment effects have been maintained for up to 6 months. However, the long-term effects of this treatment, or any other treatment, for childhood social phobia are unknown. The study proposed in this application is designed to extend the followup period for those children who were successfully treated with SET-C in our current study (MH53703). The study is designed to extend the followup period for these children to 5 years posttreatment. Assessments will include diagnostic interviews, self-report inventories, parental and clinician ratings, behavioral assessments of social skill, and daily diaries. This followup study will provide the longest followup to date for children treated for childhood social phobia. The assessment strategy is designed to allow for the determination of the durability of treatment, determination of risk factors for relapse or the development of other disorders, gauge academic, social, and emotional functioning. Data from this study will be particularly useful because the followup period will cover the children during the age of highest risk for social phobia (15-18 years). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE/BEHAVIORAL ADOLESCENCE
TREATMENT
OF
PANIC
IN
Principal Investigator & Institution: Mattis, Sara G.; Psychology; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: (Adapted from Applicant's Abstract): While Panic Control Treatment (PCT) has been found to be widely effective in the treatment of panic disorder in adults, no large-scale controlled treatment studies have evaluated the use of similar cognitivebehavioral approaches in the treatment of adolescents with panic disorder. Given that late adolescence has been suggested as the initial peak age for onset of panic disorder, the purpose of this project is to establish an empirically validated intervention aimed at treating panic disorder at its earliest stages. Specifically, the aims of this project are: to evaluate the effectiveness of a developmental adaptation of PCT for the treatment of panic disorder in adolescents; to determine the long-term impact of such treatment through follow-up assessment; and to assess the impact of treatment on the quality of life of adolescents beyond the specific symptoms of panic disorder. A total of 52 adolescents (aged 12 to 17) with a diagnosis of panic disorder, assessed via the Anxiety Disorders Interview Schedule, will be randomly assigned to either an immediate PCT treatment condition or to a self-monitoring waitlist in which participants will wait approximately 12 weeks prior to receiving PCT. All participants will undergo a pretreatment and a posttreatment/waitlist assessment, as well as three follow-up assessments, conducted 3-, 6-, and 12 months following completion of treatment. Assessments will consist of diagnostic interviews with adolescents and their parent(s), a behavioral and physiological assessment of response to symptom induction tasks designed to elicit sensations similar to naturally occurring panic, and self-report measures of anxiety, anxiety sensitivity, depression, and fear. Participants will also be asked to self-monitor their panic attacks as well as daily anxiety and depression. It is hypothesized that adolescents receiving PCT will evidence greater improvement than those in the waitlist group, and will continue to show improvement at follow-up, on panic-specific variables (e.g., frequency of panic attacks), psychopathology variables (e.g., anxiety sensitivity score), behavioral and physiological variables (e.g., average change in heart rate from baseline to the symptom induction tasks), and clinical severity ratings of panic disorder.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE-BEHAVIOR THERAPY FOR KHMER REFUGEES Principal Investigator & Institution: Hinton, Devon E.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 07-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): This is an application for a Mentored PatientOriented Research Career Development Award with a focus on developing expertise in treatment development and outcome assessment for anxiety disorders in minority and refugee populations. The Candidate proposes to build upon his clinical and research experience treating refugee populations in order to develop cognitive-behavioral interventions for refugee populations and to test the outcome with standard assessment measures and measures of culture-specific anxiety psychopathology. Post-traumatic stress disorder and panic attacks are common in Southeast Asian refugee populations but there is relatively little research available to guide the provision of culturally sensitive treatment for affected individuals. The proposed study is designed as an early step in addressing this treatment gap in a systematic manner. Research Plan: The study investigates the efficacy of a 12-week cognitive-behavioral therapy intervention for Cambodian refugees with PTSD, the treatment guided by a manual, and outcome assessed with standard psychometric instruments, culturally specific scales, and orthostatic challenge. Environment: The proposed study will be based at a Southeast Asian Refugee Clinic affiliated with the Massachusetts General Hospital and will complement a program of training and supervised research under the mentorship of Dr. Mark Pollack with consultation from experts. Career Development Plan: Training will emphasize learning skills to develop culturally appropriate assessment and treatment for traumatized non-English speaking groups. To lay the foundation for future independent investigation by the candidate, training will include supervision with consultants regarding outcome assessment, cognitive behavioral therapy, instrument validation, a psychophysiological outcome measure (i.e., orthostatic challenge), and a structured ethnographic interview, as well as taking courses at the Harvard School of Public Health on statistics and instrument development and evaluation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MVPS: HEALTH CONCERNS, ROLE FUNCTION, HEALTH SERVICE USE Principal Investigator & Institution: Scordo, Kristine A.; None; Wright State University Colonel Glenn Hwy Dayton, Oh 45435 Timing: Fiscal Year 2002; Project Start 15-MAR-2002; Project End 14-MAR-2004 Summary: (provided by applicant) Mitral valve prolapse (MVP) is the most common valvular heart disease with millions of people newly diagnosed each year. Some of these patients have actual structural changes that require mitral valve replacement; others have a constellation of symptoms that are unrelated to these structural changes and are diagnosed with MVP syndrome (MVPS). For these individuals, treatment is aimed at symptom control. While the course for those with anatomical valvular dysfunction is documented, the course for those with MVPS is less well known. Anecdotal reports by individuals with MVPS indicate a variety of frightening symptoms, including chest pain, shortness of breath, palpitations, migraine headaches, lightheadedness, fatigue, dizziness on standing, mood swings, and anxiety or panic attacks. Individuals with these symptoms often seek help in emergency rooms; urgent care centers, and primary
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care offices. However, little is known about the profile and the effects of these symptoms on the individual's role status, and use of health care services. Thus, the purpose of this study is to develop a profile of health concerns, symptoms and treatments, and to examine the relationships of symptoms to functional and role status and use of health care services for patients diagnosed with MVPS. Specifically, the research questions are: (1) what are the health concerns, symptoms, and treatments reported by patients with MVPS? (2) Are symptoms related to age, time since diagnosis, symptoms, anxiety, social support, diet (magnesium, sodium, water and caffeine), and treatment (beta and calcium channel blockers; anxiolytics; mediation/relaxation therapy; fluid; exercise; activity limitation)? (3) What is the relationship of symptoms to patients' health concerns, functional and role status, and use of health care services? A descriptive cross-sectional design will be used. Questionnaire packets will be mailed to all of the men and women (N = 3022) on The Mitral Valve Prolapse Program of Cincinnati's mailing list diagnosed with MVPS. The self-complete questionnaires will include measures of MVPS symptoms (MVPS symptom checklist); the outcome variables of health concerns (MUIS), functional and role status (SF-36), and healthcare service use (Life History Calendar); and the independent variables of age, time since diagnosis, anxiety (STAI), social support (MOS Social Support), treatment, and diet (Food Frequency Questionnaire). Descriptive statistics and multiple regression analysis will be used to address the study's research questions. The proposed study is the next step in developing data on symptoms of MVPS and their effect on health and functioning. These data are necessary in developing and modifying existing education and self management interventions aimed at reducing anxiety and improving the health and well being of the millions of Americans newly diagnosed with this syndrome annually. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROBIOLOGY OF ANXIETY IN MICE LACKING 5HT 1A RECEPTOR Principal Investigator & Institution: Toth, Miklos; Associate Professor; Pharmacology; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 23-SEP-2000; Project End 31-AUG-2005 Summary: (Adapted from the Investigator's Abstract) Functional abnormalities in the serotonin (5-HT) receptors have been consistently associated with anxiety. We have shown that inactivation of the 5-HTA receptor (5-HTAR) results in anxiety in mice. Surprisingly, we found that these mutant mice are insensitive to the anxiolytic effect of diazepam, a classical benzodiazepine (BZ). The importance of this finding is that a significant proportion of patients suffering from generalized anxiety do not respond to BZs. Also, BZs are not particularly effective in other forms of anxiety such as panic attacks and phobias. Since BZs bind and facilitate the function of the BZ sensitive gamma-aminobutyric acid receptors (GABAAR) receptors, abnormalities in these receptors could underlie the BZ-resistant anxiety and the anxiety-like behavior of the 5HTAR mutant mice. Indeed, we found abnormalities in the subunit composition of GABAARs in mutant mice. Our data show that the 5-HT and GABA systems, two important neurotransmitter systems implicated in anxiety disorders, are mechanistically linked. The objective of this application is to elucidate key features of the 5-HTARmediated regulation of GABAAR subunits that have a relevance to the KO phenotype and that could be applied to the understanding of anxiety. We ask the following questions: 1) Is the expression of the GABAAR subunits sensitive to the dosage of the 5HTA receptor? Anxiety in heterozygote KO mice suggests that GABAAR subunit expression is sensitive to 5-HTAR dosage. This would imply a pathogenic role for 5-
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HTAR hypofunction described in panic anxiety. 2) Are the abnormal GABAAR subunit levels in 5-HTAR KO mice caused by a developmental arrest in subunit expression? Dysregulation of GABAAR subunits may occur during development because 5-HTAR represents a developmental signal in brain. 3) Are particular regions within amygdala and hippocampus of 5-HTAR KO mice specifically associated with altered GABAAR subunit expression? 4) Is GABA and glutamate release altered in the amygdala and hippocampus of 5-HTAR KO mice? These changes may occur to compensate GABAAR subunit abnormalities. 5) Can 5-HTA receptor agonists alter the expression of GABAAR subunits? Increasing signaling through the 5-HTAR by agonists may elicit GABAAR subunit changes that are beneficial in anxiety. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROCHEMICAL CHALLENGES IN PTSD Principal Investigator & Institution: Yehuda, Rachel; Mount Sinai School of Medicine of Cuny New York, Ny 10029 Timing: Fiscal Year 2001 Summary: This study will use a well known panic-causing drug called CCK-4 (cholecystokinin-tetrapeptide) in individuals with posttraumatic stress disorder (PTSD). The purpose of this study is to see whether this naturally occurring poly-peptide will also cause flashbacks and panic attacks in patients with PTSD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PANIC AND SMOKING CESSATION Principal Investigator & Institution: Zvolensky, Michael J.; Assistant Professor; Psychology; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 30-APR-2005 Summary: (provided by applicant): Smokers with a history of panic attacks represent a common, albeit understudied, segment of the smoking population who may be at heightened risk for continued nicotine dependence and its associated morbidity and mortality. Though researchers have attempted to understand the impact of certain emotional disorders on the relative degree of success in smoking cessation, research has not examined the impact of panic-related problems on smoking cessation outcomes. To address this gap in the existing literature, the present R21 proposal seeks to test the extent to which a history of panic attacks interferes with successful smoking cessation. The project also will clarify theoretically relevant negative emotional processes involved with smoking cessation more generally. Findings from the proposed investigation should result in improved methods of identifying smokers at-risk for relapse, so that they may be targeted for nicotine dependence treatments that will meet their specific needs. The proposed study employs a prospective design to follow for three months a sample of 84 smokers with and without a history of panic attacks after they attempt to quit smoking on their own. Subjects will complete a diagnostic interview and a medical screening, provide saliva for cotinine analysis, and will complete a set of self-report measures assessing theoretically relevant emotional and smoking characteristics. They also will complete a well-established voluntary hyperventilation challenge procedure on a day prior to their cessation attempt on which they will come to the laboratory not smoking for a 12-hour experimental abstinence period. Beginning on quit day and also at days 3, 7, 14, 28, and 90, subjects will return to the study center for assessment of smoking outcomes, psychological/emotional status, and withdrawal symptoms.
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Because smokers with panic attacks may represent a recalcitrant group of smokers who are at-risk for continued nicotine dependence, these research findings should hold considerable clinical and public health significance and may result in the development of specialized treatment approaches for this population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESPIRATORY & AUTONOMIC PATHOPHYSIOLOGY--PANIC DISORDER Principal Investigator & Institution: Roth, Walton T.; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 15-MAY-1997; Project End 30-APR-2003 Summary: As is now more widely recognized, Panic Disorder often results in considerable emotional suffering and a reduction in quality of life. Although progress has been made in identifying its biological substrates, much about its pathophysiology and etiology remains obscure. Latest research findings in our laboratory and laboratories of other research groups point towards a central role for respiratory mechanisms. Experiments are proposed to investigate markers and mechanisms of Panic Disorder in and outside the laboratory. Respiratory, sympathetic, and parasympathetic measures in Panic Disorder patients of two types, those with and without prominent respiratory symptoms, will be examined and compared to measures in two groups without panic attacks, Generalized Anxiety Disorder patients and controls. In the laboratory the relative importance of several possible respiratory mechanisms will be determined by examining probe-specific and group-specific effects of several kinds of probes: increased inspired CO2, increased inspiratory resistance load, and decreased inspired O2. Each is known to produce feelings of suffocation at moderate intensities, and sometimes panic in Panic Disorder patients at high intensities. Respiratory responses to a noise stressor not directly linked to suffocation fears will serve as a comparison. To resolve contradictions in the literature about slower recovery from voluntary hyperventilation in Panic Disorder, which was a specific marker for Panic Disorder in one of our recent experiments, the effects of different durations of hyperventilation will be examined. In another experiment, central and peripheral chemoreceptor thresholds and sensitivities will be distinguished in Panic Disorder for the first time. Outside the laboratory two ways of recording pCO2 (transcutaneous vs. nasal prongs) will be compared methodologically, and it will be determined whether valid indices of respiratory sinus arrhythmia that take into account variations in breathing will distinguish patients with panic attack-related driving phobia from controls. The significance of this proposal lies in the possibility of its establishing specific and sensitive physiological markers of Panic Disorder, which could lead to better diagnosis and more appropriate treatment, facilitate research in the molecular genetics of Panic Disorder, and lead to a better understanding of dysfunctional biological control mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SLEEP IN PTSD/PANIC: A MULTIMODAL NATURALISTIC STUDY Principal Investigator & Institution: Sheikh, Javaid I.; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003; Project Start 22-SEP-2003; Project End 30-JUN-2007 Summary: (provided by applicant): The past decade has seen exciting advances in our understanding of central fear systems, information regarding the extended amygdala,
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the broader limbic system, their targets and modulating structures, is providing new avenues for the formation of testable models of anxiety disorders that are amongst the most common psychiatric illnesses. Panic disorder (PD) and posttraumatic stress disorder (PTSD) are prime candidates for explication by reference to central fear systems. Further, because they converge and diverge in important ways, PD and PTSD challenge our understanding of how central fear systems can support related yet distinct anxiety syndromes. A strong version of this challenge is presented by the sleep disturbances of PD and PTSD. Both are associated with subjectively disturbed sleep continuity, nocturnal paroxysmal episodes (nocturnal panic attacks and trauma-related nightmares, respectively), and, our data would suggest, suppression of sleep movement. Nevertheless, these two anxiety disorders appear to exhibit divergent modifications of nocturnal respiration, elevated tidal volume variability in PD, versus accelerated respiration in association with nightmares in PTSD. The aim of this project is to lay the foundation for a more comprehensive account of the interaction of sleep and fear systems in PD and PTSD by optimally quantifying domains in which they converge and diverge: arousals from sleep, sleep movements and sleep respiration. In this study, sleep data will be obtained from 180 community-residents, unmedicated, female and male subjects with PD (30 with and 30 without a history of nocturnal panic attacks), PTSD (30 with and 30 without a history of trauma-related nightmares), comorbid PD and PTSD (30), and normal controls. The proposed methods represent an advanced approach to naturalistic sleep data acquisition, combining an initial phase of ambulatory polysomnography (PSG) with extended (21+days) actigraphy and auditory sonography. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAIT MARKER FOR PANIC DISORDER Principal Investigator & Institution: Coryell, William H.; Professor; Psychiatry; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2003 Summary: (Applicant's Abstract): According to substantial evidence, an abnormal threshold for suffocation alarm underlies panic disorder. This project aims to determine whether this abnormality, as manifested in panic attacks following carbon dioxide inhalation, constitutes a trait marker for panic disorder. The following describes a highrisk paradigm to test both sensitivity and specificity. The project also seeks to refine the definitions and thresholds used to identify meaningful hypersensitivity to CO2 and to explore relationships between such hypersensitivity and morbid childhood separation anxiety. Finally, it will assess the relationship between CO2 hypersensitivity, morbid childhood separation anxiety sensitivity. It will thus work toward a synthesis of etiological theories. Never-ill subjects will be grouped by family history to yield 64 at high risk for panic disorder, 22 at high risk for affective disorder and 22 at high risk for neither disorder. Another two groups of never-ill subjects will be identified through ill probands attending an outpatient facility; 33 will have a proband with primary depression complicated by panic attacks and 22 will have a proband with panic disorder complicated by secondary depression. All high-risk subjects will undergo structured diagnostic interviews and a CO2 inhalation test. In addition, for each highrisk subject, the ill family member who defines the pedigree will be interviewed directly. According to predictions, panic attacks will occur only among subjects with a family history of autonomous panic disorder. Moreover, a relationship will emerge between hypersensitivity to CO2 inhalation and a history of morbid childhood separation anxiety. Raters will maintain annual contact with subjects using brief telephone interviews. If the study's predictions are sustained, subsequent efforts will be directed
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toward lengthening the follow-up period and toward an eventual, ten-year diagnostic reassessment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT REFRACTORY PANIC DISORDER Principal Investigator & Institution: Simon, Naomi M.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 15-FEB-2000; Project End 31-JAN-2005 Summary: This is an application for a Mentored Patient-Oriented Research Career Development Award with a focus on developing expertise in the study of treatment refractory panic disorder. The candidate proposes to build upon her expertise studying novel therapeutics for panic disorder, and obtain training to assess "next-step" psychopharmacologic and cognitive-behavioral therapy approaches for patients who remain symptomatic despite initial intervention. Panic disorder with or without agoraphobia is a common anxiety disorder, and when broader measures assessing remission including panic attacks, anticipatory anxiety, agoraphobic avoidance, and functional and quality of life measures are used, it is clear that many patients remain symptomatic and significantly impaired despite initial treatment. However, there is minimal data to guide clinicians in their approach to these patients, and the proposed study is designed as an initial step in addressing this issue in a systematic manner. Research Plan: The primary study is a three phase, twenty-four week clinical trial in which patients who remain symptomatic at the end of one phase enter the next. Phase I is a six-week open sertraline treatment trial to prospectively determine treatment refractoriness. Phase II is a six-week double-blind three arm randomized trial of sertraline at continued dose, sertraline at elevated dose, and sertraline plus clonazepam. Phase III is a twelve-week randomized single-blind trial of the addition of cognitivebehavioral therapy versus "medication optimization" with sertraline and clonazepam. Environment: The proposed study will be based at the Massachusetts General Hospital and will complement a program of training and supervised research under the mentorship of Dr. Mark Pollack, with consultation from experts. Career Development Plan: Training will emphasize skills necessary for designing and carrying out studies to evaluate treatment interventions for patients with panic disorder who remain symptomatic despite initial intervention, and will include work at the Harvard School of Public Health on research methodology and statistics, and supervision with consultants regarding training in outcome assessment, cognitive-behavioral therapy training, and strategies to study the transmission of findings regarding panic treatment to primary care and community settings that will lay the foundation for future independent investigation by the candidate in this area. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 3
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with panic attacks, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “panic attacks” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for panic attacks (hyperlinks lead to article summaries): •
A 1-year prospective study of panic attacks: clinical course and factors associated with maintenance. Author(s): Ehlers A. Source: Journal of Abnormal Psychology. 1995 February; 104(1): 164-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7897040&dopt=Abstract
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A comparison of people with and without nocturnal panic attacks. Author(s): Norton GR, Norton PJ, Walker JR, Cox BJ, Stein MB. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1999 March; 30(1): 37-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10365864&dopt=Abstract
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A comparison of persons with early-versus late-onset panic attacks. Author(s): Katerndahl DA, Talamantes M. Source: The Journal of Clinical Psychiatry. 2000 June; 61(6): 422-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10901340&dopt=Abstract
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A descriptive report of features of initial unexpected panic attacks in minimal and extensive avoiders. Author(s): Craske MG, Miller PP, Rotunda R, Barlow DH. Source: Behaviour Research and Therapy. 1990; 28(5): 395-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2256897&dopt=Abstract
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A hyperventilation interpretation of the termination of panic attacks: a reply to van den Hout, de Jong, Zandbergen and Merckelbach. Author(s): Ley R. Source: Behaviour Research and Therapy. 1992 March; 30(2): 191-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1520364&dopt=Abstract
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A pilot study of panic attacks in a child and adolescent psychiatric population. Author(s): Bradley S, Wachsmuth R, Swinson R, Hnatko G. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1990 August; 35(6): 526-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2207987&dopt=Abstract
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A short term open clinical trial of clobazam in the treatment of patients with panic attacks. Author(s): Judd FK, Burrows GD, Marriott PF, Norman TR. Source: International Clinical Psychopharmacology. 1989 October; 4(4): 285-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2575098&dopt=Abstract
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A study of the phenomenology of panic attacks in patients from India. Author(s): Neerakal I, Srinivasan K. Source: Psychopathology. 2003 March-April; 36(2): 92-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766319&dopt=Abstract
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A woman with panic attacks and double vision who liked cheese. Author(s): Vogt T, Hasler P. Source: Lancet. 1999 July 24; 354(9175): 300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10440308&dopt=Abstract
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An analysis of panic symptoms during hypercarbia compared to hypocarbia in patients with panic attacks. Author(s): Zandbergen J, Pols H, Fernandez I, Griez E. Source: Journal of Affective Disorders. 1991 November; 23(3): 131-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1774428&dopt=Abstract
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Anger-associated panic attacks in Cambodian refugees with PTSD; a multiple baseline examination of clinical data. Author(s): Hinton D, Hsia C, Um K, Otto MW. Source: Behaviour Research and Therapy. 2003 June; 41(6): 647-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732373&dopt=Abstract
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Anticonvulsant-responsive panic attacks with temporal lobe EEG abnormalities. Author(s): McNamara ME, Fogel BS. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 1990 Spring; 2(2): 193-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2136075&dopt=Abstract
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Anxiety induced by cardiac perceptions in patients with panic attacks: a field study. Author(s): Pauli P, Marquardt C, Hartl L, Nutzinger DO, Holzl R, Strian F. Source: Behaviour Research and Therapy. 1991; 29(2): 137-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2021376&dopt=Abstract
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Anxiety sensitivity and nonclinical panic attacks. Author(s): Cox BJ, Endler NS, Norton GR, Swinson RP. Source: Behaviour Research and Therapy. 1991; 29(4): 367-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1888327&dopt=Abstract
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Anxiety sensitivity and panic attacks in a nonclinical population. Author(s): Donnell CD, McNally RJ. Source: Behaviour Research and Therapy. 1990; 28(1): 83-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2302152&dopt=Abstract
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Anxiety sensitivity and panic attacks in an asthmatic population. Author(s): Carr RE, Lehrer PM, Rausch LL, Hochron SM. Source: Behaviour Research and Therapy. 1994 May; 32(4): 411-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8192640&dopt=Abstract
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Anxiety sensitivity as a predictor of the development of panic symptoms, panic attacks, and panic disorder: a prospective study. Author(s): Plehn K, Peterson RA. Source: Journal of Anxiety Disorders. 2002; 16(4): 455-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213039&dopt=Abstract
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Anxiety symptoms and panic attacks preceding pancreatic cancer diagnosis. Author(s): Passik SD, Roth AJ. Source: Psycho-Oncology. 1999 May-June; 8(3): 268-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10390740&dopt=Abstract
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Aortic aneurysm in the differential for panic attacks. Author(s): Benjamin AB, Wright J. Source: Psychosomatics. 2000 May-June; 41(3): 282-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10849463&dopt=Abstract
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Are gonadotrophic hormonal factors perceived to be important by women with panic attacks? Author(s): Birchall HM. Source: Anxiety. 1994; 1(2): 102-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9160556&dopt=Abstract
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Are panic attacks traumatic stressors? Author(s): McNally RJ, Lukach BM. Source: The American Journal of Psychiatry. 1992 June; 149(6): 824-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1590501&dopt=Abstract
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Assessment and phenomenology of nonclinical panic attacks in adolescent girls. Author(s): Hayward C, Killen JD, Kraemer HC, Blair-Greiner A, Strachowski D, Cunning D, Taylor CB. Source: Journal of Anxiety Disorders. 1997 January-February; 11(1): 17-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9131879&dopt=Abstract
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Association of panic disorder and panic attacks with hypertension. Author(s): Davies SJ, Ghahramani P, Jackson PR, Noble TW, Hardy PG, Hippisley-Cox J, Yeo WW, Ramsay LE. Source: The American Journal of Medicine. 1999 October; 107(4): 310-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10527031&dopt=Abstract
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Asthma and panic attacks among youth in the community. Author(s): Goodwin RD, Pine DS, Hoven CW. Source: The Journal of Asthma : Official Journal of the Association for the Care of Asthma. 2003 April; 40(2): 139-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765315&dopt=Abstract
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Asthma and panic attacks. Author(s): Perna G, Bertani A, Politi E, Colombo G, Bellodi L. Source: Biological Psychiatry. 1997 October 1; 42(7): 625-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9376459&dopt=Abstract
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Asthma and the risk of panic attacks among adults in the community. Author(s): Goodwin RD, Eaton WW. Source: Psychological Medicine. 2003 July; 33(5): 879-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877402&dopt=Abstract
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Atrial natriuretic hormone in lactate-induced panic attacks: mode of release and endocrine and pathophysiological consequences. Author(s): Kellner M, Knaudt K, Jahn H, Holsboer F, Wiedemann K. Source: Journal of Psychiatric Research. 1998 January-February; 32(1): 37-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9693999&dopt=Abstract
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Atypical depression, panic attacks, and response to imipramine and phenelzine. A replication. Author(s): Quitkin FM, McGrath PJ, Stewart JW, Harrison W, Tricamo E, Wager SG, Ocepek-Welikson K, Nunes E, Rabkin JG, Klein DF. Source: Archives of General Psychiatry. 1990 October; 47(10): 935-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2222132&dopt=Abstract
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Autonomic dysregulation in panic disorder and in post-traumatic stress disorder: application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks. Author(s): Cohen H, Benjamin J, Geva AB, Matar MA, Kaplan Z, Kotler M. Source: Psychiatry Research. 2000 September 25; 96(1): 1-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10980322&dopt=Abstract
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Autonomic reactivity and hormonal secretion in lactate-induced panic attacks. Author(s): Seier FE, Kellner M, Yassouridis A, Heese R, Strian F, Wiedemann K. Source: The American Journal of Physiology. 1997 June; 272(6 Pt 2): H2630-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9227540&dopt=Abstract
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Benzodiazepines for treatment of panic attacks: a new look. Author(s): Rickels K, Schweizer EE. Source: Psychopharmacology Bulletin. 1986; 22(1): 93-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2873621&dopt=Abstract
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Beyond the usual suspects: a cholinergic route for panic attacks. Author(s): Battaglia M. Source: Molecular Psychiatry. 2002; 7(3): 239-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11920151&dopt=Abstract
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Binding of imipramine to platelet membranes is reduced in panic attacks. Author(s): Marazziti D, Rotondo A, Placidi GF, Perugi G, Cassano GB, Pacifici GM. Source: Fundamental & Clinical Pharmacology. 1988; 2(2): 69-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3391497&dopt=Abstract
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Brief treatment of emergency room patients with panic attacks. Author(s): Swinson RP, Soulios C, Cox BJ, Kuch K. Source: The American Journal of Psychiatry. 1992 July; 149(7): 944-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1351703&dopt=Abstract
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Bromazepam, another high-potency benzodiazepine, for panic attacks. Author(s): Beaudry P, Fontaine R, Chouinard G. Source: The American Journal of Psychiatry. 1984 March; 141(3): 464-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6142658&dopt=Abstract
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Buspirone metabolite and panic attacks. Author(s): Fuller RW. Source: Lancet. 1990 February 24; 335(8687): 470. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1968185&dopt=Abstract
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Caffeine and panic attacks. Author(s): Rowlands MW. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1987 May; 150: 720. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3651720&dopt=Abstract
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Calm response soothes patients' panic attacks, but nervousness needs to be addressed earlier. Author(s): Biron CR. Source: Rdh. 1996 November; 16(11): 42-4, 46. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9442673&dopt=Abstract
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Carbon dioxide induced panic attacks and short term clonazepam treatment. Preliminary study. Author(s): Nardi AE, Valenca AM, Zin W, Nascimento I. Source: Arquivos De Neuro-Psiquiatria. 1999 June; 57(2B): 361-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10450339&dopt=Abstract
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Carcinoma of breast and panic attacks. Author(s): Mark P. Source: Br Homeopath J. 2000 January; 89(1): 35-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10703910&dopt=Abstract
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Carla's panic attacks: insight and transformation. What comes out of the 'cracks'-monsters or nascent thoughts? Author(s): Ferro A. Source: The International Journal of Psycho-Analysis. 1996 October; 77 ( Pt 5): 997-1011. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8933222&dopt=Abstract
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Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks. Author(s): Stewart SH, Taylor S, Jang KL, Cox BJ, Watt MC, Fedoroff IC, Borger SC. Source: Behaviour Research and Therapy. 2001 April; 39(4): 443-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280342&dopt=Abstract
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Characteristics of people with infrequent panic attacks. Author(s): Norton GR, Harrison B, Hauch J, Rhodes L. Source: Journal of Abnormal Psychology. 1985 May; 94(2): 216-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3998290&dopt=Abstract
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Cholecystokinin-tetrapeptide induces panic attacks in patients with panic disorder. Author(s): Bradwejn J, Koszycki D, Meterissian G. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1990 February; 35(1): 83-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2180549&dopt=Abstract
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Chronic life stress and treatment outcome in agoraphobia with panic attacks. Author(s): Wade SL, Monroe SM, Michelson LK. Source: The American Journal of Psychiatry. 1993 October; 150(10): 1491-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8379552&dopt=Abstract
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Clinical characteristics and response to sodium lactate of patients with infrequent panic attacks. Author(s): Cowley DS, Dager SR, Foster SI, Dunner DL. Source: The American Journal of Psychiatry. 1987 June; 144(6): 795-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3592002&dopt=Abstract
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Clinical features of panic attacks in schizophrenia. Author(s): Bayle FJ, Krebs MO, Epelbaum C, Levy D, Hardy P. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2001 September; 16(6): 349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11585715&dopt=Abstract
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Clonazepam and imipramine in the treatment of panic attacks: a double-blind comparison of efficacy and side effects. Author(s): Svebak S, Cameron A, Levander S. Source: The Journal of Clinical Psychiatry. 1990 May; 51 Suppl: 14-7; Discussion 50-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2186020&dopt=Abstract
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CO2 inhalation in the treatment of panic attacks. Author(s): Griez E, van den Hout MA. Source: Behaviour Research and Therapy. 1986; 24(2): 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3083806&dopt=Abstract
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CO2-induced panic attacks: a twin study. Author(s): Bellodi L, Perna G, Caldirola D, Arancio C, Bertani A, Di Bella D. Source: The American Journal of Psychiatry. 1998 September; 155(9): 1184-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9734540&dopt=Abstract
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Cocaine-associated panic attacks in methadone-maintained patients. Author(s): Rosen MI, Kosten T. Source: The American Journal of Drug and Alcohol Abuse. 1992; 18(1): 57-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1314016&dopt=Abstract
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Cognitive and performance-based treatments for panic attacks in people with varying degrees of agoraphobic disability. Author(s): Williams SL, Falbo J. Source: Behaviour Research and Therapy. 1996 March; 34(3): 253-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8881094&dopt=Abstract
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Cognitive aspects of panic attacks. Content, course and relationship to laboratory stressors. Author(s): Zucker D, Taylor CB, Brouillard M, Ehlers A, Margraf J, Telch M, Roth WT, Agras WS. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1989 July; 155: 86-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2605437&dopt=Abstract
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Cognitive-behavioral treatment of panic attacks in chronic schizophrenia. Author(s): Arlow PB, Moran ME, Bermanzohn PC, Stronger R, Siris SG. Source: The Journal of Psychotherapy Practice and Research. 1997 Spring; 6(2): 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9071665&dopt=Abstract
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Combat-related flashbacks in posttraumatic stress disorder: phenomenology and similarity to panic attacks. Author(s): Mellman TA, Davis GC. Source: The Journal of Clinical Psychiatry. 1985 September; 46(9): 379-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4030701&dopt=Abstract
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Combined alprazolam and phenelzine treatment of refractory depression with panic attacks. Author(s): Deicken RF. Source: Biological Psychiatry. 1987 June; 22(6): 762-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3593814&dopt=Abstract
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Community correlates of outcomes in subjects with panic attacks. Author(s): Katerndahl DA. Source: Depression and Anxiety. 2001; 13(4): 194-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11413568&dopt=Abstract
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Comorbid psychiatric disorders in subjects with panic attacks. Author(s): Katerndahl DA, Realini JP. Source: The Journal of Nervous and Mental Disease. 1997 November; 185(11): 669-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9368542&dopt=Abstract
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Comparative phenomenology of ataques de nervios, panic attacks, and panic disorder. Author(s): Lewis-Fernandez R, Guarnaccia PJ, Martinez IE, Salman E, Schmidt A, Liebowitz M. Source: Culture, Medicine and Psychiatry. 2002 June; 26(2): 199-223. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211325&dopt=Abstract
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Comparative phenomenology of early-onset versus late-onset panic attacks: a pilot survey. Author(s): Sheikh JI, King RJ, Taylor CB. Source: The American Journal of Psychiatry. 1991 September; 148(9): 1231-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1883003&dopt=Abstract
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Comparative symptomatology of phobic and nonphobic panic attacks. Author(s): Katerndahl DA, Gabel LL, Monk JS. Source: Fam Pract Res J. 1986 Winter; 6(2): 106-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3455111&dopt=Abstract
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Controlling panic attacks with fenfluramine. Author(s): Solyom L. Source: The American Journal of Psychiatry. 1994 April; 151(4): 621-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8147473&dopt=Abstract
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Co-occurrence of panic attacks in delusional disorder. Author(s): Gupta N, KuLhara P. Source: Psychiatry and Clinical Neurosciences. 2001 December; 55(6): 653. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11737801&dopt=Abstract
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Correlation of panic attacks and hostility in chronic schizophrenia. Author(s): Chen CY, Liu CY, Yang YY. Source: Psychiatry and Clinical Neurosciences. 2001 August; 55(4): 383-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11442890&dopt=Abstract
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CSF prostaglandin-E in agoraphobia with panic attacks. Author(s): Anton RF, Ballenger JC, Lydiard RB, Laraia MT, Howell EF, Gold PW. Source: Biological Psychiatry. 1989 July; 26(3): 257-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2545288&dopt=Abstract
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Cultural formulation of psychiatric diagnosis. Death on a horse's back: adjustment disorder with panic attacks. Author(s): Barrett RJ. Source: Culture, Medicine and Psychiatry. 1997 December; 21(4): 481-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9492975&dopt=Abstract
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Definitions of panic attacks and panic disorder in the DSM-IV: implications for research. Author(s): Barlow DH, Brown TA, Craske MG. Source: Journal of Abnormal Psychology. 1994 August; 103(3): 553-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7930055&dopt=Abstract
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Depressed women with panic attacks. Author(s): Van Valkenburg C, Winokur G, Behar D, Lowry M. Source: The Journal of Clinical Psychiatry. 1984 September; 45(9): 367-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6469919&dopt=Abstract
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Depression and panic attacks related to phenol-formaldehyde composite material exposure in an aerospace manufacturing plant. Author(s): Sparks PJ, Ayars GH, Simon GE, Katon WJ, Altman LC, Johnson RL. Source: Allergy Proc. 1991 November-December; 12(6): 389-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1838999&dopt=Abstract
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Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. Author(s): Coryell W, Endicott J, Andreasen NC, Keller MB, Clayton PJ, Hirschfeld RM, Scheftner WA, Winokur G. Source: The American Journal of Psychiatry. 1988 March; 145(3): 293-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3344844&dopt=Abstract
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Derealization and panic attacks: a clinical evaluation on 150 patients with panic disorder/agoraphobia. Author(s): Cassano GB, Petracca A, Perugi G, Toni C, Tundo A, Roth M. Source: Comprehensive Psychiatry. 1989 January-February; 30(1): 5-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2924566&dopt=Abstract
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Desipramine in agoraphobia with panic attacks: an open, fixed-dose study. Author(s): Lydiard RB. Source: Journal of Clinical Psychopharmacology. 1987 August; 7(4): 258-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3624509&dopt=Abstract
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Dexamethasone suppression test in patients with panic attacks. Author(s): Bridges M, Yeragani VK, Rainey JM, Pohl R. Source: Biological Psychiatry. 1986 July; 21(8-9): 853-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3730467&dopt=Abstract
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Differential diagnosis and treatment of panic attacks and phobic states. Author(s): Liebowitz MR, Klein DF. Source: Annual Review of Medicine. 1981; 32: 583-99. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7013690&dopt=Abstract
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Differential treatment of phobias: use of imipramine for panic attacks. Author(s): Zitrin CM. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1983 March; 14(1): 11-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6134756&dopt=Abstract
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Distinguishing between partial seizures and panic attacks. Epileptic panic attacks are not limited to adults. Author(s): Huppertz HJ, Schulze-Bonhage A. Source: Bmj (Clinical Research Ed.). 2001 April 7; 322(7290): 864. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321014&dopt=Abstract
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Distinguishing between partial seizures and panic attacks. Psychotic and behavioural symptoms are also common in elderly patients. Author(s): Dale MC. Source: Bmj (Clinical Research Ed.). 2001 April 7; 322(7290): 864. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321013&dopt=Abstract
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Diurnal rhythms and symptom severity in panic disorder. A preliminary study of 24hour changes in panic attacks, generalised anxiety, and avoidance behaviour. Author(s): Geraci MF, Uhde TW. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1992 October; 161: 512-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1393338&dopt=Abstract
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Do antidepressants selectively suppress spontaneous (unexpected) panic attacks? A replication. Author(s): Uhlenhuth EH, Matuzas W, Warner TD, Paine S, Lydiard RB, Pollack MH. Source: Journal of Clinical Psychopharmacology. 2000 December; 20(6): 622-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11106133&dopt=Abstract
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Do higher preinfusion heart rates predict laboratory-induced panic attacks? Author(s): Yeragani VK, Balon R, Pohl R, Ortiz A, Weinberg P, Rainey JM. Source: Biological Psychiatry. 1987 May; 22(5): 554-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3580431&dopt=Abstract
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Does ischemia occur with panic attacks? Author(s): Lint DW, Taylor CB, Fried-Behar L, Kenardy J. Source: The American Journal of Psychiatry. 1995 November; 152(11): 1678-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7485636&dopt=Abstract
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Double-blind acute clonazepam vs. placebo in carbon dioxide-induced panic attacks. Author(s): Nardi AE, Valenca AM, Nascimento I, Mezzasalma MA, Zin WA. Source: Psychiatry Research. 2000 May 15; 94(2): 179-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10808043&dopt=Abstract
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Dream recall, nightmare frequency, and nocturnal panic attacks in patients with panic disorder. Author(s): Schredl M, Kronenberg G, Nonnell P, Heuser I. Source: The Journal of Nervous and Mental Disease. 2001 August; 189(8): 559-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11531210&dopt=Abstract
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DSM-IV panic attacks and panic disorder in a community sample of adolescents and young adults: how specific are panic attacks? Author(s): Reed V, Wittchen HU. Source: Journal of Psychiatric Research. 1998 November-December; 32(6): 335-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9844949&dopt=Abstract
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Dyspnea during panic attacks. An Internet survey of incidences of changes in breathing. Author(s): Anderson B, Ley R. Source: Behavior Modification. 2001 September; 25(4): 546-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530715&dopt=Abstract
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Dyspneic-fear and catastrophic cognitions in hyperventilatory panic attacks. Author(s): Ley R. Source: Behaviour Research and Therapy. 1989; 27(5): 549-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2684135&dopt=Abstract
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Dyspneic-fear theory explains hyperventilatory panic attacks: a reply to Carr, Lehrer and Hochron. Author(s): Ley R. Source: Behaviour Research and Therapy. 1994 January; 32(1): 109-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8135706&dopt=Abstract
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EEG abnormalities in patients with atypical panic attacks. Author(s): Weilburg JB, Schachter S, Worth J, Pollack MH, Sachs GS, Ives JR, Schomer DL. Source: The Journal of Clinical Psychiatry. 1995 August; 56(8): 358-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7635852&dopt=Abstract
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Effect of a selective serotonin uptake inhibitor in agoraphobia with panic attacks. A double-blind comparison of zimeldine, imipramine and placebo. Author(s): Evans L, Kenardy J, Schneider P, Hoey H. Source: Acta Psychiatrica Scandinavica. 1986 January; 73(1): 49-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2938422&dopt=Abstract
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Effect of alcoholism on the incidence of lactate-induced panic attacks. Author(s): George DT, Lindquist T, Ragan PW, Alim T, Eckardt MJ, Linnoila M. Source: Biological Psychiatry. 1997 December 1; 42(11): 992-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9386850&dopt=Abstract
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Effect of alprazolam and diazepam on anxiety and panic attacks in panic disorder: a controlled study. Author(s): Dunner DL, Ishiki D, Avery DH, Wilson LG, Hyde TS. Source: The Journal of Clinical Psychiatry. 1986 September; 47(9): 458-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2875064&dopt=Abstract
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Effect of chloride or glucose on the incidence of lactate-induced panic attacks. Author(s): George DT, Lindquist T, Nutt DJ, Ragan PW, Alim T, McFarlane V, Leviss J, Eckardt MJ, Linnoila M. Source: The American Journal of Psychiatry. 1995 May; 152(5): 692-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7726308&dopt=Abstract
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Effect of panic attacks on the treatment of atypical depressives. Author(s): Liebowitz MR, Quitkin FM, Stewart JW, McGrath PJ, Harrison W, Rabkin J, Tricamo E, Markowitz JS, Klein DF. Source: Psychopharmacology Bulletin. 1985; 21(3): 558-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4034874&dopt=Abstract
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Effect of phenelzine on the prolapsed mitral valve in a patient with agoraphobia with panic attacks. Author(s): Evans DL, Kalina K. Source: Journal of Clinical Psychopharmacology. 1983 February; 3(1): 36-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6833522&dopt=Abstract
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Effect of the cholecystokinin-B receptor antagonist L-365,260 on lactate-induced panic attacks in panic disorder patients. Author(s): van Megen HJ, Westenberg HG, den Boer JA. Source: Biological Psychiatry. 1996 October 15; 40(8): 804-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8894076&dopt=Abstract
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Effect of the selective serotonin reuptake inhibitor fluvoxamine on CCK-4 induced panic attacks. Author(s): van Megen HJ, Westenberg HG, den Boer JA, Slaap B, Scheepmakers A. Source: Psychopharmacology. 1997 February; 129(4): 357-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9085405&dopt=Abstract
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Effects of lactate-induced panic attacks on brain stem auditory evoked potentials. Author(s): Knott VJ, Lapierre YD. Source: Neuropsychobiology. 1986; 16(1): 9-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3574642&dopt=Abstract
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Effects of naloxone on patients with panic attacks. Author(s): Liebowitz MR, Gorman JM, Fyer AJ, Dillon DJ, Klein DF. Source: The American Journal of Psychiatry. 1984 August; 141(8): 995-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6087689&dopt=Abstract
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Elderly widow develops panic attacks, followed by depression. Author(s): Frances A, Flaherty JA. Source: Hosp Community Psychiatry. 1989 January; 40(1): 19-20, 23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2912837&dopt=Abstract
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Electroencephalographic sleep in panic disorder. A focus on sleep-related panic attacks. Author(s): Mellman TA, Uhde TW. Source: Archives of General Psychiatry. 1989 February; 46(2): 178-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2913974&dopt=Abstract
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Electroencephalographic study of nighttime panic attacks. Author(s): Lesser IM, Poland RE, Holcomb C, Rose DE. Source: The Journal of Nervous and Mental Disease. 1985 December; 173(12): 744-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4067597&dopt=Abstract
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Elevated serum lactate associated with panic attacks induced by hyperventilation. Author(s): Maddock RJ, Carter CS, Gietzen DW. Source: Psychiatry Research. 1991 September; 38(3): 301-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1754640&dopt=Abstract
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Elevations of urinary MHPG in depressed patients with panic attacks. Author(s): Garvey MJ, Tollefson GD, Orsulak PJ. Source: Psychiatry Research. 1987 March; 20(3): 183-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3588779&dopt=Abstract
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Endocrine and physiological changes during “spontaneous” panic attacks. Author(s): Cameron OG, Lee MA, Curtis GC, McCann DS. Source: Psychoneuroendocrinology. 1987; 12(5): 321-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3432497&dopt=Abstract
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Epidemiologic evidence on cocaine use and panic attacks. Author(s): Anthony JC, Tien AY, Petronis KR. Source: American Journal of Epidemiology. 1989 March; 129(3): 543-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2916547&dopt=Abstract
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Epilepsy mistaken for panic attacks in an adolescent girl. Author(s): Laidlaw JD, Khin-Maung-Zaw. Source: Bmj (Clinical Research Ed.). 1993 March 13; 306(6879): 709-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8471931&dopt=Abstract
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Epinephrine-induced panic attacks and hyperventilation. Author(s): van Zijderveld GA, Veltman DJ, van Dyck R, van Doornen LJ. Source: Journal of Psychiatric Research. 1999 January-February; 33(1): 73-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10094243&dopt=Abstract
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Estrogen-induced panic attacks. Author(s): Price WA, Heil D. Source: Psychosomatics. 1988 Fall; 29(4): 433-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3227101&dopt=Abstract
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Evoking analogue subtypes of panic attacks in a nonclinical population using carbon dioxide-enriched air. Author(s): Forsyth JP, Eifert GH, Canna MA. Source: Behaviour Research and Therapy. 2000 June; 38(6): 559-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10846805&dopt=Abstract
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Expected versus unexpected panic attacks: a naturalistic prospective study. Author(s): Kenardy J, Taylor CB. Source: Journal of Anxiety Disorders. 1999 July-August; 13(4): 435-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10504111&dopt=Abstract
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Factors associated with persons with panic attacks seeking medical care. Author(s): Katerndahl DA. Source: Family Medicine. 1990 November-December; 22(6): 462-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2262109&dopt=Abstract
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Familial patterns in patients with infrequent panic attacks. Author(s): Dumas CA, Katerndahl DA, Burge SK. Source: Archives of Family Medicine. 1995 October; 4(10): 863-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7551134&dopt=Abstract
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Family characteristics of subjects with panic attacks. Author(s): Katerndahl DA, Realini JP. Source: Family Medicine. 1997 September; 29(8): 563-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9310754&dopt=Abstract
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Family history of anxiety disorders in control subjects with lactate-induced panic attacks. Author(s): Balon R, Jordan M, Pohl R, Yeragani VK. Source: The American Journal of Psychiatry. 1989 October; 146(10): 1304-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2782475&dopt=Abstract
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Fearful and non-fearful panic attacks in a student population. Author(s): Wilson KG, Sandler LS, Asmundson GJ. Source: Behaviour Research and Therapy. 1993 May; 31(4): 407-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8512540&dopt=Abstract
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Flumazenil provocation of panic attacks. Evidence for altered benzodiazepine receptor sensitivity in panic disorder. Author(s): Nutt DJ, Glue P, Lawson C, Wilson S. Source: Archives of General Psychiatry. 1990 October; 47(10): 917-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2171449&dopt=Abstract
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Fluoxetine-associated panic attacks. Author(s): Altshuler LL. Source: Journal of Clinical Psychopharmacology. 1994 December; 14(6): 433-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7884030&dopt=Abstract
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Focal neurologic symptoms in panic attacks. Author(s): Coyle PK, Sterman AB. Source: The American Journal of Psychiatry. 1986 May; 143(5): 648-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3963257&dopt=Abstract
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Focal paroxysmal EEG changes during atypical panic attacks. Author(s): Weilburg JB, Schachter S, Sachs GS, Worth J, Pollack MH, Ives JR, Schomer DL. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 1993 Winter; 5(1): 50-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8428135&dopt=Abstract
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Follow-up study of control subjects with lactate- and isoproterenol-induced panic attacks. Author(s): Balon R, Pohl R, Yeragani VK, Rainey JM Jr, Berchou R. Source: The American Journal of Psychiatry. 1988 February; 145(2): 238-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3341469&dopt=Abstract
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Follow-up study of patients with panic disorder and agoraphobia with panic attacks treated with tricyclic antidepressants. Author(s): Noyes R Jr, Garvey MJ, Cook BL. Source: Journal of Affective Disorders. 1989 March-June; 16(2-3): 249-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2522124&dopt=Abstract
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Frequency of isolated panic attacks and panic disorder in patients with the mitral valve prolapse syndrome. Author(s): Alpert MA, Sabeti M, Kushner MG, Beitman BD, Russell JL, Thiele JR, Mukerji V. Source: The American Journal of Cardiology. 1992 June 1; 69(17): 1489-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1590243&dopt=Abstract
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Frequency of panic attacks and panic disorder in adolescents. Author(s): Essau CA, Conradt J, Petermann F. Source: Depression and Anxiety. 1999; 9(1): 19-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9989346&dopt=Abstract
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Full remission of panic attacks in a schizophrenic patient after switching from haloperidol to risperidone. Author(s): Takahashi H, Higuchi H, Shimizu T. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 2001 Winter; 13(1): 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207340&dopt=Abstract
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Globus hystericus and panic attacks. Author(s): Liebowitz MR. Source: The American Journal of Psychiatry. 1987 March; 144(3): 390-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3826445&dopt=Abstract
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Heart rate and blood pressure during placebo-associated panic attacks. Author(s): Balon R, Ortiz A, Pohl R, Yeragani VK. Source: Psychosomatic Medicine. 1988 July-August; 50(4): 434-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3045849&dopt=Abstract
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Hemodynamic, ventilatory, and biochemical responses of panic patients and normal controls with sodium lactate infusion and spontaneous panic attacks. Author(s): Gaffney FA, Fenton BJ, Lane LD, Lake CR. Source: Archives of General Psychiatry. 1988 January; 45(1): 53-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3337609&dopt=Abstract
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Hemolytic anemia presenting as recurrent panic in a patient with a history of panic attacks. Author(s): Elks ML. Source: Psychosomatics. 1994 July-August; 35(4): 410-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8084993&dopt=Abstract
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High altitudes, anxiety, and panic attacks: is there a relationship? Author(s): Roth WT, Gomolla A, Meuret AE, Alpers GW, Handke EM, Wilhelm FH. Source: Depression and Anxiety. 2002; 16(2): 51-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219335&dopt=Abstract
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HLA system and panic attacks. Author(s): Cottraux J, Gebuhrer L, Bardi R, Betuel H. Source: Biological Psychiatry. 1989 February 15; 25(4): 505-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2930815&dopt=Abstract
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Hypersensitivity to inhalation of carbon dioxide and panic attacks. Author(s): Perna G, Gabriele A, Caldirola D, Bellodi L. Source: Psychiatry Research. 1995 August 28; 57(3): 267-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7501737&dopt=Abstract
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Hypersensitivity to m-chlorophenylpiperazine in a subject with subclinical panic attacks. Author(s): Kalus O, Kahn RS, Wetzler S, Asnis GM, van Praag HM. Source: Biological Psychiatry. 1990 December 15; 28(12): 1053-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2288999&dopt=Abstract
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Hyperthyroidism and panic attacks. Author(s): Katerndahl DA, Vande Creek L. Source: Psychosomatics. 1983 May; 24(5): 491-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6878603&dopt=Abstract
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Hyperventilation and panic attacks in general hospital patients. Author(s): Spinhoven P, Onstein EJ, Sterk PJ, Le Haen-Versteijnen D. Source: General Hospital Psychiatry. 1993 May; 15(3): 148-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8325495&dopt=Abstract
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Hyperventilation and panic attacks. Author(s): Garssen B, Buikhuisen M, van Dyck R. Source: The American Journal of Psychiatry. 1996 April; 153(4): 513-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8599399&dopt=Abstract
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Hyperventilation and panic attacks. Author(s): Kenardy J, Oei TP, Evans L. Source: The Australian and New Zealand Journal of Psychiatry. 1990 June; 24(2): 261-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2118758&dopt=Abstract
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Hyperventilation and panic attacks. Author(s): Hoes MJ, Colla P, van Doorn P, Folgering H, de Swart J. Source: The Journal of Clinical Psychiatry. 1987 November; 48(11): 435-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3680183&dopt=Abstract
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Hyperventilation as a cause of panic attacks. Author(s): Hibbert GA. Source: British Medical Journal (Clinical Research Ed.). 1984 January 28; 288(6413): 263-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6419888&dopt=Abstract
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Hyperventilation challenge test in panic disorder and depression with panic attacks. Author(s): Nardi AE, Valenca AM, Nascimento I, Zin WA. Source: Psychiatry Research. 2001 December 15; 105(1-2): 57-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740975&dopt=Abstract
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Hyperventilation in panic attacks. Ambulant monitoring of transcutaneous carbon dioxide. Author(s): Hibbert G, Pilsbury D. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1988 July; 153: 76-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3224254&dopt=Abstract
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Hyperventilation: is it a cause of panic attacks? Author(s): Hibbert G, Pilsbury D. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1989 December; 155: 805-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2515911&dopt=Abstract
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Hyperventilation-induced panic attacks in panic disorder with agoraphobia. Author(s): Maddock RJ, Carter CS. Source: Biological Psychiatry. 1991 May 1; 29(9): 843-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1904781&dopt=Abstract
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Hypnogenic paroxysmal dystonia with panic attacks responsive to drug therapy. Author(s): Stoudemire A, Ninan PT, Wooten V. Source: Psychosomatics. 1987 May; 28(5): 280-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3423180&dopt=Abstract
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Hypochondriasis with panic attacks. Author(s): Fava GA, Grandi S, Saviotti FM, Conti S. Source: Psychosomatics. 1990 Summer; 31(3): 351-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2388990&dopt=Abstract
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Hypoglycemia and panic attacks. Author(s): Gorman JM, Martinez JM, Liebowitz MR, Fyer AJ, Klein DF. Source: The American Journal of Psychiatry. 1984 January; 141(1): 101-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6691421&dopt=Abstract
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Identifying and treating patients with panic attacks. Author(s): Pary R, Lewis S. Source: American Family Physician. 1992 September; 46(3): 841-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1514477&dopt=Abstract
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Illness attitudes and coping process in subjects with panic attacks. Author(s): Katerndahl DA. Source: The Journal of Nervous and Mental Disease. 1999 September; 187(9): 561-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10496511&dopt=Abstract
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Imipramine versus propranolol for the treatment of panic attacks: a pilot study. Author(s): Munjack DJ, Rebal R, Shaner R, Staples F, Braun R, Leonard M. Source: Comprehensive Psychiatry. 1985 January-February; 26(1): 80-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3881216&dopt=Abstract
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Immunological response to stress in agoraphobia and panic attacks. Author(s): Surman OS, Williams J, Sheehan DV, Strom TB, Jones KJ, Coleman J. Source: Biological Psychiatry. 1986 July; 21(8-9): 768-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3524696&dopt=Abstract
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Impact of panic attacks on rehabilitation and quality of life among persons with severe psychotic disorders. Author(s): Goodwin R, Stayner DA, Chinman MJ, Davidson L. Source: Psychiatric Services (Washington, D.C.). 2001 July; 52(7): 920-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433109&dopt=Abstract
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Increased ACTH concentrations associated with cholecystokinin tetrapeptideinduced panic attacks in patients with panic disorder. Author(s): Strohle A, Holsboer F, Rupprecht R. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2000 March; 22(3): 251-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10693152&dopt=Abstract
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Increased risk of stroke in patients with panic attacks: real or perceived? Author(s): Burch EA Jr. Source: The American Journal of Psychiatry. 1991 October; 148(10): 1420-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1897638&dopt=Abstract
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Independent relationships among outcomes and their predictors in subjects with panic attacks. Author(s): Katerndahl DA, Palmer RF. Source: The Journal of Nervous and Mental Disease. 2000 October; 188(10): 714-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11048822&dopt=Abstract
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Induced panic attacks shift gamma-aminobutyric acid type A receptor modulatory neuroactive steroid composition in patients with panic disorder: preliminary results. Author(s): Strohle A, Romeo E, di Michele F, Pasini A, Hermann B, Gajewsky G, Holsboer F, Rupprecht R. Source: Archives of General Psychiatry. 2003 February; 60(2): 161-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578433&dopt=Abstract
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Infrequent and limited-symptom panic attacks. Author(s): Katerndahl DA. Source: The Journal of Nervous and Mental Disease. 1990 May; 178(5): 313-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2338539&dopt=Abstract
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Infrequent panic attacks: psychiatric comorbidity, personality characteristics and functional disability. Author(s): Katon W, Hollifield M, Chapman T, Mannuzza S, Ballenger J, Fyer A. Source: Journal of Psychiatric Research. 1995 March-April; 29(2): 121-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7666380&dopt=Abstract
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Initial care seeking for panic attacks. Author(s): Katerndahl D. Source: Psychiatric Services (Washington, D.C.). 2003 August; 54(8): 1168. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883155&dopt=Abstract
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Insulin-induced hypoglycemia and panic attacks. Author(s): Schweizer E, Winokur A, Rickels K. Source: The American Journal of Psychiatry. 1986 May; 143(5): 654-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3515974&dopt=Abstract
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Intrapatient agreement on phenomenology of panic attacks. Author(s): Katerndahl DA. Source: Psychological Reports. 1996 August; 79(1): 219-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8873808&dopt=Abstract
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Is panic attack a mask of psychogenic seizures?--a comparative analysis of phenomenology of psychogenic seizures and panic attacks. Author(s): Vein AM, Djukova GM, Vorobieva OV. Source: Funct Neurol. 1994 May-June; 9(3): 153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7988943&dopt=Abstract
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Isoproterenol-induced panic attacks. Author(s): Pohl R, Yeragani VK, Balon R, Rainey JM, Lycaki H, Ortiz A, Berchou R, Weinberg P. Source: Biological Psychiatry. 1988 December; 24(8): 891-902. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3069135&dopt=Abstract
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Lactate- and isoproterenol-induced panic attacks in panic disorder patients and controls. Author(s): Balon R, Pohl R, Yeragani VK, Rainey JM, Weinberg P. Source: Psychiatry Research. 1988 February; 23(2): 153-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3363024&dopt=Abstract
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Lactate infusion induces panic attacks in patients with premenstrual syndrome. Author(s): Levenstein S. Source: Psychosomatic Medicine. 1993 January-February; 55(1): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8446747&dopt=Abstract
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Lactate infusion induces panic attacks in patients with premenstrual syndrome. Author(s): Facchinetti F, Romano G, Fava M, Genazzani AR. Source: Psychosomatic Medicine. 1992 May-June; 54(3): 288-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1620805&dopt=Abstract
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Lactate infusions and panic attacks: do patients and controls respond differently? Author(s): Ehlers A, Margraf J, Roth WT, Taylor CB, Maddock RJ, Sheikh J, Kopell ML, McClenahan KL, Gossard D, Blowers GH, et al. Source: Psychiatry Research. 1986 April; 17(4): 295-308. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3714912&dopt=Abstract
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Lactate infusions in major depression without panic attacks. Author(s): Cowley DS, Dager SR, Dunner DL. Source: Journal of Psychiatric Research. 1987; 21(3): 243-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3681759&dopt=Abstract
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Lactate provocation of panic attacks in depressed outpatients. Author(s): McGrath PJ, Stewart JW, Liebowitz MR, Markowitz JM, Quitkin FM, Klein DF, Gorman JM. Source: Psychiatry Research. 1988 July; 25(1): 41-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3217465&dopt=Abstract
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Lactate provocation of panic attacks. I. Clinical and behavioral findings. Author(s): Liebowitz MR, Fyer AJ, Gorman JM, Dillon D, Appleby IL, Levy G, Anderson S, Levitt M, Palij M, Davies SO, et al. Source: Archives of General Psychiatry. 1984 August; 41(8): 764-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6742978&dopt=Abstract
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Lactate provocation of panic attacks. II. Biochemical and physiological findings. Author(s): Liebowitz MR, Gorman JM, Fyer AJ, Levitt M, Dillon D, Levy G, Appleby IL, Anderson S, Palij M, Davies SO, et al. Source: Archives of General Psychiatry. 1985 July; 42(7): 709-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4015313&dopt=Abstract
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Lactate-induced panic attacks: possible involvement of serotonin reuptake stimulation. Author(s): Lingjaerde O. Source: Acta Psychiatrica Scandinavica. 1985 August; 72(2): 206-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4050513&dopt=Abstract
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Lifetime comorbidity of panic attacks and major depression in a population-based study. Symptom profiles. Author(s): Andrade L, Eaton WW, Chilcoat H. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1994 September; 165(3): 363-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7994507&dopt=Abstract
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Lifetime co-morbidity of panic attacks and major depression in a population-based study: age of onset. Author(s): Andrade L, Eaton WW, Chilcoat HD. Source: Psychological Medicine. 1996 September; 26(5): 991-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8878331&dopt=Abstract
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Lifetime history of panic attacks and epilepsy: an association from a general population survey. Author(s): Pariente PD, Lepine JP, Lellouch J. Source: The Journal of Clinical Psychiatry. 1991 February; 52(2): 88-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1993644&dopt=Abstract
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Limited-symptom panic attacks. Author(s): Rosenbaum JF. Source: Psychosomatics. 1987 August; 28(8): 407-8, 411-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3423182&dopt=Abstract
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Low dose desipramine treatment of cocaine-related panic attacks. Author(s): Bystritsky A, Ackerman DL, Pasnau RO. Source: The Journal of Nervous and Mental Disease. 1991 December; 179(12): 755-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1744635&dopt=Abstract
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Management of anxiety and panic attacks in immediate care facilities. Author(s): Ross CA, Walker JR, Norton GR, Neufeld K. Source: General Hospital Psychiatry. 1988 March; 10(2): 129-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3360311&dopt=Abstract
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Managing panic attacks in emergency patients. Author(s): Pollard CA, Lewis LM. Source: The Journal of Emergency Medicine. 1989 September-October; 7(5): 547-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2691565&dopt=Abstract
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Mechanisms of change of panic attacks with exposure treatment of agoraphobia. Author(s): Fava GA, Grandi S, Canestrari R, Grasso P, Pesarin F. Source: Journal of Affective Disorders. 1991 May-June; 22(1-2): 65-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1679064&dopt=Abstract
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Medical evaluation of panic attacks. Author(s): Raj A, Sheehan DV. Source: The Journal of Clinical Psychiatry. 1987 August; 48(8): 309-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3301823&dopt=Abstract
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Medication in the treatment of panic attacks and phobic states. Author(s): Klein DF. Source: Psychopharmacology Bulletin. 1982 October; 18(4): 85-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7156302&dopt=Abstract
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Metronidazole and panic attacks. Author(s): Brown JT. Source: Southern Medical Journal. 1985 May; 78(5): 627. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3992315&dopt=Abstract
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Migraine associated with panic attacks. Author(s): Ossipova VV, Kolosova OA, Vein AM. Source: Cephalalgia : an International Journal of Headache. 1999 October; 19(8): 728-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10570728&dopt=Abstract
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Migraine headaches and panic attacks. Author(s): Stewart WF, Linet MS, Celentano DD. Source: Psychosomatic Medicine. 1989 September-October; 51(5): 559-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2798702&dopt=Abstract
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Mitral valve prolapse and panic attacks. Author(s): Grunhaus L, Gloger S, Rein A, Lewis BS. Source: Isr J Med Sci. 1982 February; 18(2): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7068351&dopt=Abstract
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Mitral valve prolapse and thyroid abnormalities in patients with panic attacks. Author(s): Matuzas W, Al-Sadir J, Uhlenhuth EH, Glass RM. Source: The American Journal of Psychiatry. 1987 April; 144(4): 493-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3565620&dopt=Abstract
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Mitral valve prolapse in patients with panic attacks in Korea. Author(s): Min SK, Lee HY. Source: Yonsei Medical Journal. 1987; 28(4): 310-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3439200&dopt=Abstract
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Mode of action of the triazolobenzodiazepines in the treatment of panic attacks: a hypothesis. Author(s): Van Gool D, Igodt P, De Cuyper H. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 1992 December; 2(4): 433-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1362662&dopt=Abstract
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Naltrexone-induced panic attacks. Author(s): Maremmani I, Marini G, Fornai F. Source: The American Journal of Psychiatry. 1998 March; 155(3): 447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9501763&dopt=Abstract
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Neuroanatomic correlates of CCK-4-induced panic attacks in healthy humans: a comparison of two time points. Author(s): Javanmard M, Shlik J, Kennedy SH, Vaccarino FJ, Houle S, Bradwejn J. Source: Biological Psychiatry. 1999 April 1; 45(7): 872-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10202575&dopt=Abstract
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Neurobiological mechanisms of panic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks. Author(s): Charney DS, Woods SW, Goodman WK, Heninger GR. Source: The American Journal of Psychiatry. 1987 August; 144(8): 1030-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3037926&dopt=Abstract
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Neuroleptic-induced panic attacks in a patient with delusional depression. Author(s): Bachmann KM, Modestin J. Source: The Journal of Nervous and Mental Disease. 1987 June; 175(6): 373-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2884274&dopt=Abstract
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Neuroticism and age of onset for agoraphobia with panic attacks. Author(s): Kenardy J, Oei TP, Evans L. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1990 September; 21(3): 193-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2086604&dopt=Abstract
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New insights into panic attacks. Author(s): Yeragani VK. Source: Journal of Psychiatric Research. 1995 September-October; 29(5): 343-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8748059&dopt=Abstract
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New-onset panic attacks in a patient treated with olanzapine. Author(s): Mandalos GE, Szarek BL. Source: Journal of Clinical Psychopharmacology. 1999 April; 19(2): 191. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10211927&dopt=Abstract
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Nicotine and panic attacks. Author(s): Maany I, Woody G, Foulks E. Source: The American Journal of Psychiatry. 1987 February; 144(2): 255. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3812807&dopt=Abstract
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Nicotine and panic attacks. Author(s): Yeragani VK, Pohl R, Balon R, Jankowski W. Source: Biological Psychiatry. 1988 July; 24(3): 365-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3401530&dopt=Abstract
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Nicotine and panic attacks. Author(s): Dilsaver SC. Source: The American Journal of Psychiatry. 1987 September; 144(9): 1245-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3631336&dopt=Abstract
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Nicotine gum to treat panic attacks? Author(s): Hughes JR. Source: The American Journal of Psychiatry. 1986 February; 143(2): 271. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3946684&dopt=Abstract
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No evidence that panic attacks are associated with the white coat effect in hypertension. Author(s): Davies SJ, Jackson PR, Ramsay LE, Ghahramani P, Palmer RL, Hippisley-Cox J. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 March-April; 5(2): 145-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671328&dopt=Abstract
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No mitral valve prolapse in Korean patients with panic attacks. Author(s): Min SK, Lee HY. Source: The American Journal of Psychiatry. 1986 July; 143(7): 943-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3717453&dopt=Abstract
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Nocturnal and daytime panic attacks--comparison of sleep architecture, heart rate variability, and response to sodium lactate challenge. Author(s): Sloan EP, Natarajan M, Baker B, Dorian P, Mironov D, Barr A, Newman DM, Shapiro CM. Source: Biological Psychiatry. 1999 May 15; 45(10): 1313-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10349038&dopt=Abstract
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Nocturnal panic attacks. Author(s): Lopes FL, Nardi AE, Nascimento I, Valenca AM, Zin WA. Source: Arquivos De Neuro-Psiquiatria. 2002 September; 60(3-B): 717-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364936&dopt=Abstract
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Nonclinical panic attacks in late adolescence prevalence and associated psychopathology. Author(s): Mattis SG, Ollendick TH. Source: Journal of Anxiety Disorders. 2002; 16(4): 351-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213032&dopt=Abstract
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Non-fearful panic disorder: panic attacks without fear. Author(s): Beitman BD, Basha I, Flaker G, DeRosear L, Mukerji V, Lamberti J. Source: Behaviour Research and Therapy. 1987; 25(6): 487-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3426511&dopt=Abstract
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Nonresponse of adrenocorticotropic hormone in first-ever lactate-induced panic attacks in healthy volunteers. Author(s): Kellner M, Wiedemann K. Source: Archives of General Psychiatry. 1998 January; 55(1): 85-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9435765&dopt=Abstract
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Normalization of venous pH, pCO2, and bicarbonate levels after blockade of panic attacks. Author(s): Gorman JM, Fyer AJ, Ross DC, Cohen BS, Martinez JM, Liebowitz MR, Klein DF. Source: Psychiatry Research. 1985 January; 14(1): 57-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3921997&dopt=Abstract
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Nortriptyline in the treatment of panic disorder and agoraphobia with panic attacks. Author(s): Munjack DJ, Usigli R, Zulueta A, Crocker B, Adatia N, Buckwalter JG, Baltazar P, Kurvink W, Inglove H, Kelly R, et al. Source: Journal of Clinical Psychopharmacology. 1988 June; 8(3): 204-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3379145&dopt=Abstract
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Olanzapine and panic attacks. Author(s): Etxebeste M, Aragues E, Malo P, Pacheco L. Source: The American Journal of Psychiatry. 2000 April; 157(4): 659-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10739446&dopt=Abstract
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On panic attacks and neurologic problems. Author(s): Weilburg JB, Pollack M, Murray GB, Garber HJ. Source: The American Journal of Psychiatry. 1986 December; 143(12): 1626-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3789218&dopt=Abstract
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On the termination of panic attacks. A reply to Ley. Author(s): van den Hout MA. Source: Behaviour Research and Therapy. 1993 January; 31(1): 117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8417722&dopt=Abstract
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Otoneurological examination in panic disorder and agoraphobia with panic attacks: a pilot study. Author(s): Jacob RG, Moller MB, Turner SM, Wall C 3rd. Source: The American Journal of Psychiatry. 1985 June; 142(6): 715-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3873876&dopt=Abstract
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Panic attacks and lactated Ringer's solution: is there a relationship? Author(s): Tsen LC, Datta S. Source: Anesthesia and Analgesia. 1999 April; 88(4): 795-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195527&dopt=Abstract
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Panic attacks and panic disorder. Author(s): Katerndahl DA. Source: The Journal of Family Practice. 1996 September; 43(3): 275-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8797756&dopt=Abstract
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Panic attacks and suicide attempts in mid-adolescence. Author(s): Pilowsky DJ, Wu LT, Anthony JC. Source: The American Journal of Psychiatry. 1999 October; 156(10): 1545-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10518164&dopt=Abstract
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Panic attacks associated with citalopram. Author(s): Brauer HR, Nowicki PW, Catalano G, Catalano MC. Source: Southern Medical Journal. 2002 September; 95(9): 1088-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356120&dopt=Abstract
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Panic attacks during discontinuation of mirtazepine. Author(s): Klesmer J, Sarcevic A, Fomari V. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2000 August; 45(6): 570-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10986577&dopt=Abstract
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Panic attacks in patients with chronic schizophrenia: a complication of long-term neuroleptic treatment. Author(s): Higuchi H, Kamata M, Yoshimoto M, Shimisu T, Hishikawa Y. Source: Psychiatry and Clinical Neurosciences. 1999 February; 53(1): 91-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10201291&dopt=Abstract
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Panic attacks in schizophrenia. Author(s): Goodwin R, Lyons JS, McNally RJ. Source: Schizophrenia Research. 2002 December 1; 58(2-3): 213-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409161&dopt=Abstract
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Panic attacks in the differential diagnosis and treatment of resistant epilepsy. Author(s): Bernik MA, Corregiari FM, Braun IM. Source: Depression and Anxiety. 2002; 15(4): 190-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112726&dopt=Abstract
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Panic attacks keep patients stressed. Author(s): Fessler JL. Source: Wis Med J. 1996 December; 95(12): 844-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8993220&dopt=Abstract
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Panic attacks with psychotic features. Author(s): Galynker I, Ieronimo C, Perez-Acquino A, Lee Y, Winston A. Source: The Journal of Clinical Psychiatry. 1996 September; 57(9): 402-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9746448&dopt=Abstract
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Panic attacks, spike-wave activity, and limbic dysfunction. A case report. Author(s): Gallinat J, Stotz-Ingenlath G, Lang UE, Hegerl U. Source: Pharmacopsychiatry. 2003 May; 36(3): 123-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806571&dopt=Abstract
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Panic attacks: a twin study. Author(s): Perna G, Caldirola D, Arancio C, Bellodi L. Source: Psychiatry Research. 1997 January 15; 66(1): 69-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9061805&dopt=Abstract
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Patients with panic attacks seeking care from family physicians compared with those seeking care from psychiatrists. Author(s): Katerndahl DA, Realini JP. Source: The Journal of Nervous and Mental Disease. 1998 April; 186(4): 249-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9569895&dopt=Abstract
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Pentagastrin-induced sleep panic attacks: panic in the absence of elevated baseline arousal. Author(s): Geraci M, Anderson TS, Slate-Cothren S, Post RM, McCann UD. Source: Biological Psychiatry. 2002 December 15; 52(12): 1183-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488064&dopt=Abstract
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Peritraumatic and persistent panic attacks in acute stress disorder. Author(s): Nixon RD, Bryant RA. Source: Behaviour Research and Therapy. 2003 October; 41(10): 1237-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12971943&dopt=Abstract
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Phenomenology of panic attacks: responsiveness of individual symptoms to imipramine. Author(s): Mavissakalian MR. Source: Journal of Clinical Psychopharmacology. 1996 June; 16(3): 233-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784655&dopt=Abstract
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Possible role of sweating in the pathophysiology of panic attacks. Author(s): Janszky I, Szedmak S, Istok R, Kopp M. Source: International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology. 1997 December; 27(3): 249-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9451583&dopt=Abstract
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Predictors and outcomes in people told that they have panic attacks. Author(s): Katerndahl DA. Source: Depression and Anxiety. 2003; 17(2): 98-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621599&dopt=Abstract
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Predictors of panic attacks in adolescents. Author(s): Hayward C, Killen JD, Kraemer HC, Taylor CB. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2000 February; 39(2): 207-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10673832&dopt=Abstract
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Pulmonary and systemic nitric oxide measurements during CCK-5-induced panic attacks. Author(s): Lara N, Chrapko WE, Archer SL, Bellavance F, Mayers I, Le Melledo JM. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 October; 28(10): 1840-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12865901&dopt=Abstract
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Rational self-directed hypnotherapy: a treatment for panic attacks. Author(s): Der DF, Lewington P. Source: Am J Clin Hypn. 1990 January; 32(3): 160-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2296917&dopt=Abstract
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Raynaud's phenomenon and panic attacks. Author(s): Pies RW. Source: Journal of Clinical Psychopharmacology. 1986 October; 6(5): 319-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3771820&dopt=Abstract
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Recognition and acute management of patients with panic attacks in the emergency department. Author(s): Merritt TC. Source: Emergency Medicine Clinics of North America. 2000 May; 18(2): 289-300, Ix. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10767885&dopt=Abstract
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Reduction of CO2-induced anxiety in patients with panic attacks after repeated CO2 exposure. Author(s): van den Hout MA, van der Molen GM, Griez E, Lousberg H, Nansen A. Source: The American Journal of Psychiatry. 1987 June; 144(6): 788-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3109265&dopt=Abstract
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Relapse and rebound following discontinuation of benzodiazepine treatment of panic attacks: alprazolam versus diazepam. Author(s): Roy-Byrne PP, Dager SR, Cowley DS, Vitaliano P, Dunner DL. Source: The American Journal of Psychiatry. 1989 July; 146(7): 860-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2742010&dopt=Abstract
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Relationship between panic attacks and health locus of control. Author(s): Katerndahl DA. Source: The Journal of Family Practice. 1991 April; 32(4): 391-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2010738&dopt=Abstract
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Relationship between substance abuse and panic attacks. Author(s): Katerndahl DA, Realini JP. Source: Addictive Behaviors. 1999 September-October; 24(5): 731-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10574314&dopt=Abstract
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Relationship of panic attacks to paranoia. Author(s): Bermanzohn PC, Arlow PB, Albert C, Siris SG. Source: The American Journal of Psychiatry. 1999 September; 156(9): 1469. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10484965&dopt=Abstract
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Relevance of assessment of cognitions during panic attacks in the treatment of panic disorder. Author(s): Bakker A, Spinhoven P, van Balkom AJ, van Dyck R. Source: Psychotherapy and Psychosomatics. 2002 May-June; 71(3): 158-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12021558&dopt=Abstract
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Reply to Ley's “dyspneic-fear theory explains hyperventilatory panic attacks”. Author(s): Carr RE, Lehrer PM. Source: Behaviour Research and Therapy. 1994 January; 32(1): 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8135707&dopt=Abstract
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Respiration disorders in panic attacks. Author(s): Klein DF. Source: Jama : the Journal of the American Medical Association. 1995 November 15; 274(19): 1504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7474207&dopt=Abstract
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Respiration disorders in panic attacks. Author(s): Gorman JM. Source: Jama : the Journal of the American Medical Association. 1995 November 15; 274(19): 1504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7474206&dopt=Abstract
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Respiratory control in the treatment of panic attacks: replication and extension with concurrent measurement of behaviour and pCO2. Author(s): Salkovskis PM, Jones DR, Clark DM. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1986 May; 148: 526-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3096411&dopt=Abstract
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Respiratory control: its contribution to the treatment of panic attacks. A controlled study. Author(s): Hibbert GA, Chan M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1989 February; 154: 232-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2673476&dopt=Abstract
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Respiratory disease and panic attacks among adults in the United States. Author(s): Goodwin RD, Pine DS. Source: Chest. 2002 August; 122(2): 645-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12171845&dopt=Abstract
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Respiratory distress during panic attacks associated with agoraphobia. Author(s): Pollard CA. Source: Psychological Reports. 1986 February; 58(1): 61-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3961082&dopt=Abstract
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Respiratory symptoms in nocturnal panic attacks. Author(s): Lopes FL, Nascimento I, Valenca AM, Versiani M, Nardi AE. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 September; 47(7): 684-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355683&dopt=Abstract
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Response to sodium lactate infusion in alcoholics with panic attacks. Author(s): Cowley DS, Jensen CF, Johannessen D, Parker L, Dager SR, Walker RD. Source: The American Journal of Psychiatry. 1989 November; 146(11): 1479-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2817122&dopt=Abstract
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Risk factors for the onset of panic disorder and other panic attacks in a prospective, population-based study. Author(s): Keyl PM, Eaton WW. Source: American Journal of Epidemiology. 1990 February; 131(2): 301-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2296982&dopt=Abstract
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Role of panic attacks in the intractability of asthma in children. Author(s): Baron C, Marcotte JE. Source: Pediatrics. 1994 July; 94(1): 108-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8008514&dopt=Abstract
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Salivary cortisol in panic attacks. Author(s): Bandelow B, Wedekind D, Pauls J, Broocks A, Hajak G, Ruther E. Source: The American Journal of Psychiatry. 2000 March; 157(3): 454-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10698825&dopt=Abstract
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Self-monitoring of panic attacks and retrospective estimates of panic: discordant findings. Author(s): de Beurs E, Lange A, Van Dyck R. Source: Behaviour Research and Therapy. 1992 July; 30(4): 411-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1352100&dopt=Abstract
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Sequence of improvement in agoraphobia with panic attacks. Author(s): Rifkin A, Pecknold JC, Swinson RP, Ballenger JC, Burrows GD, Noyes R, Dupont RL, Lesser I. Source: Journal of Psychiatric Research. 1990; 24(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2195163&dopt=Abstract
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Serotonin uptake inhibitors are superior to imipramine and alprazolam in alleviating panic attacks: a meta-analysis. Author(s): Boyer W. Source: International Clinical Psychopharmacology. 1995 March; 10(1): 45-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7622804&dopt=Abstract
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Sertraline-induced panic attacks. Author(s): Catalano G, Hakala SM, Catalano MC. Source: Clinical Neuropharmacology. 2000 May-June; 23(3): 164-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10895401&dopt=Abstract
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Sibutramine and panic attacks. Author(s): Binkley K, Knowles SR. Source: The American Journal of Psychiatry. 2002 October; 159(10): 1793-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359693&dopt=Abstract
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Situational panic attacks: impact on distress and impairment among patients with social phobia. Author(s): Jack MS, Heimberg RG, Mennin DS. Source: Depression and Anxiety. 1999; 10(3): 112-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10604084&dopt=Abstract
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Situations and specific coping strategies associated with clinical and nonclinical panic attacks. Author(s): Cox BJ, Endler NS, Swinson RP, Norton GR. Source: Behaviour Research and Therapy. 1992 January; 30(1): 67-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1540115&dopt=Abstract
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Sleep apnea and panic attacks. Author(s): Edlund MJ, McNamara ME, Millman RP. Source: Comprehensive Psychiatry. 1991 March-April; 32(2): 130-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2022111&dopt=Abstract
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Sleep panic attacks: an association with childhood anxiety and adult psychopathology. Author(s): Labbate LA, Pollack MH, Otto MW, Langenauer S, Rosenbaum JF. Source: Biological Psychiatry. 1994 July 1; 36(1): 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8080905&dopt=Abstract
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Smoking and panic attacks: an epidemiologic investigation. Author(s): Breslau N, Klein DF. Source: Archives of General Psychiatry. 1999 December; 56(12): 1141-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10591292&dopt=Abstract
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Smoking cessation and panic attacks: a report of 2 cases. Author(s): Vessicchio JC, Termine A, George TP. Source: The Journal of Clinical Psychiatry. 2002 July; 63(7): 594-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12143916&dopt=Abstract
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Somatic and psychological symptoms during isoproterenol-induced panic attacks. Author(s): Balon R, Yeragani VK, Pohl R, Muench J, Berchou R. Source: Psychiatry Research. 1990 May; 32(2): 103-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2195575&dopt=Abstract
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Specific sensitivity of patients with panic attacks to carbon dioxide inhalation. Author(s): Griez E, de Loof C, Pols H, Zandbergen J, Lousberg H. Source: Psychiatry Research. 1990 February; 31(2): 193-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2109330&dopt=Abstract
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Stressful reactions and panic attacks induced by flumazenil in chronic benzodiazepine users. Author(s): Bernik MA, Gorenstein C, Vieira Filho AH. Source: Journal of Psychopharmacology (Oxford, England). 1998; 12(2): 146-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9694026&dopt=Abstract
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Substance use and non-clinical panic attacks in a young adult sample. Author(s): Deacon BJ, Valentiner DP. Source: Journal of Substance Abuse. 2000; 11(1): 7-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10756510&dopt=Abstract
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Suicide and violence associated with panic attacks. Author(s): Korn ML, Kotler M, Molcho A, Botsis AJ, Grosz D, Chen C, Plutchik R, Brown SL, van Praag HM. Source: Biological Psychiatry. 1992 March 15; 31(6): 607-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1581440&dopt=Abstract
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Suicide attempt history in depressed patients with and without a history of panic attacks. Author(s): King MK, Schmaling KB, Cowley DS, Dunner DL. Source: Comprehensive Psychiatry. 1995 January-February; 36(1): 25-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7705084&dopt=Abstract
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Survey questionnaire data on panic attacks gathered using the World Wide Web. Author(s): Stones A, Perry D. Source: Depression and Anxiety. 1997; 6(2): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9451550&dopt=Abstract
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Sympathetic activity in patients with panic disorder at rest, under laboratory mental stress, and during panic attacks. Author(s): Wilkinson DJ, Thompson JM, Lambert GW, Jennings GL, Schwarz RG, Jefferys D, Turner AG, Esler MD. Source: Archives of General Psychiatry. 1998 June; 55(6): 511-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9633669&dopt=Abstract
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Tachycardia and panic attacks. Author(s): Schweitzer R. Source: Aust Fam Physician. 1994 September; 23(9): 1784-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7980179&dopt=Abstract
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Temporal lobe epilepsy presenting as panic attacks: detection of interictal hypometabolism with positron emission tomography. Author(s): Meyer MA, Zimmerman AW, Miller CA. Source: Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging. 2000 April; 10(2): 120-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10800267&dopt=Abstract
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The “suffocation alarm” theory of panic attacks: a critical commentary. Author(s): Ley R. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1994 December; 25(4): 269-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7706503&dopt=Abstract
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The biology of panic attacks. Author(s): Gorman JM. Source: Clinical Neuropharmacology. 1992; 15 Suppl 1 Pt A: 17A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1498797&dopt=Abstract
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The epidemiology of panic attacks and panic disorder. Results of three community surveys. Author(s): Von Korff MR, Eaton WW, Keyl PM. Source: American Journal of Epidemiology. 1985 December; 122(6): 970-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4061447&dopt=Abstract
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The influence of an illusion of control on panic attacks induced via inhalation of 5.5% carbon dioxide-enriched air. Author(s): Sanderson WC, Rapee RM, Barlow DH. Source: Archives of General Psychiatry. 1989 February; 46(2): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2492423&dopt=Abstract
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The many faces of Pan: psychological and physiological differences among three types of panic attacks. Author(s): Ley R. Source: Behaviour Research and Therapy. 1992 July; 30(4): 347-57. Erratum In: Behav Res Ther 1992 November; 30(6): 657. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1616470&dopt=Abstract
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The match-mismatch model and panic patients' accuracy in predicting naturally occurring panic attacks. Author(s): de Beurs E, Chambless DL, Goldstein AJ. Source: Depression and Anxiety. 2002; 16(4): 172-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12497649&dopt=Abstract
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The Ondine curse, false suffocation alarms, trait-state suffocation fear, and dyspneasuffocation fear in panic attacks. Author(s): Ley R. Source: Archives of General Psychiatry. 1997 July; 54(7): 677-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9236552&dopt=Abstract
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The prevalence of panic attacks in the United States: 1980 to 1995. Author(s): Goodwin RD. Source: Journal of Clinical Epidemiology. 2003 September; 56(9): 914-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14505778&dopt=Abstract
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The relation of anxiety sensitivity to higher and lower order personality dimensions: implications for the etiology of panic attacks. Author(s): Lilienfeld SO. Source: Journal of Abnormal Psychology. 1997 November; 106(4): 539-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9358684&dopt=Abstract
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The role of anxiety sensitivity in the pathogenesis of panic: prospective evaluation of spontaneous panic attacks during acute stress. Author(s): Schmidt NB, Lerew DR, Jackson RJ. Source: Journal of Abnormal Psychology. 1997 August; 106(3): 355-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9241937&dopt=Abstract
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The symptom structure of panic attacks. Author(s): Cox BJ, Swinson RP, Endler NS, Norton GR. Source: Comprehensive Psychiatry. 1994 September-October; 35(5): 349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7995026&dopt=Abstract
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Trauma and depersonalization during panic attacks. Author(s): McWilliams LA, Cox BJ, Enns MW. Source: The American Journal of Psychiatry. 2001 April; 158(4): 656-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11282717&dopt=Abstract
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Treatment of Koro and panic attacks after stroke. Author(s): Dantendorfer K, Amering M, Prayer D, Maierhofer D, Schnider P, Katschnig H. Source: Anxiety. 1996; 2(1): 53-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9160601&dopt=Abstract
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Treatment of negative crises (panic attacks). Author(s): Dyukova GM, Shepeleva IP, Vorob'eva OV. Source: Neuroscience and Behavioral Physiology. 1992 July-August; 22(4): 343-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1528426&dopt=Abstract
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Treatment of panic attacks using cognitive therapy without exposure or breathing retraining. Author(s): Salkovskis PM, Clark DM, Hackmann A. Source: Behaviour Research and Therapy. 1991; 29(2): 161-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2021378&dopt=Abstract
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TSH response to TRH in depression with and without panic attacks. Author(s): Gillette GM, Garbutt JC, Quade DE. Source: The American Journal of Psychiatry. 1989 June; 146(6): 743-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2499197&dopt=Abstract
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Types of panic attacks and their association with psychiatric disorder and physical illness. Author(s): Bovasso G, Eaton W. Source: Comprehensive Psychiatry. 1999 November-December; 40(6): 469-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10579380&dopt=Abstract
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Tyramine induced hypertensive episodes and panic attacks in hereditary deficient monoamine oxidase patients: case reports. Author(s): Caston JC, Eaton CL, Gheorghiu BP, Ware LL. Source: J S C Med Assoc. 2002 August; 98(4): 187-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12216380&dopt=Abstract
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Understanding ambulatory care use by people with panic attacks: testing the behavioral model for vulnerable populations. Author(s): Katerndahl DA, Parchman ML. Source: The Journal of Nervous and Mental Disease. 2002 August; 190(8): 554-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12193842&dopt=Abstract
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Understanding panic attacks. Author(s): Blenkiron P. Source: The Practitioner. 2001 October; 245(1627): 866-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11677901&dopt=Abstract
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Unresolved issues in the treatment of agoraphobia with panic attacks. Author(s): Liebowitz MR, Klein DF. Source: Psychopharmacology Bulletin. 1982 October; 18(4): 109-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7156270&dopt=Abstract
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Update on the treatment of panic attacks. Author(s): Davis DM. Source: J Med Assoc Ga. 1988 November; 77(11): 831-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3057099&dopt=Abstract
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Urinary tribulin output in patients with panic attacks. Author(s): Norman TR, Acevedo A, Burrows GD, Judd FK, McIntyre IM. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1988 February; 152: 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3167358&dopt=Abstract
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Use of the Behavioral Model of Health Care Use to identify correlates of use of treatment for panic attacks in the community. Author(s): Goodwin R, Andersen RM. Source: Social Psychiatry and Psychiatric Epidemiology. 2002 May; 37(5): 212-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107712&dopt=Abstract
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Usefulness of olanzapine in refractory panic attacks. Author(s): Khaldi S, Kornreich C, Dan B, Pelc I. Source: Journal of Clinical Psychopharmacology. 2003 February; 23(1): 100-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544382&dopt=Abstract
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Valproate treatment of panic disorder and lactate-induced panic attacks. Author(s): Keck PE Jr, Taylor VE, Tugrul KC, McElroy SL, Bennett JA. Source: Biological Psychiatry. 1993 April 1; 33(7): 542-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8513040&dopt=Abstract
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Vascular reactivity and panic attacks. Author(s): Freedman RR. Source: Jama : the Journal of the American Medical Association. 1985 November 1; 254(17): 2411. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4046161&dopt=Abstract
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CHAPTER 2. NUTRITION AND PANIC ATTACKS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and panic attacks.
Finding Nutrition Studies on Panic Attacks The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “panic attacks” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “panic attacks” (or a synonym): •
A comparison of sodium bicarbonate and sodium lactate infusion in the induction of panic attacks. Author(s): Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY. Source: Gorman, J M Battista, D Goetz, R R Dillon, D J Liebowitz, M R Fyer, A J Kahn, J P Sandberg, D Klein, D F Arch-Gen-Psychiatry. 1989 February; 46(2): 145-50 0003-990X
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Effect of chloride or glucose on the incidence of lactate-induced panic attacks. Author(s): Laboratory of Clinical Studies, NIAAA, Bethesda, MD 20892, USA. Source: George, D T Lindquist, T Nutt, D J Ragan, P W Alim, T McFarlane, V Leviss, J Eckardt, M J Linnoila, M Am-J-Psychiatry. 1995 May; 152(5): 692-7 0002-953X
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Elevated serum lactate associated with panic attacks induced by hyperventilation. Author(s): Department of Psychiatry, University of California, Davis School of Medicine, Sacramento. Source: Maddock, R J Carter, C S Gietzen, D W Psychiatry-Res. 1991 September; 38(3): 301-11 0165-1781
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Induced panic attacks shift gamma-aminobutyric acid type A receptor modulatory neuroactive steroid composition in patients with panic disorder: preliminary results. Author(s): Max Planck Institute of Psychiatry, Munich, Germany.
[email protected] Source: Strohle, A Romeo, E di Michele, F Pasini, A Hermann, B Gajewsky, G Holsboer, F Rupprecht, R Arch-Gen-Psychiatry. 2003 February; 60(2): 161-8 0003-990X
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Neurobiological mechanisms of panic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks. Source: Charney, D S Woods, S W Goodman, W K Heninger, G R Am-J-Psychiatry. 1987 August; 144(8): 1030-6 0002-953X
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Panic attacks during placebo procedures in the laboratory. Physiology and symptomatology. Author(s): Biological Studies Unit, New York State Psychiatric Institute, NY. Source: Goetz, R R Klein, D F Gully, R Kahn, J Liebowitz, M R Fyer, A J Gorman, J M Arch-Gen-Psychiatry. 1993 April; 50(4): 280-5 0003-990X
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Panic attacks. A neurochemical overview of models and mechanisms. Author(s): Colman Psychopharmacology Unit, School of Medical Sciences, University Walk, Bristol. Source: Nutt, D Lawson, C Br-J-Psychiatry. 1992 February; 160165-78 0007-1250
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Psychophysiological and biochemical changes in patients with panic attacks in a defined situational arousal. Author(s): Department of Neurology, Hospital of the University of Freiburg, Germany. Source: Braune, S Albus, M Frohler, M Hohn, T Scheibe, G Eur-Arch-Psychiatry-ClinNeurosci. 1994; 244(2): 86-92 0940-1334
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Sleep panic attacks: new clinical findings and theoretical implications. Author(s): Section on Anxiety and Affective Disorders, NIMH, Bethesda, MD 20892. Source: Mellman, T A Uhde, T W Am-J-Psychiatry. 1989 September; 146(9): 1204-7 0002953X
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Valproate treatment of panic disorder and lactate-induced panic attacks. Author(s): Department of Psychiatry, University of Cincinnati College of Medicine, Ohio 45267-0559.
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Source: Keck, P E Taylor, V E Tugrul, K C McElroy, S L Bennett, J A Biol-Psychiatry. 1993 April 1; 33(7): 542-6 0006-3223 •
Where do panic attack sufferers seek care? Author(s): Department of Family Practice, University of Texas Health Science Center at San Antonio 78284-7795. Source: Katerndahl, D A Realini, J P J-Fam-Pract. 1995 March; 40(3): 237-43 0094-3509
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to panic attacks; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Minerals Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html
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Food and Diet Coffee Source: Healthnotes, Inc.; www.healthnotes.com Omega-3 Fatty Acids Source: Integrative Medicine Communications; www.drkoop.com
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CHAPTER 3. ATTACKS
ALTERNATIVE
MEDICINE
AND
PANIC
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to panic attacks. 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 panic attacks 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 “panic attacks” (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 panic attacks: •
A 28-year-old woman with panic disorder, 1 year later. Author(s): Burns RB, Hartman EE. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 494. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132981&dopt=Abstract
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A 28-year-old woman with panic disorder. Author(s): Gorman JM. Source: Jama : the Journal of the American Medical Association. 2001 July 25; 286(4): 450-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11466124&dopt=Abstract
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A case of panic disorder treated with breathing retraining. Author(s): Rapee RM. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1985 March; 16(1): 63-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3998176&dopt=Abstract
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A clinical study of autogenic training-based behavioral treatment for panic disorder. Author(s): Sakai M. Source: Fukuoka Igaku Zasshi. 1996 March; 87(3): 77-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8727357&dopt=Abstract
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A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder. Author(s): Clark DM, Salkovskis PM, Hackmann A, Middleton H, Anastasiades P, Gelder M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1994 June; 164(6): 759-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7952982&dopt=Abstract
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A concept analysis of panic. Author(s): Beck CT. Source: Archives of Psychiatric Nursing. 1996 October; 10(5): 265-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8897709&dopt=Abstract
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A neuro-evolutionary approach to the anxiety disorders. Author(s): Stein DJ, Bouwer C. Source: Journal of Anxiety Disorders. 1997 July-August; 11(4): 409-29. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9276785&dopt=Abstract
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A review of the usefulness of the standard EEG in psychiatry. Author(s): Hughes JR. Source: Clin Electroencephalogr. 1996 January; 27(1): 35-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8719500&dopt=Abstract
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A scoring system for capnogram biofeedback: preliminary findings. Author(s): Landis B, Romano PM. Source: Applied Psychophysiology and Biofeedback. 1998 June; 23(2): 75-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9789622&dopt=Abstract
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A short unobtrusive hypnotic induction for assessing hypnotizability: II. Clinical case reports. Author(s): Pekala RJ.
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Source: Am J Clin Hypn. 1995 April; 37(4): 284-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7741084&dopt=Abstract •
Acute alkalosis, but not acute hypocalcemia, increases panic behavior in an animal model. Author(s): Di Lorenzo R, Bernardi M, Genedani S, Zirilli E, Grossi G, Guaraldi GP, Bertolini A. Source: Physiology & Behavior. 1987; 41(4): 357-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2829248&dopt=Abstract
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Adverse effect of EMDR: a case report. Author(s): Kaplan R, Manicavasagar V. Source: The Australian and New Zealand Journal of Psychiatry. 1998 October; 32(5): 7312. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9805601&dopt=Abstract
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Agoraphobia and panic disorder: 3.5 years after alprazolam and/or exposure treatment. Author(s): Kilic C, Noshirvani H, Basoglu M, Marks I. Source: Psychotherapy and Psychosomatics. 1997; 66(4): 175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9259039&dopt=Abstract
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Alprazolam reduces response to loud tones in panic disorder but not in posttraumatic stress disorder. Author(s): Shalev AY, Bloch M, Peri T, Bonne O. Source: Biological Psychiatry. 1998 July 1; 44(1): 64-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9646885&dopt=Abstract
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Analysis of the medical use of marijuana and its societal implications. Author(s): Taylor HG. Source: Journal of the American Pharmaceutical Association (Washington,D.C. : 1996). 1998 March-April; 38(2): 220-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9654850&dopt=Abstract
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Anxiety disorders: diagnosis and treatment. Author(s): Jack RA, Mathew RJ. Source: Compr Ther. 1985 July; 11(7): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2863030&dopt=Abstract
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Anxiety management for persistent generalised anxiety. Author(s): Butler G, Cullington A, Hibbert G, Klimes I, Gelder M.
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Source: The British Journal of Psychiatry; the Journal of Mental Science. 1987 October; 151: 535-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3328992&dopt=Abstract •
Anxiety management training for anxiety states: positive compared with negative self-statements. Author(s): Ramm E, Marks IM, Yuksel S, Stern RS. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1982 April; 140: 367-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7093613&dopt=Abstract
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Application of the relaxation technique in general hospital psychiatry. Author(s): Hosaka T, Yamamoto K, Ikeda K, Taniyama F, Yanagisawa J. Source: Psychiatry and Clinical Neurosciences. 1995 December; 49(5-6): 259-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8726110&dopt=Abstract
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Applied relaxation training for generalised anxiety and panic attacks: the efficacy of a learnt coping strategy on subjective reports. Author(s): Tarrier N, Main CJ. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1986 September; 149: 330-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3535980&dopt=Abstract
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Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder. Author(s): Ost LG, Westling BE. Source: Behaviour Research and Therapy. 1995 February; 33(2): 145-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7887873&dopt=Abstract
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Applied relaxation, exposure in vivo and cognitive methods in the treatment of panic disorder with agoraphobia. Author(s): Ost LG, Westling BE, Hellstrom K. Source: Behaviour Research and Therapy. 1993 May; 31(4): 383-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8099789&dopt=Abstract
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Asystole during trigger point injections in a patient with panic disorder. Author(s): Spevak C. Source: Reg Anesth. 1997 November-December; 22(6): 583. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9425979&dopt=Abstract
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Carcinoma of breast and panic attacks. Author(s): Mark P.
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Source: Br Homeopath J. 2000 January; 89(1): 35-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10703910&dopt=Abstract •
Hyperventilation and panic attacks. Author(s): Kenardy J, Oei TP, Evans L. Source: The Australian and New Zealand Journal of Psychiatry. 1990 June; 24(2): 261-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2118758&dopt=Abstract
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Low dose desipramine treatment of cocaine-related panic attacks. Author(s): Bystritsky A, Ackerman DL, Pasnau RO. Source: The Journal of Nervous and Mental Disease. 1991 December; 179(12): 755-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1744635&dopt=Abstract
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Mode of action of the triazolobenzodiazepines in the treatment of panic attacks: a hypothesis. Author(s): Van Gool D, Igodt P, De Cuyper H. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 1992 December; 2(4): 433-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1362662&dopt=Abstract
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Panic attack in a context of comorbid anxiety and depression in a Tibetan refugee. Author(s): Jacobson E. Source: Culture, Medicine and Psychiatry. 2002 June; 26(2): 259-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211327&dopt=Abstract
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Panic attacks and interoceptive acuity for cardiac sensations. Author(s): Asmundson GJ, Sandler LS, Wilson KG, Norton GR. Source: Behaviour Research and Therapy. 1993 February; 31(2): 193-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8442744&dopt=Abstract
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Panic attacks during relaxation and relaxation-induced anxiety: a hyperventilation interpretation. Author(s): Ley R. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1988 December; 19(4): 253-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3148637&dopt=Abstract
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Panic attacks, spike-wave activity, and limbic dysfunction. A case report. Author(s): Gallinat J, Stotz-Ingenlath G, Lang UE, Hegerl U.
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Source: Pharmacopsychiatry. 2003 May; 36(3): 123-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806571&dopt=Abstract •
Psychophysiology of relaxation-associated panic attacks. Author(s): Cohen AS, Barlow DH, Blanchard EB. Source: Journal of Abnormal Psychology. 1985 February; 94(1): 96-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3980861&dopt=Abstract
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Rational self-directed hypnotherapy: a treatment for panic attacks. Author(s): Der DF, Lewington P. Source: Am J Clin Hypn. 1990 January; 32(3): 160-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2296917&dopt=Abstract
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Reactivity to imagery and nocturnal panic attacks. Author(s): Tsao JC, Craske MG. Source: Depression and Anxiety. 2003; 18(4): 205-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14661190&dopt=Abstract
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Respiratory control: its contribution to the treatment of panic attacks. A controlled study. Author(s): Hibbert GA, Chan M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1989 February; 154: 232-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2673476&dopt=Abstract
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Skin conductance feedback and panic attacks. Author(s): Gilbert C. Source: Biofeedback Self Regul. 1986 September; 11(3): 251-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3607092&dopt=Abstract
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Where do panic attack sufferers seek care? Author(s): Katerndahl DA, Realini JP. Source: The Journal of Family Practice. 1995 March; 40(3): 237-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7876780&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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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to panic attacks; 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 Alcohol Withdrawal Source: Healthnotes, Inc.; www.healthnotes.com Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Anxiety Source: Healthnotes, Inc.; www.healthnotes.com Anxiety and Panic Attacks Source: Prima Communications, Inc.www.personalhealthzone.com Fainting Source: Integrative Medicine Communications; www.drkoop.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.drkoop.com Syncope Source: Integrative Medicine Communications; www.drkoop.com
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Vertigo Source: Healthnotes, Inc.; www.healthnotes.com •
Alternative Therapy Hypnotherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,706,00.html Light Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,713,00.html
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Herbs and Supplements Benzodiazepines Source: Healthnotes, Inc.; www.healthnotes.com Inositol Source: Prima Communications, Inc.www.personalhealthzone.com Kava Source: Prima Communications, Inc.www.personalhealthzone.com Kava Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html St. John's Wort Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,824,00.html Valerian Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html Yohimbe Alternative names: Pausinystalia yohimbe Source: Healthnotes, Inc.; www.healthnotes.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page
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dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON PANIC ATTACKS Overview In this chapter, we will give you a bibliography on recent dissertations relating to panic attacks. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “panic attacks” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on panic attacks, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Panic Attacks ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to panic attacks. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Heuristic Study of the Experiential, Transformative Process of Long-term Panic Attacks and Associated Altered States of Consciousness: toward a Transpersonal Perspective by Taylor, Rosemary Elaine; PhD from Institute of Transpersonal Psychology, 2003, 299 pages http://wwwlib.umi.com/dissertations/fullcit/3095416
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Differences in Cognitive Responses to Fear among Individuals Diagnosed As Panic Disorder, Generalized Anxiety Disorder, Agoraphobia with Panic Attacks, and Simple Phobia by Dattilio, Frank Mark, PhD from Temple University, 1987, 232 pages http://wwwlib.umi.com/dissertations/fullcit/8711320
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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. PATENTS ON PANIC ATTACKS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “panic attacks” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on panic attacks, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Panic Attacks By performing a patent search focusing on panic attacks, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 5Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on panic attacks: •
2-{4-[4-(4,5-dichloro-2-methylimidazol-1-yl)butyl]-1-piperazinyl}-5-fluorop yrimidine, its preparation and its therapeutic use Inventor(s): Frigola-Constansa; Jordi (Barcelone, ES), Merce-Vidal; Ramon (Barcelone, ES) Assignee(s): Laboratorios Del Dr. Esteve, S.A. (Barcelone, ES) Patent Number: 6,303,608 Date filed: February 29, 2000 Abstract: 2-{4-[4-(4,5-dichloro-2-methylimidazol-1-yl)butyl]-1-piperazinyl}-5-fluorop yrimidine, and its physiologically acceptable salts; pharmaceutical compositions containing these compounds, and a method of treating vertigo, travel sickness, nausea, depression, anxiety, gastric acid secretion, obsessive/compulsive disorders, panic attacks or sleep apnea using these compounds are disclosed. Excerpt(s): Patents EP 382,637 and EP 497,659 of the Applicant Company disclosed various pyrimidinylpiperazinylalkylazole derivatives having anxiolytic and/or tranquilizing properties. Although Patent EP 382,637 claims pyrimidinylpiperazinylalkylazole derivatives substituted at the 5-position of the pyrimidine by a halogen atom, only two examples of compounds of this type are disclosed and, in both cases, it is a bromine atom. The Applicant Company has now discovered that the introduction of a fluorine atom as substituent at the 5-position of the pyrimidine, in the special case where the azole is an imidazole trisubstituted by a methyl group at the 2-position and by two chlorine atoms at the 4- and 5-positions, gives rise to the compound which is the subject-matter of the present patent, which compound exhibits some advantageous biological properties which make it of particular use in its application in human and/or veterinary therapeutics. In particular, the compound which is the subject-matter of the present patent is of use as an antiemetic against seasickness (nausea caused by motion), as an antidepressant or anxiolytic, as an inhibitor of gastric acid secretion or obsessive-compulsive disorders, in panic attacks and in sleep apnea in mammals, including man. It is possible to prepare the compound 2-{4-[4-(4,5-dichloro-2-methylimidazol-1-yl)butyl]-1-piperazinyl}-5-fluoro pyrimidine and its physiologically acceptable salts according to the invention by one of the processes shown hereinbelow. Web site: http://www.delphion.com/details?pn=US06303608__
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Cholecystokinin antagonists useful in the treatment of panic attacks Inventor(s): Woodruff; Geoffrey N. (Herts, GB) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,318,981 Date filed: March 17, 1993 Abstract: Unnatural dipeptoids of.alpha.-substituted Try-Phe derivatives are useful as agents in the treatment of panic disorders. These dipeptoids are Cholecystokinin-B Receptor (CCK.sub.B) antagonists having utility in the prevention of panic attacks in patients prone to these attacks.
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Excerpt(s): The neuropeptide cholecystokinin-8 (CCK-8) is an important neuromodulator and neurotransmitter in the brain. There are two types of CCK receptor which are currently referred to as CCK.sub.A and CCK.sub.B receptors. The major of the CCK receptor types in brain is the CCK.sub.B receptor (Review by Woodruff & Hughes, Annual Review of Pharmacology Toxicology 31:469-501 (1991)). The functional role of CCK in brain is not fully understood. Recently there has been evidence that CCK is involved in anxiety and that CCK.sub.B antagonists have an anxiolytic action in animal models of anxiety (Hughes, et al, Proc Natnl Acad Sci, USA 87:6728-6732 (1990). It has recently been shown (de Montigny, C Arch Gen Psychiatry 46:511-517 (1989); Bradwejn J, Koszyckl, D, and Metesissian, G, Can J Psychiatr 35:83-85 (1990) that the injection of the tetrapeptide cholecystokinin (30-33) (CCK-4) into human volunteers or into patients suffering from panic disorder precipitates a panic attack. The tetrapeptide cholecystokinin (30-33) (CCK-4) is a substance that stimulates CCK.sub.B receptors, i.e., is a CCK.sub.B antagonist. The injection of the tetrapeptide cholecystokinin (30-33) (CCK-4) into the cerebral ventricles of the brain of rats precipitates the onset of an anxiogenic reaction. This anxiogenic response can be prevented by pretreatment of the rats with the CCK.sub.B antagonist CI-988 (Sing, et al, Proc Natnl Acad Sci USA 88:11301133 (1991)). Web site: http://www.delphion.com/details?pn=US05318981__ •
Duplications of human chromosome 15q24-25 and anxiety disorders, diagnostic methods for their detection Inventor(s): Estivill Palleja; Xavier (Barcelona, ES), Gratacos; Monica (Barcelona, ES), Nadal; Marga (Barcelona, ES), Pujana; Miguel Angel (Barcelona, ES), Volpini; Victor (Barcelona, ES) Assignee(s): Palleja, Zavier Estivell (Barcelona, ES) Patent Number: 6,225,057 Date filed: July 23, 1998 Abstract: A method for identifying a person at risk for developing an anxiety disorder, said anxiety disorder selected from the group consisting of agoraphobia, social phobia, panic attacks, panic disorders, simple phobia, mood disorders, major depression, schizophrenia, and hypermobility syndrome associated with duplication of a region of the genomic sequence of human chromosome 15q24-25 defined by boundaries D15S925 (proximal end) and DS15S736 (distal end). The method comprises identifying the presence of duplication in the region of the genomic sequence of human chromosome 15q24-25 defined by the boundaries D15S925 (proximal end) and DS15S736 (distal end) in said person. Excerpt(s): Panic disorder, agoraphobia, social phobia and other anxiety disorders affect 5-10% of the general population. There are no biochemical, cytological or molecular tools for the diagnosis of anxiety disorders. Moreover, the gene or genes predisposing to anxiety disorders have not yet been localised. We have studied the clinical association between panic/agoraphobia and joint hypermobility syndrome, and have identified several pedigrees in which these disorders cosegregate. We have detected a 10 centiMorgan (cM) duplication of human chromosome 15 (15q24-25) in the affected subjects of families with several members suffering from anxiety and depression disorders. The 15q24-25 duplication segregates with panic disorder, agoraphobia, social phobia, depression and joint hypermobility syndrome. The 15q24-25 duplication is strongly linked to panic disorder, agoraphobia, social phobia and joint hypermobility
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syndrome (lod score 4.9). Affected-only analysis for the phenotype defined only by the anxiety disorders gave a lod score of 3.36. All but one of the 45 subjects of these families with these anxiety disorders had the 15q24-25 duplication. Mosaicism was detected in 80% of the affected subjects, with 40-70% of their lymphocytes having the 15q24-25 duplication. We have also studied 50 unrelated non-familial cases of panic disorder and/or agoraphobia and all had the 15q24-25 duplication. The duplicated region contains 10 known genes of which NTRK3 and LOXL1 are likely to be involved in anxiety and joint hypermobility. We propose that this genomic mutation, which is present in 7% of the general population, is the major susceptibility mutation for panic disorder, agoraphobia, major depression and social phobia in familial and sporadic cases. We have developed cytological, cytogenetic and molecular methods for the specific diagnosis of the 15q24-25 duplication causing anxiety disorders. Anxiety disorders are neurotic alterations that include generalised anxiety disorder, phobic disorders, panic disorders (panic attacks, panic disorder and agoraphobia) and obsessive-compulsive disorders. The prevalence of this group of alterations is estimated in about 10% in the adult population and up to 5% in infantile patients. Several million people worldwide are affected by anxiety disorders, but the actual prevalence rates of these alterations are probably higher. Anxiety and panic disorders aggregate in families. The familial transmission of anxiety disorders has often been explained by common familial environmental factors. Twin studies of anxiety disorders have shown a high concordance among monozygotic twins. The mode of familial transmission of panic disorder is unclear, but it has been suggested that anxiety, panic attacks and agoraphobia have an autosomal dominant pattern of inheritance with incomplete penetrance. Although a major gene is supposed to be involved in panic disorder, multifactorial/polygenic inheritance has also been postulated. Web site: http://www.delphion.com/details?pn=US06225057__ •
Gepirone for alleviation of panic disorders Inventor(s): Kurtz; Neil (Weston, CT), Newton; Roger E. (Evansville, IN), Temple, Jr.; Davis L. (Wallingford, CT) Assignee(s): Bristol-Myers Company (New York, NY) Patent Number: 4,782,060 Date filed: July 29, 1987 Abstract: Gepirone and its pharmaceutically acceptable salts are useful in alleviation of panic disorders which can take the form of clinical syndromes comprising, for example, panic attacks, agoraphobia and phobic anxiety. Excerpt(s): This invention is concerned with a drug bio-affecting body-treating process which employs the pyrimidine compound 4,4-dimethyl-1-[4-[4-(2-pyrimidinyl)-1piperazinyl]butyl]-2,6-piperidinedi one or a pharmaceutically acceptable acid addition salt thereof. The synthesis of the compound and the disclosure of its anxiolytic properties are described in the following patents and publications. 1. D. L. Temple, Jr., U.S. Pat. No. 4,423,049, issued Dec. 27, 1983. Web site: http://www.delphion.com/details?pn=US04782060__
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Method and apparatus for manipulating nervous systems Inventor(s): Loos; Hendricus G. (3019 Cresta Way, Laguna Beach, CA 92651) Assignee(s): none reported Patent Number: 5,782,874 Date filed: January 24, 1997 Abstract: Apparatus and method for manipulating the nervous system of a subject through afferent nerves, modulated by externally applied weak fluctuating electric fields, tuned to certain frequencies such as to excite a resonance in certain neural circuits. Depending on the frequency chosen, excitation of such resonances causes relaxation, sleepiness, sexual excitement, or the slowing of certain cortical processes. The weak electric field for causing the excitation is applied to skin areas away from the head of the subject, such as to avoid substantial polarization current densities in the brain. By exploiting the resonance phenomenon, these physiological effects can be brought about by very weak electric fields produced by compact battery-operated devices with very low current assumption. The fringe field of doublet electrodes that form a parallel-plate condenser can serve as the required external electric field to be administered to the subject's skin. Several such doublets can be combined such as to induce an electric field with short range, suitable for localized field administration. A passive doublet placed such as to face the doublet on either side causes a boost of the distant induced electric field, and allows the design of very compact devices. The method and apparatus can be used by the general public as an aid to relaxation, sleep, or arousal, and clinically for the control and perhaps the treatment of tremors and seizures, and disorders of the autonomic nervous system, such as panic attacks. Excerpt(s): The invention relates to electrical neurostimulation, wherein electric currents are passed to the brain, the spinal cord, an organ, or peripheral nerves ›1-3!. Such stimulation has been used with various degrees of success for anesthesia, induction of relaxation and sleep, as well as for the treatment of pain, intractable epilepsy, behavioral disorders, movement disorders, and cardiac arrhythmia. The electric current is usually delivered by contact electrodes i.e., electrodes that are in Ohmic contact with the biological tissue. An exception is the capacitor electrode of Guyton and Hambrecht ›4!, which consists of an implanted porous tantalum disc with a thin insulating coating of tantalum pentoxide. After implantation, the pores fill with extracellular fluid and thus present a large capacitive interface to the fluid. The electrode is capable of delivering sizable currents to tissue without causing accumulation of electrochemical byproducts. Mauro ›5! has proposed another capacitor electrode in which one of the "plates" of a large capacitor is formed by an electrolyte that is in Ohmic contact with the tissue, via a thin tube. In both these cases the capacitance employed is large, such as to pass currents of a magnitude and duration large enough to cause firing of the nerves, as expressed by the strength-duration curve with typical times of 0.1 ms and currents of the order of 1 mA ›6,7!. The nerves fire as a result of substantial depolarization of the nerve membrane by the applied electric current, a process here called classical nerve stimulation. An area of neurostimulation that has attracted much attention is the induction of relaxation and sleep. One method, called Cranial Electric Stimulation (CES) involves passing an alternating current through the brain via contact electrodes attached to the head or held in the mouth. With properly chosen strength and frequency, these currents may excite or support brain waves that accompany deep sleep. The method has been explored extensively in the Former Soviet Union, under the name "Electrosleep". A commercially available device is the Japanese "Sleepy" ›8!, which generates for one hour square pulses of 4 V and 0.2 ms duration, with a frequency that sweeps from 14 to 0 Hz, every 3
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minutes. The device requires contact electrodes placed on the head. Other commercial CES devices ›9! are Alpha Stim, Mindman, and Endo Stim, which all require contact electrodes attached to the head. Web site: http://www.delphion.com/details?pn=US05782874__ •
Method and system for applying low energy emission therapy Inventor(s): Barbault; Alexandre (Colmar, FR), Chang; Rea-Woun (Singapore, SG), Kunz; Henry (Zurich, CH), Kuster; Niels (Zurich, CH), Lebet; Jean-Pierre (Montreaux, CH), Pasche; Boris (New York, NY) Assignee(s): Symtonic, S.A. (CH) Patent Number: 5,441,528 Date filed: September 25, 1992 Abstract: A low energy emission therapy system is provided which includes an emitter of low energy electromagnetic emissions and a probe for applying the emissions to a patient under treatment. The emitter emits a high frequency electromagnetic emission in the form of a carrier signal modulated by a plurality of modulation signals. The invention also includes an impedance transformer located intermediate the emitter and the probe in order to match the impedance of the patient with that of the output of the emitter. Particular modulation signal frequencies and application times and sequences are provided for the treatment of insomnia, and for the treatment of general anxiety disorder which may include panic attacks. Excerpt(s): The invention relates to systems and methods for applying low energy emission therapy for the treatment of central nervous system disorders. Low energy emission therapy involving application of low energy electromagnetic emissions to a patient has been found to be an effective mode of treating a patient suffering from central nervous system (CNS) disorders such as generalized anxiety disorders, panic disorders, sleep disorders including insomnia, circadian rhythm disorders such as delayed sleep, psychiatric disorders such as depression, obsessive compulsive disorders, disorders resulting from substance abuse, sociopathy, post traumatic stress disorders or other disorders of the central nervous system. Apparatus and methods for carrying out such treatment are described in U.S. Pat. Nos. 4,649,935 and 4,765,322, assigned to the same assignee as the present application, the disclosures of which are expressly incorporated herein by reference. Since the time of these earlier disclosures, a substantially greater understanding of the mechanisms of the treatment and how to secure best results has been gained, which has led to important developments being made to the apparatus (herein described as a system). Although the apparatus and methods described in the above patents have provided satisfactory results in many cases, consistency and significance of results has sometimes been lacking. Also, it was not always possible to properly control or monitor the duration of treatment or the quantities or nature of the low energy emissions being applied to the patient. Furthermore, the efficiency of transfer of the low energy emissions to the patient was limited and was affected by such factors as patient movement, outside interference and the like. Web site: http://www.delphion.com/details?pn=US05441528__
Patents 81
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Method for alleviation of panic disorders Inventor(s): Kurtz; Neil M. (Westport, CT), Newton; Roger E. (Evansville, IN), Temple, Jr.; Davis L. (Wallingford, CT) Assignee(s): Bristol-Myers Company (New York, NY) Patent Number: 4,634,703 Date filed: October 25, 1985 Abstract: Buspirone and its pharmaceutically acceptable salts are useful in alleviation of panic disorders which can take the form of clinical syndromes comprising, for example, panic attacks, agoraphobia and phobic anxiety. Excerpt(s): This invention is concerned with a drug bioaffecting body-treating process which employs the pyrimidine compound 8-[4-[4-(2-pyrimidinyl)-1-piperazinyl]butyl]8-azaspiro[4.5]decane-7,9-dio ne or a pharmaceutically acceptable acid addition salt thereof. The synthesis of the compound and the disclosure of its psychotropic properties are described in the following patents and publications. 1. Y. H. Wu, et al., J. Med. Chem., 15, 477 (1972). Web site: http://www.delphion.com/details?pn=US04634703__
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Method for the treatment of panic disorder Inventor(s): Schweizer; Edward E. (Wilmington, DE) Assignee(s): Trustees of the University of Pennsylvania (Philadelphia, PA) Patent Number: 5,166,202 Date filed: December 13, 1991 Abstract: Midazolam and its pharmaceutically acceptable salts are useful in the treatment of panic disorder, panic attacks and the prevention of panic attacks. Excerpt(s): This invention relates to a method for treatment of panic disorder. More particularly, a method of treating panic disorder with intranasal midazolam is provided. Panic disorder is an illness which is estimated to afflict 1.5-2% of the adult population. The hallmark of panic disorder is the sudden, crescendo panic attack which may be as fleeting as a few minutes in duration, or may persist for over an hour before subsiding. The majority of patients suffering from panic disorder report an average attack frequency (four 4-symptom attacks) of less than one per day, which is true even for many moderate-to-severely ill patients such as those treated in the large Cross-National Collaborative Panic Study (Ballenger, J. C. et al., "Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment," Arch Gen Psychiatry, 45:413-422 (1988)). Current treatment strategies for panic disorder focus on attempts to control and prevent these intermittent, but severe and often disabling panic attacks, and thereby to reduce the associated inter-episode anticipatory anxiety, phobic avoidance, and somatic preoccupations. To accomplish this effectively with drug therapy requires daily doses of high potency benzodiazepines such as alprazolam, or daily doses of antidepressants such as imipramine. Web site: http://www.delphion.com/details?pn=US05166202__
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Method of treating symptoms of panic attacks Inventor(s): Cox; Stephen M. (Lexington, KY), Lawrence; Lowell J. (Richmond, KY) Assignee(s): PTRL East, Inc. (Richmond, KY) Patent Number: 6,432,172 Date filed: March 7, 1996 Abstract: A method is provided for treating an individual for the symptoms of panic disorder and related maladies including agoraphobia, social phobia and claustrophobia. The method includes the step of reducing the levels of carbon dioxide being inspired by the individual. Excerpt(s): The present invention relates generally to the medical treatment field and, more particularly, to a method of treating the symptoms of panic attacks resulting from panic disorder, agoraphobia, social phobia and claustrophobia. Anxiety has been defined as a feeling of fear, dread or apprehension that arises without a clear or appropriate justification. Anxiety includes a number of symptoms that are physical, psychological and behavioral in nature. Anxiety during a panic attack may manifest itself in a number of physical signs that are typically produced from over activity of the sympathetic nervous system or even from tension in the skeletal muscles. These physical manifestations include palpitations, dry mouth, dilation of the pupils, sweating, throat tightening, trembling, dizziness and even nausea. Psychological manifestations include irritability, restlessness and loss of concentration. Behavioral manifestations primarily include avoidance behavior: that is, running away from the feared object or situation. This avoidance behavior is commonly associated with specific environments including shopping malls, stores, restaurants, church services, meetings, classes, automobiles (particularly on bridges, in tunnels or in congested traffic), airplanes and elevators. Many of these "agoraphobic environments" may be characterized as an enclosed space with a high ratio of the number of people to the volume of air in the enclosed space. Of course, where a relatively large number of individuals are exhaling carbon dioxide (CO.sub.2) into a relatively small volume of enclosed space the ambient level of carbon dioxide rises. In fact the CO.sub.2 level may rise by as much as 200% or more above the level present in the ambient outdoor atmosphere. Web site: http://www.delphion.com/details?pn=US06432172__
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Methods for treating anxiety and panic Inventor(s): Brown; Jason Peter (Stapleford, GB), Gee; Nicolas Steven (Stansted, GB), Singh; Lakhbir (Haddenham, GB), Woodruff; Geoffrey Neil (Dassels, GB) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,792,796 Date filed: June 6, 1995 Abstract: The instant invention is novel uses of known cyclic amino acids. Such compounds as gabapentin are useful in the treatment of anxiety and in the treatment and/or prevention of panic attacks. Excerpt(s): The present invention relates to novel therapeutic uses of a known compound, gabapentin, its derivatives, and pharmaceutically acceptable salts. The present invention concerns a method for treating and/or preventing anxiety in a mammal in need of such treatment. It also concerns treating and/or preventing panic
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attacks in a mammal. U.S. Pat. No. 5,084,479 concerns a method for treating neurodegenerative disorders. Such neurodegenerative disorders are, for example, Alzheimer's disease, Huntingdon's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis. It also covers treating those neurodegenerative disorders termed acute brain injury. These include but are not limited to: stroke, head trauma, and asphyxia. Web site: http://www.delphion.com/details?pn=US05792796__ •
Methods of using a somatostatin analogue Inventor(s): Moreau; Jacques-Pierre (Upton, MA) Assignee(s): Biomeasure, Inc. (Milford, MA) Patent Number: 6,150,333 Date filed: July 26, 1999 Abstract: The present invention is directed to a method of treating one or more of the following disease and/or conditions, which comprises administering to a patient in need thereof the compound H-.beta.-D-Nal-Cys-Tyr-D-Trp-Lys-Val-Cys-Thr-NH.sub.2, where the Cysteines are bonded by a disulfide bond, or a pharmaceutically acceptable salt thereof, most preferably the acetate salt of the compound, in the treatment of certain diseases and/or conditions such as gastroenterological conditions and/or diseases, endocrinological diseases and/or conditions, various types of cancers and conditions associated with cancer such as cancer cachexia and in the treatment of hypotension and panic attacks. Excerpt(s): The present invention is directed to a method of treating one or more of the following diseases and/or conditions in a patient in need thereof, which comprises the administration of the compound of the formula H-.beta.-D-Nal-Cys-Tyr-D-Trp-Lys-ValCys-Thr-NH.sub.2 (also known as lanreotide), where the two Cysteines are bonded by a disulfide bond, or a pharmaceutically acceptable salt thereof, most preferably the acetate salt of the compound, in the treatment of certain diseases and/or conditions such as gastroenterological conditions and/or diseases, such as Crohn's disease, systemic sclerosis, external and internal pancreatic pseudocysts and ascites, VIPoma, nesidoblastosis, hyperinsulinism, gastrinoma, Zollinger-Ellison Syndrome, diarrhea, AIDS related diarrhea, chemotherapy related diarrhea, scleroderma, Irritable Bowel Syndrome, pancreatitis, upper gastrointestinal bleeding, postprandial portal venous hypertension especially in cirrhotic patients, complications of portal hypertension, small bowel obstruction, gastroesophageal reflux, duodenogastric reflux and in treating endocrinological diseases and/or conditions, such as Cushing's Syndrome, gonadotropinoma, hyperparathyroidism, Graves' Disease, diabetic neuropathy, macular degeneration, hypercalcemia of malignancy, Paget's disease, and polycystic ovary disease; in treating various types of cancer such as thyroid cancer, leukemia, meningioma and conditions associated with cancer such as cancer cachexia; in the treatment of such conditions as hypotension such as orthostatic hypotension and postprandial hypotension and panic attacks. Lanreotide is an analog of somatostatin and is known to inhibit growth hormone release as well as inhibit insulin, glucagon and pancreatic exocrine secretion. U.S. Pat. No. 4,853,371 discloses lanreotide, a method for making it and a method for inhibiting the secretion of growth hormone, insulin, glucagon and pancreatic exocrine secretion. Web site: http://www.delphion.com/details?pn=US06150333__
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Pro-drugs for CCK antagonists Inventor(s): Horwell; David C. (Cambridge, GB2), Pritchard; Martyn C. (Cambridge, GB2), Richardson; Reginald S. (Suffolk, GB2) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,554,643 Date filed: April 13, 1994 Abstract: Novel pro-drugs to new and unnatural depeptoids of.alpha.-substituted TrpPhe derivatives useful as agents in the treatment of obesity, hypersecretion of gastric acid in the gut, gastrin-dependent tumors, or as antipsychotics are disclosed. Further, the dipeptoids are antianxiety agents and antiulcer agents. They are agents useful for preventing the response to the withdrawal from chronic treatment or with use of nicotine, diazepam, alcohol, cocaine, caffeine, or opioids. The pro-drugs are also useful in treating and/or preventing panic attacks. Also disclosed are pharmaceutical compositions and methods of treatment using the pro-drugs as well as processes for preparing them and novel intermediates useful in their preparation. An additional feature of the invention is the use of the subject pro-drug compounds in diagnostic compositions. Excerpt(s): Agents acting at central cholecystokinin (CCK) receptors may induce satiety (Schick, Yaksh and Go, Regulatory Peptides 14:277-291, 1986). They are also expected to act as analgesics (Hill, Hughes and Pittaway, Neuropharmacology 26:289-300, 1987), and as anticonvulsants (MacVicar, Kerrin and Davison, Brain Research 406:130-135, 1987). Reduced levels of CCK-peptides have been found in the brains of schizophrenic patients compared with controls (Roberts, Ferrier, Lee, Crow, Johnstone, Owens, BacareseHamilton, McGregory, O'Shaughnessey, Polak and Bloom. Brain Research 288:199-211, 1983). It has been proposed that changes in the activity of CCK neurones projecting to the nucleus accumbens may play a role in schizophrenic processes by influencing dopaminergic function (Totterdell and Smith, Neuroscience 19:181-192, 1986). This is consistent with numerous reports that CCK peptides modulate dopaminergic function in the basal ganglia and particularly the nucleus accumbens (Weiss, Tanzer, and Ettenberg, Pharmacology, Biochemistry and Behaviour 30:309-317, 1988; Schneider, Allpert and Iversen, Peptides 4:749-753, 1983. It may therefore be expected that agents modifying CCK receptor activity may have therapeutic value in conditions associated with disturbed function of central dopaminergic function such as schizophrenia and Parkinson's disease. The CCK peptides are widely distributed in various organs of the body including the gastrointestinal tract, endocrine glands, and the nerves of the peripheral and central nervous systems. Various biologically active forms have been identified including a 33-amino acid hormone and various carboxyl-terminus fragments of this peptide (e.g., the octapeptide CCK26-33 and the tetrapeptide CCK30-33). (G. J. Dockray, Br. Med. Bull. 38(3):253-258, 1982). Web site: http://www.delphion.com/details?pn=US05554643__
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Pulsative manipulation of nervous systems Inventor(s): Loos; Hendricus G. (3019 Cresta Way, Laguna Beach, CA 92651) Assignee(s): none reported Patent Number: 6,091,994 Date filed: August 31, 1998
Patents 85
Abstract: Method and apparatus for manipulating the nervous system by imparting subliminal pulsative cooling to the subject's skin at a frequency that is suitable for the excitation of a sensory resonance. At present, two major sensory resonances are known, with frequencies near 1/2 Hz and 2.4 Hz. The 1/2 Hz sensory resonance causes relaxation, sleepiness, ptosis of the eyelids, a tonic smile, a "knot" in the stomach, or sexual excitement, depending on the precise frequency used. The 2.4 Hz resonance causes the slowing of certain cortical activities, and is characterized by a large increase of the time needed to silently count backward from 100 to 60, with the eyes closed. The invention can be used by the general public for inducing relaxation, sleep, or sexual excitement, and clinically for the control and perhaps a treatment of tremors, seizures, and autonomic system disorders such as panic attacks. Embodiments shown are a pulsed fan to impart subliminal cooling pulses to the subject's skin, and a silent device which induces periodically varying flow past the subject's skin, the flow being induced by pulsative rising warm air plumes that are caused by a thin resistive wire which is periodically heated by electric current pulses. Excerpt(s): The invention relates to influencing the nervous system of a subject by pulsative stimulation of sensory receptors, relying on the mechanisms of sensory resonance and frequency modulation of spontaneous spike patterns, as discussed in U.S. Pat. No. 5,782,874. [1]. In that patent, the stimulation is provided by an external electric field applied to the skin of the subject. The electric field appears to cause a modulation of the spiking patterns of certain cutaneous receptors, so that a pulsative field gives rise to a frequency modulation (fm) of the produced spike trains. Afferent nerves carry the frequency modulated spike trains to the brain, where in certain neural circuits the evoked fm signals cause excitation of a resonance with observable physiological consequences. One such "sensory resonance" that occurs near 1/2 Hz causes sleepiness, relaxation, a tonic smile, ptosis of the eyelids, a tense feeling in the stomach, or sexual excitement, depending on the precise pulse frequency used. The 1/2 Hz sensory resonance can also be excited by magnetic fields, as discussed in U.S. Pat. No. 5,935,054 [2]. Another known sensory resonance occurs near 2.4 Hz and causes a slowing of certain cortical activities. Experiments have shown that sensory resonances can be excited by imparting cooling pulses to the skin, when the pulse frequency is set to the resonance frequency of the sensory resonance, and the pulses have a proper subliminal amplitude. The sensory resonance near 1/2 Hz causes autonomic responses characterized by relaxation, sleepiness, ptosis of the eyelids, a tonic smile, a "knot" in the stomach, or sexual excitement, depending on the precise frequency used. The sensory resonance near 2.4 Hz causes slowing of certain cortical activities and is indicated by a large increase in the time needed to count silently backward from 100 to 60, with the eyes closed. The described effects occur only if the amplitude of the cooling pulses falls in a certain range called the effective intensity window. Web site: http://www.delphion.com/details?pn=US06091994__ •
Serotonin receptor binding benzo[e]isoindoles and benzo[h]isoquinolines Inventor(s): Bos; Michael (Rheinfelden, CH), Stadler; Heinz (Rheinfelden, CH), Wichmann; Jurgen (Steinen, DE) Assignee(s): Hoffmann-La Roche Inc. (Nutley, NJ) Patent Number: 6,310,208 Date filed: January 6, 1998
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Abstract: Since the compounds in accordance with the invention can bind to serotonin receptors (5HT.sub.2), they are especially suitable for the treatment or prevention of central nervous disorders such as depressions, bipolar disorders, anxiety states, sleep and sexual disorders, psychoses, schizophrenia, migraine and other conditions associated with cephalic pain or pain of a different kind, personality disorders or obsessive-compulsive disorders, social phobias or panic attacks, mental organic disorders, mental disorders in childhood, aggressivity, age-related memory disorders and behavioral disorders, addiction, obesity, bulimia etc., nervous system damage caused by trauma, stroke, neurodegenerative diseases etc.; cardiovascular disorders such as hypertension, thrombosis, stroke etc.; and gastrointestinal disorders such as dysfunction of the gastrointestinal tract motility. Excerpt(s): Serotonin is a vasoconstrictor and neurotransmitter present in the brain, intestinal tissue and blood platelets. Regulation of the binding of serotonin can provide a method of treatment and prevention of a variety of illnesses including central nervous disorders, personality disorders, nervous system damage, cardiovascular disorders and gastrointestinal disorders. The compounds of this invention bind to serotonin receptors and are suitable for treatment of many therapeutic indications including those listed above. n signifies 0 or 1 as well as pharmaceutically acceptable acid addition salts of the compounds of formula I, with the exception of racemic 2-methyl-1,3,4,4a,5,10bhexahydro-2H-benzo[h]isoquinolin-6-one. The compounds of formula I are novel with the exception of rac. 2-methyl-1,3,4,4a,5,10b-hexahydro-2H-benzo[h]isoquinolin-6-one (DE 19 26 022). The compounds described in this Offenlegungsschrift have antiphologistic properties for use against inflammations as well as oedemas following contusions, distortions or fractures. Web site: http://www.delphion.com/details?pn=US06310208__ •
Surface stimulation of specific acupuncture points to reduce anxiety Inventor(s): Garcia-Rill; Edgar (Roland, AR), Gellman; Harris (Little Rock, AR), Skinner; Robert D. (Little Rock, AR) Assignee(s): Board of Trustees of the University of Arkansas (Little Rock, AR) Patent Number: 5,950,635 Date filed: January 20, 1998 Abstract: A method of treating various anxiety-related disorders, such as PostTraumatic Stress Disorder, panic attacks, or general anxiety disorder is disclosed. It has been found that the P1 midlatency auditory evoked potential of such patients undergoes increased amplitude and decreased habituation. Stimulation of three specific acupuncture points LR3, HT3, and PC6) on three different acupuncture meridians has been found to reduce the amplitude of the P1 potential using 20-minute periods of stimulation. Low frequency stimulation (around 5 Hz) was found to be most effective. Repeated periods of stimulation were also found to increase the effect of the treatment. Excerpt(s): The present invention relates generally to the stimulation of acupuncture points to effect medical treatment. The present invention relates particularly to the stimulation of three acupuncture points to treat anxiety-related disorders. For more than three thousand years, Chinese physicians have used acupuncture to alleviate pain and treat a myriad of diseases. While the principles underlying the effectiveness of acupuncture as a treatment form are not yet completely understood, it has been well recognized that the stimulation of certain points on the human body has therapeutic
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effects. Such stimulation may be effected through the insertion of needles, activation of surface electrodes, or other means. The practice of acupuncture is based on the theory that certain lines running across the human body, referred to as meridians, are each associated with a certain organ. For example, the Lung Meridian (designated "L") runs from the tip of the thumb, along the forearm above the radius, and up to the shoulder. Other meridians include the Liver Meridian ("LR"), Stomach Meridian ("S"), Spleen Meridian ("SP"), Heart Meridian ("HT"), and Pericardium Meridian ("PC"). Along these meridians are certain points that, when stimulated, have certain effects (either therapeutic or deleterious) on the human body. Points along a meridian are designated by the meridian symbol combined with a number for that point; for example, the point on the Lung Meridian that lies just above the joint between the radius and the humerus is designated "L5". The stimulation of each point along a meridian is believed to have an effect different from the stimulation of other points along the same meridian. Thus according to acupuncture theory, the correct location of the proper meridian, and the correct location of the proper point along that meridian, is crucial to effecting a proper treatment. In particular, the traditional acupuncture treatment to relieve anxiety-related disorders requires the insertion of needles at two specific points, LR3 and HT3. A standard reference work identifying the acupuncture meridians and points, and the believed effects of stimulating many of those points, is Charles A. Meeker, Acupuncture for the Practitioner or Advanced Student (3d Ed. 1979), which is incorporated by reference herein. Web site: http://www.delphion.com/details?pn=US05950635__ •
Treatment of panic attacks Inventor(s): Hogg; Sandra (Frederiksberg, DK), Jessa; Maria (Warsawa, PL), Sanchez; Connie (Glostrup, DK) Assignee(s): H. Lundbeck A/S (Valby-Copenhagen, DK) Patent Number: 6,262,061 Date filed: October 6, 2000 Abstract: The compound 1'-[4-[1-(4-fluorophenyl)-1H-indole-3-yl]-1-butyl]spiro[isobenzo-furan-1( 3H),4'-piperidine] is active in models predictive of effect on panic attacks and is useful for the preparation of a medicament for the treatment of diseases associated with panic attacks. Excerpt(s): The present invention relates to the use of the compound 1'-[4-[1-(4fluorophenyl)-1H-indole-3-yl]-1-butyl]-spiro[isobenzofuran-1(3 H),4'-piperidine] or a pharmaceutically acceptable salt thereof for the preparation of medicaments for the treatment of panic attacks. International Patent Publication No. WO 92/22554 describes a series of sigma receptor ligands considered useful for the treatment of a range of psychic and neurological disorders. The structure activity relationship of these compounds has been further investigated by Perregaard, J. et al., J. Med. Chem., 1995, 38, 11,p. 1998-2008. which is the subject of the present invention. This compound was shown in Perregaard, J. et al., J. Med. Chem., 1995, 38, 11, p. 1998-2008 to be a potent and selective sigma ligand, in particular a sigma, ligand. Furthermore, the anxiolytic potential of the compound was tested in the black/white exploration test in rats, which is an animal model predictive for effect in the treatment of generalised anxiety disorder. It was found to be active over a large dose range. Results of further tests in generalised anxiety disorder models are reported in J. Pharmacol Exp Ther., 1997, 283, No. 2.
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Web site: http://www.delphion.com/details?pn=US06262061__
Patent Applications on Panic Attacks As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to panic attacks: •
Antidepressant azaheterocyclylmethyl derivatives of oxaheterocycle-fused-[1,4]benzodioxans Inventor(s): Gao, Hong; (Plainsboro, NJ), Gildersleeve, Elizabeth S.; (San Diego, CA), Stack, Gary P.; (Ambler, PA) Correspondence: Wyeth; Patent Law Group; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20020183353 Date filed: April 24, 2002 Abstract: Compounds of the formula 1useful for the treatment of depression such as obsessive compulsive disorder, panic attacks, generalized anxiety disorder, social anxiety disorder, sexual dysfunction, eating disorders, obesity, addictive disorders caused by ethanol or cocaine abuse and related illnesses Excerpt(s): This application claims priority from co-pending provisional application serial No. 60/286,569, filed on Apr. 26, 2001, the entire disclosure of which is hereby incorporated by reference. Major depression is a serious health problem affecting more than 5% of the population, with a life-time prevalence of 15-20%. Selective serotonin reuptake inhibitors have produced significant success in treating depression and related illnesses and have become among the most prescribed drugs. They nonetheless have a slow onset of action, often taking several weeks to produce their full therapeutic effect. Furthermore, they are effective in fewer than two-thirds of patients. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Dihydroimidazo[2,1-b]thiazole antidepressant agents
and
dihydro-5h-thiazolo[3,2-A]pyrimidines
as
Inventor(s): Doyle, Kevin James; (Nottingham, GB), Kerrigan, Frank; (Nottingham, GB), Watts, John Paul; (Nottingham, GB) Correspondence: Bromberg & Sunstein Llp; 125 Summer Street; Boston; MA; 02110-1618; US Patent Application Number: 20030166628 Date filed: January 16, 2003 Abstract: The present invention relates to certain novel substituted dihydroimidazo[2,1b]thiazole and dihydro-5H-thiazolo[3,2-a]pyrimidine compounds of Formula (I) including pharmaceutically acceptable salts thereof in which have affinity for 56
This has been a common practice outside the United States prior to December 2000.
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HT.sub.1A receptors and which inhibits neuronal reuptake of 5-hydroxytryptamine and/or noradrenaline, to processes for their preparation, to pharmaceutical compositions containing them and to their use in the treatment of depression, anxiety, psychoses (for example schizophrenia), tardive dyskinesia, obesity, drug addiction, drug abuse, cognitive disorders, Alzheimer's disease, obsessive-compulsive behaviour, panic attacks, social phobias, eating disorders such as bulimia, anorexia, snacking and binge eating, non-insulin dependent diabetes mellitus, hyperglycaemia, hyperlipidaemia, stress, as an aid to smoking cessation and in the treatment and/or prophylaxis of seizures, neurological disorders such as epilepsy and/or in which there is neurological damage such as stroke, brain trauma, cerebral ischaemia, head injuries and haemorrhage. Excerpt(s): The present invention relates to certain novel substituted dihydroimidazo[2,1-b]thiazole and dihydro-5H-thiazolo[3,2-a]pyrimidine compounds which have affinity for 5-HT.sub.1A receptors and which inhibit neuronal reuptake of 5hydroxytryptamine and/or noradrenaline, to processes for their preparation, to pharmaceutical compositions containing them and to their use in the treatment of depression, anxiety, psychoses (for example schizophrenia), tardive dyskinesia, obesity, drug addiction, drug abuse, cognitive disorders, Alzheimer's disease, obsessivecompulsive behaviour, panic attacks, social phobias, eating disorders such as bulimia, anorexia, snacking and binge eating, non-insulin dependent diabetes mellitus, hyperglycaemia, hyperlipidaemia, stress, as an aid to smoking cessation and in the treatment and/or prophylaxis of seizures, neurological disorders such as epilepsy and/or conditions in which there is neurological damage such as stroke, brain trauma, cerebral ischaemia, head injuries and haemorrhage. are useful in the treatment of depression, anxiety, Parkinson's disease, obesity, cognitive disorders, seizures, neurological disorders such as epilepsy, and as neuroprotective agents to protect against conditions such as stroke. The compounds of the present invention are not disclosed or suggested in this document. Sharpe C. J and Shadbolt R. S. (Journal of Medicinal Chemistry, 1971, Vol 14 No.10, p977-982) disclose certain dihydroimidazo[2,1-b]thiazole compounds having antidepressant activity. However, the document also states that these compounds were generally less active and more toxic than the imidazolines also disclosed in the document. The compounds of the present invention are not disclosed or suggested in this document. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods and kits for treating depression or preventing deterioration of cognitive function Inventor(s): Day, Wesley W.; (San Diego, CA), Lee, Andrew G.; (Old Lyme, CT), Petrie, Charles D.; (Cranston, RI), Thompson, David D.; (Gales Ferry, CT) Correspondence: Pfizer INC.; Patent Department, Ms8260-1611; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20030092719 Date filed: April 24, 2002 Abstract: The present invention provides methods and kits for treating depression, perimenopausal depression, schizophrenia, anxiety, panic attacks, binge eating, social phobia, or preventing deterioration of cognitive function by administering to a patient in need thereof a therapeutically effect amount of an estrogen agonist/antagonist of formula I 1
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Excerpt(s): This application claims priority of U.S. provisional application No. 60/286,433, filed Apr. 25, 2001. The present invention relates to the use of an estrogen agonist/antagonist for treating depression, perimenopausal depression, schizophrenia, anxiety, panic attacks, binge eating, social phobia, or preventing deterioration of cognitive function. Estrogen has been associated with affective disorders. Depression is an affective disorder in which a patient feels sadness of such a scope and/or duration as to be clinically distinguishable from normal sadness. Depressed patients can have an overwhelming sense of uselessness and can feel lethargic and possibly suicidal. Unlike normal depression due to causative factors such as a death or bad news, a patient with clinical depression is unable to adjust to the causative factors over time and can remain in the depressed state for long periods of time. Other types of affective disorders can occur at particular time periods in a patient's life. For example, perimenopausal depression can occur in women who are near menopause. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Therapeutic agents Inventor(s): Birch, Alan Martin; (Nottingham, GB), Bradley, Paul Anthony; (Nottingham, GB) Correspondence: Herbert B. Keil; Keil & Weinkauf; 1101 Connecticut Avenue, N.W.; Washington; DC; 20036; US Patent Application Number: 20010008903 Date filed: December 27, 2000 Abstract: Compounds of formula I 1and pharmaceutically acceptable salts thereof in which A is methylene or --O--; B is methylene or --O--; G.sub.1-G.sub.2-G.sub.3 form a heteroaromatic or heteroaliphatic chain; g is 0, 1 or 2; U is an alkylene chain optionally substituted by one or more alkyl; Q represents a divalent group containing nitrogen atoms; and T is an optionally substituted aryl or heteroaryl group, have utility in the treatment of central nervous system disorders, for example depression, anxiety, psychoses (for example schizophrenia), tardive dyskinesia, Parkinson's disease, obesity, hypertension, Tourette's syndrome, sexual dysfunction, drug addiction, drug abuse, cognitive disorders, Alzheimer's disease, senile dementia, obsessive-compulsive behaviour, panic attacks, social phobias, eating disorders and anorexia, cardiovascular and cerebrovascular disorders, non-insulin dependent diabetes mellitus, hyperglycaemia, constipation, arrhythmia, disorders of the neuroendocrine system, stress, and spasticity. Excerpt(s): The present invention relates to novel dioxinoindole and thienobenzodioxin compounds which have affinity for 5-HT.sub.1A and/or D.sub.2-like (D.sub.2, D.sub.3 and/or D.sub.4 sub-types) receptors, to processes for their preparation, to pharmaceutical compositions containing them and to their use in the treatment, of central nervous system disorders, for example depression, anxiety, psychoses (for example schizophrenia), tardive dyskinesia, Parkinson's disease, obesity, hypertension, Tourette's syndrome, sexual dysfunction, drug addiction, drug abuse, cognitive disorders, Alzheimer's disease, senile dementia, obsessive-compulsive behaviour, panic attacks, social phobias, eating disorders and anorexia, cardiovascular and cerebrovascular disorders, non-insulin dependent diabetes mellitus, hyperglycaemia, constipation, arrhythmia, disorders of the neuroendocrine system, stress, and spasticity. and T is an optionally substituted aromatic group optionally containing one or more N atoms. These compounds are described as being useful in the treatment of central
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nervous system disorders. T represents phenyl, 1- or 2-naphthyl, 1-naphth[2,1d][1,2,3]oxadia- zolyl, 2-, 3- or 4-pyridyl, 2-, 4- or 5-pyrimidinyl, 2- or 3-thienyl, 2- or 3furyl, 2-, 3- or benzo[b]furanyl, 2,3-dihydro-7-benzo[b]furanyl, 2-, 3- or 7benzo[b]thiophenyl, 3-, 4-5-pyrazolyl, 1,2,3-triazol-4-yl, 1,2,3-triazol-5-yl, 1,2,4-triazol-2yl, 5-tetrazolyl, 2-, 3- or 4-quinolinyl, 2- or 4-quinazolinyl, 3-, 4- or 5-isoxazolyl, 2-, 4- or 5-oxazolyl, 3 isothiazolyl or 2-, 4- or 5-thiazolyl each of which may be optionally substituted by one or more substituents selected from a) halo, b) an alkyl group containing 1 to 4 carbon atoms optionally substituted by one or more halo, c) an alkoxy group containing 1 to 3 carbon atoms optionally substituted by one or more halo, d) an alkylthio group containing 1 to 3 carbon atoms optionally substituted by one or more halo, e) hydroxy, f) an acyloxy group containing 1 to 3 carbon atoms, g) hydroxymethyl, h) cyano, i) an alkanoyl group containing 1 to 6 carbon atoms, j) an alkoxycarbonyl group containing 2 to 6 carbon atoms, k) a carbamoyl group or carbamoylmethyl group each optionally N-substituted by one or two alkyl groups each containing 1 to 3 carbon atoms, I) a sulphamoyl or sulphamoylmethyl group each optionally N-substituted by one or two alkyl groups each containing 1 to 3 carbon atoms, m) an amino group optionally substituted by one or two alkyl groups each containing 1 to 5 carbon atoms, n) 1-pyrrolidinyl or 1 -piperidinyl, o) nitro or p) acetamido. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Treatment of neurotic disorders Inventor(s): Hogg, Sandra; (Frederiksberg, DK), Sanchez, Connie; (Glostrup, DK) Correspondence: Darby & Darby P.C.; 805 Third Avenue; New York; NY; 10022; US Patent Application Number: 20020086899 Date filed: December 12, 2001 Abstract: Use of escitalopram (the S-(+)-enantiomer of citalopram) or a pharmaceutically acceptable salt thereof for the preparation of a medicament useful in the treatment of neurotic disorders is provided, including anxiety states, in particular generalised anxiety disorder and social anxiety disorder, post traumatic stress disorder, obsessive compulsive disorder and panic attacks. Excerpt(s): The present invention relates to the use of the compound escitalopram (INNname), which is the S-enantiomer of the well-known antidepressant drug citalopram, i.e. (S)-1-[3-(dimethyl-amino)propyl]-1-(4-fluorophenyl)-1,3-dihydro-5isobenzofurancarbonitrile, or a pharmaceutically acceptable salt thereof for the preparation of medicaments for the treatment of neurotic disorders, including anxiety states and panic attacks. It is a selective, centrally acting serotonin (5-hydroxytyptamine; 5-HT) reuptake inhibitor, accordingly having antidepressant activities. The antidepressant activity of the compound has been reported in several publications, eg. J. Hyttel, Prog. Neuro-Psychopharmacol. & Biol. Psychiat., 1982, 6, 277-295 and A. Gravem, Acta Psychiatr. Scand., 1987, 75, 478-486, and it is now marketed for the treatment of depression and panic disorders. The compound has further been disclosed to show effects in the treatment of dementia and cerebrovascular disorders, EP-A 474580. Escitolopram and a method for its preparation are disclosed in U.S. Pat. No. 4,943,590. The stereo selectivity of citalopram, i.e. the 5-HT-reuptake inhibition in the Senantiomer, and accordingly, the antidepressant effect of said enantiomer is also disclosed. S-citalopram is now in development as an antidepressant. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Keeping Current In order to stay informed about patents and patent applications dealing with panic attacks, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “panic attacks” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on panic attacks. You can also use this procedure to view pending patent applications concerning panic attacks. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 6. BOOKS ON PANIC ATTACKS Overview This chapter provides bibliographic book references relating to panic attacks. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on panic attacks include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “panic attacks” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “panic attacks” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “panic attacks” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Anxiety & Panic Attacks : Their Cause and Cure by Robert Handly (Author), Pauline Neff (Author); ISBN: 0449213315; http://www.amazon.com/exec/obidos/ASIN/0449213315/icongroupinterna
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Anxiety, Panic Attacks and Agoraphobia, Second Edition by Kenneth Strong; ISBN: 0929028104; http://www.amazon.com/exec/obidos/ASIN/0929028104/icongroupinterna
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Anxiety, Phobias & Panic Attacks: Your Questions Answered (Element Guide Series) by Elaine Sheehan; ISBN: 1852307730; http://www.amazon.com/exec/obidos/ASIN/1852307730/icongroupinterna
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Breaking Free From Panic Attacks by Doug Curtis; ISBN: 0971160309; http://www.amazon.com/exec/obidos/ASIN/0971160309/icongroupinterna
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Coping Successfully with Panic Attacks by Shirley Trickett (1992); ISBN: 0859696464; http://www.amazon.com/exec/obidos/ASIN/0859696464/icongroupinterna
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Coping With Anxiety and Panic Attacks by Jordan Lee; ISBN: 0823932028; http://www.amazon.com/exec/obidos/ASIN/0823932028/icongroupinterna
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Diseases Explained: Panic Attacks Wall Chart by Lexi-Comp; ISBN: 1930598564; http://www.amazon.com/exec/obidos/ASIN/1930598564/icongroupinterna
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Don't Forget To Look Up : A Christian's Guide to Overcoming Anxiety and Panic Attacks by Angela K. Brittain (1998); ISBN: 0966200306; http://www.amazon.com/exec/obidos/ASIN/0966200306/icongroupinterna
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Don't Panic: A Guide to Overcoming Panic Attacks by Sue Breton; ISBN: 081601471X; http://www.amazon.com/exec/obidos/ASIN/081601471X/icongroupinterna
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Embracing the Fear: Learning to Manage Anxiety and Panic Attacks by Judith Bemis, Amr Barrada (1994); ISBN: 089486971X; http://www.amazon.com/exec/obidos/ASIN/089486971X/icongroupinterna
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Everything You Need to Know About Anxiety and Panic Attacks by John Giacobello (2000); ISBN: 0823932192; http://www.amazon.com/exec/obidos/ASIN/0823932192/icongroupinterna
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Free Yourself from Fear: Self Hypnosis for Anxiety, Panic Attacks and Phobias by Valerie Austin; ISBN: 0722535538; http://www.amazon.com/exec/obidos/ASIN/0722535538/icongroupinterna
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Freedom from fear, anxiety, and panic attacks by David Crank; ISBN: 0892749261; http://www.amazon.com/exec/obidos/ASIN/0892749261/icongroupinterna
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Help! I Think I'm Dying! Panic Attacks & Phobias: A Consumer's Guide (New Supplement for 1999) by Abbot Lee, MD Granoff (1996); ISBN: 0938423045; http://www.amazon.com/exec/obidos/ASIN/0938423045/icongroupinterna
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How to Cope Successfully with Panic Attacks (How to Cope Successfully With.) by Karen Sullivan; ISBN: 1903784085; http://www.amazon.com/exec/obidos/ASIN/1903784085/icongroupinterna
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How to Cope with Panic Attacks (2000); ISBN: 1874690502; http://www.amazon.com/exec/obidos/ASIN/1874690502/icongroupinterna
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Living With It: A Survivor's Guide to Panic Attacks by Bev Aisbett; ISBN: 0207180407; http://www.amazon.com/exec/obidos/ASIN/0207180407/icongroupinterna
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Nature's Prozac: Natural Therapies and Techniques to Rid Yourself of Anxiety, Depression, Panic Attacks & Stress by Judith Sachs, Lendon H. Smith; ISBN: 0138876541; http://www.amazon.com/exec/obidos/ASIN/0138876541/icongroupinterna
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No Fear: Overcoming Panic Attacks and Phobias by Alice Neville (2003); ISBN: 0340861339; http://www.amazon.com/exec/obidos/ASIN/0340861339/icongroupinterna
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No More Panic Attacks: A 30-Day Plan for Conquering Anxiety by Jennifer, M.D. Shoquist, Diane Stafford (2002); ISBN: 1564146081; http://www.amazon.com/exec/obidos/ASIN/1564146081/icongroupinterna
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Over the Top: A Self-help Programme for People with Panic Attacks, Anxiety, Tensions and Stress by Reinhard Kowalski; ISBN: 0863880649; http://www.amazon.com/exec/obidos/ASIN/0863880649/icongroupinterna
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Overcoming Anxiety: Panic Attacks and Anxiety Disorders (Health Body, Healthy Soul Series) by David Hazard (2003); ISBN: 0736911944; http://www.amazon.com/exec/obidos/ASIN/0736911944/icongroupinterna
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Overcoming Panic Attacks by Shirley Babior, Carol Goldman (Contributor); ISBN: 0896382303; http://www.amazon.com/exec/obidos/ASIN/0896382303/icongroupinterna
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Overcoming Panic Attacks: Strategies to Free Yourself from the Anxiety Trap (Program for Recovery) by Shirley Babior, Carol Goldman; ISBN: 1570250456; http://www.amazon.com/exec/obidos/ASIN/1570250456/icongroupinterna
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Panic Attacks by Sue Breton (Author) (1996); ISBN: 0091813158; http://www.amazon.com/exec/obidos/ASIN/0091813158/icongroupinterna
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Panic Attacks by Christine Ingham; ISBN: 0007106904; http://www.amazon.com/exec/obidos/ASIN/0007106904/icongroupinterna
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Panic Attacks by Jenny Grahame, et al; ISBN: 0907016669; http://www.amazon.com/exec/obidos/ASIN/0907016669/icongroupinterna
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Panic Attacks 2 Ed by Shirley Trickett; ISBN: 1569751870; http://www.amazon.com/exec/obidos/ASIN/1569751870/icongroupinterna
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Panic Attacks and Phobias: Why and How They Are Misdiagnosed and Mistreated and What Can Be Done About It by Shahidul Islam; ISBN: 094441916X; http://www.amazon.com/exec/obidos/ASIN/094441916X/icongroupinterna
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Panic Buster, Learn to Conquer Panic Attacks and Agoraphobia by Bonnie Crandall; ISBN: 0966394607; http://www.amazon.com/exec/obidos/ASIN/0966394607/icongroupinterna
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Panic Free : Eliminate Anxiety / Panic Attacks Without Drugs and Take Control of Your Life by Lynne Freeman; ISBN: 0966854608; http://www.amazon.com/exec/obidos/ASIN/0966854608/icongroupinterna
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Panic No More: Your Guide to Overcome Panic Attacks by Jean Carlton (1995); ISBN: 0963963295; http://www.amazon.com/exec/obidos/ASIN/0963963295/icongroupinterna
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Phobia Free: A Medical Breakthrough Linking 90% of All Phobias and Panic Attacks to a Hidden Physical Problem by Harold N., M.D. Levinson, Steven Carter; ISBN: 0871314754; http://www.amazon.com/exec/obidos/ASIN/0871314754/icongroupinterna
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Phobia Free: Medical Breakthrough Linking 90% of All Phobias and Panic Attacks to a Hidden Physical Problem by Harold N. Levinson, Steven Carter (Contributor); ISBN: 0871315394; http://www.amazon.com/exec/obidos/ASIN/0871315394/icongroupinterna
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Prisoner of Fear: My Long Road to Freedom from Anxiety Disease Panic Attacks and Agoraphobia by Richard Maro, et al; ISBN: 096285090X; http://www.amazon.com/exec/obidos/ASIN/096285090X/icongroupinterna
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Say Goodbye to Panic Attacks: The Wasted Years by Deanna Peedell; ISBN: 1899536086; http://www.amazon.com/exec/obidos/ASIN/1899536086/icongroupinterna
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School Phobia, Panic Attacks, and Anxiety in Children by Marianna Csoti (1903); ISBN: 1843100916; http://www.amazon.com/exec/obidos/ASIN/1843100916/icongroupinterna
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Surfing the Blues: A Guide to Understanding and Coping With Mood Disorders, Panic Attack and Manic-Depressive Illness by Catherine Rzecki; ISBN: 0207188661; http://www.amazon.com/exec/obidos/ASIN/0207188661/icongroupinterna
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The Panic Attack Recovery Book by Shirley Swede, Seymour Sheppard Jaffe; ISBN: 0451200438; http://www.amazon.com/exec/obidos/ASIN/0451200438/icongroupinterna
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The Panic Attack, Anxiety and Phobia Solutions Handbook by Muriel K. MacFarlane, United Research Publishers (1997); ISBN: 188705300X; http://www.amazon.com/exec/obidos/ASIN/188705300X/icongroupinterna
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Understanding Panic Attacks by Baker; ISBN: 0745933130; http://www.amazon.com/exec/obidos/ASIN/0745933130/icongroupinterna
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Understanding Panic Attacks and Overcoming Fear by Roger Baker (2004); ISBN: 0745951236; http://www.amazon.com/exec/obidos/ASIN/0745951236/icongroupinterna
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When Panic Attacks by Aine Tubridy (2003); ISBN: 0717136140; http://www.amazon.com/exec/obidos/ASIN/0717136140/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “panic attacks” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:7 •
Anxiety and panic attacks Author: Campbell, Nancy R.; Year: 2001; Mankato, Minn.: LifeMatters, c2001; ISBN: 0736810307 http://www.amazon.com/exec/obidos/ASIN/0736810307/icongroupinterna
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Anxiety disorders, panic attacks, and phobias: proceedings of the Key Biscayne Research Conference on Anxiety Disorders, Panic Attacks, and Phobias, Key Biscayne, Florida, 9-11, December 1982 Author: Schatzberg, Alan F.; Year: 1988; Oxford; New York: Pergamon Press, 1988
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In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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Chapters on Panic Attacks In order to find chapters that specifically relate to panic attacks, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and panic attacks 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 “panic attacks” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on panic attacks: •
Complications Source: in Tanner, D.C. Family Guide to Surviving Stroke and Communication Disorders. Needham Heights, MA: Allyn and Bacon. 1999. p. 79-93. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02194. (800) 278-3525. Website: www.abacon.com. PRICE: $20.95. ISBN: 0205285384. Summary: This chapter on the complications of stroke is from a book that offers families practical information on stroke related communication disorders. Through nontechnical terms, a short story, case studies, questions and answers, and examples, the book engages families, stroke and rehabilitation specialists, and counselors on a journey toward understanding and healing. In this chapter, the author outlines side effects and complications of the stroke that can occur along with aphasia, apraxia of speech, and the dysarthrias. These complications may include impairments of perception, exaggerated emotions, difficulty shifting thoughts, echoed speech, perceptual disorders, loss of half the world (inability to recognize visual or auditory cues on the left or right side), eating problems, panic attacks, uncontrolled crying, and swallowing problems. The author concludes by encouraging readers to learn about these complications and to recognize that, even in the face of overwhelming changes, every patient has room for improvement. With proper care and strong support from family and friends, patients can and do improve.
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CHAPTER 7. MULTIMEDIA ON PANIC ATTACKS Overview In this chapter, we show you how to keep current on multimedia sources of information on panic attacks. 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.
Bibliography: Multimedia on Panic Attacks The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in panic attacks (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on panic attacks: •
Panic attack [videorecording] Source: a film by Brett Ingram; [presented by] Bright Eye Pictures; Year: 2000; Format: Videorecording; Boston, MA: Fanlight Productions, c2000
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Panic attack [videorecording]: causes and treatments Source: [presented by] Films for the Humanities & Sciences; BBC Education & Training; Q.E.D; Year: 1997; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c1997
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Panic attacks [videorecording] Source: a presentation of Films for the Humanities & Sciences; Dark Horse Productions Limited production for BBC; Year: 1997; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c1997
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What you really need to know about-- anxiety, phobias, and panic attacks [videorecording] Source: Videos for Patients; a Video Arts production for Videos for Patients; Year: 1996; Format: Videorecording; [Mississauga, Ont.]: Medical Audio Visual Communications, c1996
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CHAPTER 8. PERIODICALS AND NEWS ON PANIC ATTACKS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover panic attacks.
News Services and Press Releases One of the simplest ways of tracking press releases on panic attacks 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 “panic attacks” (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 panic attacks. 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 “panic attacks” (or synonyms). The following was recently listed in this archive for panic attacks: •
Panic attacks common among older women Source: Reuters Health eLine Date: September 23, 2003
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Panic attacks common among postmenopausal women Source: Reuters Medical News Date: September 22, 2003
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Respiratory diseases and panic attacks often coexist Source: Reuters Medical News Date: August 30, 2002
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Asthmatics also likely to have panic attacks Source: Reuters Health eLine Date: August 30, 2002
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Personality trait may link smoking to panic attacks Source: Reuters Health eLine Date: July 24, 2002
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Allergies linked to panic attacks, study finds Source: Reuters Health eLine Date: July 05, 2002
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Panic attacks endanger heart health Source: Reuters Health eLine Date: March 12, 2001
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Some epileptic seizures mistaken for panic attacks Source: Reuters Health eLine Date: January 22, 2001
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Therapy-drug combo may calm panic attacks Source: Reuters Health eLine Date: May 16, 2000
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Warner-Lambert in pact with Interneuron to market panic attack drug Source: Reuters Medical News Date: December 28, 1999
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Daily smokers at increased risk of first occurrence of panic attack Source: Reuters Medical News Date: December 15, 1999
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Smoking may increase risk of panic attack Source: Reuters Health eLine Date: December 14, 1999
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Migraine with panic attack may be a distinct condition Source: Reuters Medical News Date: November 17, 1999
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Panic attacks and hypertension frequently linked Source: Reuters Medical News Date: October 26, 1999
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Sertraline effective in reducing panic attacks Source: Reuters Medical News Date: September 18, 1998
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Early clinical trials show efficacy of pagoclone in treatment of panic attacks Source: Reuters Medical News Date: August 18, 1998
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Women Suffer More Panic Attacks Than Men Source: Reuters Health eLine Date: May 01, 1998
Periodicals and News
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Heart Disorder Mistaken for Panic Attack Source: Reuters Health eLine Date: March 10, 1997
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Symptom Clusters Differentiate Asthma Attacks From Panic Attacks Source: Reuters Medical News Date: February 20, 1997
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High CO2 May Cause Panic Attack Source: Reuters Health eLine Date: December 24, 1996
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Anxiety Sensitivity Increases Risk Of Panic Attacks Source: Reuters Medical News Date: November 27, 1996
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One In Three Americans Have Panic Attacks Source: Reuters Medical News Date: May 23, 1996
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Hyperventilation Not A Cause Of Panic Attacks Source: Reuters Medical News Date: April 08, 1996
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “panic attacks” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests.
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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 “panic attacks” (or synonyms). If you know the name of a company that is relevant to panic attacks, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “panic attacks” (or synonyms).
Academic Periodicals covering Panic Attacks Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to panic attacks. In addition to these sources, you can search for articles covering panic attacks that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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APPENDICES
107
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
8
These publications are typically written by one or more of the various NIH Institutes.
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•
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
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
9 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.
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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 Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “panic attacks” (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 4187 97 869 5 9 5167
HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “panic attacks” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
11
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
12
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
16 Adapted 17
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on panic attacks 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 panic attacks. 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 panic attacks. 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 “panic attacks”:
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•
Other guides Obsessive-Compulsive Disorder http://www.nlm.nih.gov/medlineplus/obsessivecompulsivedisorder.html Panic Disorder http://www.nlm.nih.gov/medlineplus/panicdisorder.html Post-Traumatic Stress Disorder http://www.nlm.nih.gov/medlineplus/posttraumaticstressdisorder.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 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 panic attacks. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to panic attacks. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with panic attacks. 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 panic attacks. 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 “panic attacks” (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 “panic attacks”. 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 “panic attacks” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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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 “panic attacks” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.19
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
19
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)20: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
20
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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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).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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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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PANIC ATTACKS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] 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] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent
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chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] 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] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]
Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and
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central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
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
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the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apathy: Lack of feeling or emotion; indifference. [EU] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apraxia: Loss of ability to perform purposeful movements, in the absence of paralysis or sensory disturbance, caused by lesions in the cortex. [NIH] Aqueous: Having to do with water. [NIH]
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Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Natriuretic Factor: A potent natriuretic and vasodilatory peptide or mixture of different-sized low molecular weight peptides derived from a common precursor and secreted by the heart atria. All these peptides share a sequence of about 20 amino acids. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autogenic: A type of succession when the developing vegetation itself is the cause for the succession. [NIH] Autogenic Training: Technique based on muscle relaxation during self-hypnotic exercises. It is used in conjunction with psychotherapy. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress.
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Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] 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] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium swallow: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called an esophagram. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [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] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bicuculline: Isoquinoline alkaloid from Dicentra cucullaria and other plants that is a competitive antagonist at GABA-A receptors and thus causes convulsions. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH]
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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [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] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Bromine: A halogen with the atomic symbol Br, atomic number 36, and atomic weight 79.904. It is a volatile reddish-brown liquid that gives off suffocating vapors, is corrosive to the skin, and may cause severe gastroenteritis if ingested. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH]
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Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamines: A general class of ortho-dihydroxyphenylalkylamines derived from tyrosine. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU]
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Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrovascular Disorders: A broad category of disorders characterized by impairment of blood flow in the arteries and veins which supply the brain. These include cerebral infarction; brain ischemia; hypoxia, brain; intracranial embolism and thrombosis; intracranial arteriovenous malformations; and vasculitis, central nervous system. In common usage, the term cerebrovascular disorders is not limited to conditions that affect the cerebrum, but refers to vascular disorders of the entire brain including the diencephalon; brain stem; and cerebellum. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of
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infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic 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] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening,
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prevention, diagnosis, or treatment of a disease. [NIH] Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of gaba receptor responses. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU] 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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted thinking and to replace it with more rational, adaptive thoughts and beliefs. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [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] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or
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survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] 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] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compulsions: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH]
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Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Contusions: Injuries resulting in hemorrhage, usually manifested in the skin. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cotinine: 1-Methyl-5-(3-pyridyl)-2-pyrrolidinone antidepressant. Synonym: Scotine. [NIH]
fumarate.
Stimulant
proposed
as
Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [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] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH]
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Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by
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the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [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] Duodenogastric Reflux: Reflux of duodenal contents into the stomach. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphoria: Disquiet; restlessness; malaise. [EU] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH]
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Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the 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] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said
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especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithalamus: The dorsal posterior subdivision of the diencephalon. The epithalamus is generally considered to include the habenular nuclei (habenula) and associated fiber bundles, the pineal body, and the epithelial roof of the third ventricle. The anterior and posterior paraventricular nuclei of the thalamus are included with the thalamic nuclei although they develop from the same pronuclear mass as the epithalamic nuclei and are sometimes considered part of the epithalamus. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Manometry: A test to measure muscle tone inthe esophagus. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagoscopy: Endoscopic examination, therapy, or surgery of the esophagus. [NIH] Esophagram: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called a barium swallow. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of
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energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extracellular: Outside a cell or cells. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] 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] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flumazenil: A potent benzodiazepine receptor antagonist. Since it reverses the sedative and other actions of benzodiazepines, it has been suggested as an antidote to benzodiazepine overdoses. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Forearm: The part between the elbow and the wrist. [NIH] GABA: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] 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]
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Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrinoma: A gastrin-secreting tumor of the non-beta islet cells. It is usually located in the pancreas but is also found at other sites, as in the antrum of the stomach, hilus of the spleen, and regional lymph nodes. The presence of gastrinoma is one of three requirements to be met for identification of Zollinger-Ellison syndrome, which sometimes occurs in families with multiple endocrine neoplasia type 1 (MEN-1). Gastrinomas in patients with MEN-1 are usually diffuse in nature. [NIH] Gastritis: Inflammation of the stomach. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of health-
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related institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gyrus Cinguli: One of the convolutions on the medial surface of the cerebral hemisphere. It surrounds the rostral part of the brain and interhemispheric commissure and forms part of the limbic system. [NIH] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] 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] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one
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generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Heterozygote: An individual having different alleles at one or more loci in homologous chromosome segments. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercarbia: Excess of carbon dioxide in the blood. [NIH] Hyperglycaemia: Abnormally increased content of sugar in the blood. [EU] Hyperlipidaemia: A general term for elevated concentrations of any or all of the lipids in the plasma, including hyperlipoproteinaemia, hypercholesterolaemia, etc. [EU] Hypersecretion: Excessive secretion. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] 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] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH]
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Hypnotherapy: Sleeping-cure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues
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caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Embolism: The sudden obstruction of a blood vessel by an embolus. [NIH] Intracranial Embolism and Thrombosis: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Islet: Cell producing insulin in pancreas. [NIH] Isoproterenol: Isopropyl analog of epinephrine; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant. [NIH] Jealousy: An irrational reaction compounded of grief, loss of self-esteem, enmity against the rival and self criticism. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH]
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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] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligands: A RNA simulation method developed by the MIT. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Lod: The lowest analyte content which, if actually present, will be detected with reasonable statistical certainty and can be identified according to the identification criteria of the method. If both accuracy and precision are constant over a concentration range. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH]
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Loneliness: The state of feeling sad or dejected as a result of lack of companionship or being separated from others. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]
Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Memory Disorders: Disturbances in registering an impression, in the retention of an acquired impression, or in the recall of an impression. Memory impairments are associated with dementia; craniocerebraltrauma; encephalitis; alcoholism (see also alcohol amnestic disorder); schizophrenia; and other conditions. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningioma: A type of tumor that occurs in the meninges, the membranes that cover and
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protect the brain and spinal cord. Meningiomas usually grow slowly. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]
Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mitral Valve Prolapse: Abnormal protrusion of one or both of the leaflets of the mitral valve into the left atrium during systole. This may be accompanied by mitral regurgitation, systolic murmur, nonejection click, or cardiac arrhythmia. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH]
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Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Natriuresis: The excretion of abnormal amounts of sodium in the urine. [EU] Natriuretic Hormone: A low-molecular weight substance, possibly from the hypothalamus, which is released due to plasma volume expansion. It causes natriuresis in part by inhibiting
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sodium potassium ATPase. The development of hypertension may be the consequence of an abnormality in volume regulation induced by a defect in the renal response to the natriuretic effect of the natriuretic hormone. Do not confuse with atrial natriuretic factor or cardionatrin which is a different, well characterized hormone. [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] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [EU] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]
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Neurotic Disorders: Disorders in which the symptoms are distressing to the individual and recognized by him or her as being unacceptable. Social relationships may be greatly affected but usually remain within acceptable limits. The disturbance is relatively enduring or recurrent without treatment. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH]
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Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Pain, Intractable: Persistent pain that is refractory to some or all forms of treatment. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatic Pseudocyst: Cyst-like space not lined by epithelium and contained within the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranoia: A psychotic disorder marked by persistent delusions of persecution or delusional jealousy and behaviour like that of the paranoid personality, such as suspiciousness, mistrust, and combativeness. It differs from paranoid schizophrenia, in which hallucinations
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or formal thought disorder are present, in that the delusions are logically consistent and that there are no other psychotic features. The designation in DSM III-R is delusional (paranoid) disorders, with five types : persecutory, jealous, erotomanic, somatic, and grandiose. [EU] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] 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] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perceptual Disorders: Cognitive disorders characterized by an impaired ability to perceive the nature of objects or concepts through use of the sense organs. These include spatial neglect syndromes, where an individual does not attend to visual, auditory, or sensory stimuli presented from one side of the body. [NIH] Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral
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sensory receptors. [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH]
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Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] 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] Polygenic Inheritance: A phenotypic outcome that is determined by more than one gene, such as a variety of physical characteristics or diseases. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Portal Hypertension: High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [NIH] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH]
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Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [NIH]
Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The
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predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]
Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Ptosis: 1. Prolapse of an organ or part. 2. Drooping of the upper eyelid from paralysis of the third nerve or from sympathetic innervation. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease
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and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pyrimidines: A family of 6-membered heterocyclic compounds occurring in nature in a wide variety of forms. They include several nucleic acid constituents (cytosine, thymine, and uracil) and form the basic structure of the barbiturates. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radioactive: Giving off radiation. [NIH] Radius: The lateral bone of the forearm. [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] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU]
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Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regional lymph node: In oncology, a lymph node that drains lymph from the region around a tumor. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]
Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] 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] Retrospective: Looking back at events that have already taken place. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH]
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Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septal Nuclei: Neural nuclei situated in the septal region. They have afferent and cholinergic efferent connections with a variety of forebrain and brainstem areas including the hippocampus, the lateral hypothalamus, the tegmentum, and the amygdala. Included are the dorsal, lateral, medial, and triangular septal nuclei, septofimbrial nucleus, nucleus of diagonal band, nucleus of anterior commissure, and the nucleus of stria terminalis. [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] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]
Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as
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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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Lactate: The sodium salt of racemic or inactive lactic acid. It is a hygroscopic agent
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used intravenously as a systemic and urinary alkalizer. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU]
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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] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] 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]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [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] 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] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Subliminal: Below the threshold of sensation, as a subliminal stimulus. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but,
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according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Systemic: Affecting the entire body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone,
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which helps regulate growth and metabolism. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] 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] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transient Ischemic Attacks: Focal neurologic abnormalities of sudden onset and brief duration that reflect dysfunction in the distribution of the internal carotid-middle cerebral or the vertebrobasilar arterial system. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a
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protein. It occurs on the ribosome and is unidirectional. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uracil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving
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around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] War: Hostile conflict between organized groups of people. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Yohimbine: A plant alkaloid with alpha-2-adrenergic blocking activity. Yohimbine has been used as a mydriatic and in the treatment of impotence. It is also alleged to be an aphrodisiac. [NIH]
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INDEX A Abdomen, 125, 131, 147, 148, 154, 164, 165 Abdominal, 125, 143, 154, 158 Aberrant, 125, 135 Acetylcholine, 125, 134, 153 Acuity, 67, 125 Acupuncture Points, 86, 125 Adaptation, 10, 125, 156 Adenosine, 125, 132, 156 Adjustment, 26, 125 Adolescence, 10, 44, 46, 125 Adrenal Cortex, 125, 137, 158 Adrenergic, 125, 128, 139, 141, 158, 165, 168, 169 Adverse Effect, 125, 163 Afferent, 79, 85, 125, 162 Affinity, 88, 89, 90, 125, 126, 129, 138, 163 Age of Onset, 40, 43, 126 Agonist, 8, 89, 90, 126, 139, 151, 153 Airway, 126, 131, 163 Alertness, 126, 132 Algorithms, 126, 131 Alimentary, 126, 147, 155 Alkaline, 126, 130, 132 Alkaloid, 126, 130, 135, 153, 169 Alkalosis, 65, 126 Alleles, 126, 145 Alternative medicine, 103, 126 Ambulatory Care, 57, 126 Amino acid, 82, 84, 126, 129, 134, 138, 143, 150, 152, 155, 159, 162, 165, 167, 168 Amnestic, 126, 142, 149, 150 Amphetamines, 126, 135 Amygdala, 5, 6, 13, 14, 127, 148, 162 Anaesthesia, 127, 146 Analgesics, 84, 127 Analog, 83, 127, 147 Anaphylatoxins, 127, 136 Anatomical, 9, 11, 127, 129, 134, 146, 150, 162 Anemia, 34, 127 Anesthesia, 46, 79, 126, 127, 150 Aneurysm, 19, 127 Angina, 127, 158 Angina Pectoris, 127, 158 Animal model, 65, 77, 87, 127 Anorexia, 69, 89, 90, 127, 143, 168 Antagonism, 127, 132
Antibacterial, 127, 164 Antibiotic, 127, 164 Antibody, 126, 127, 128, 136, 144, 145, 146, 149, 164 Anticonvulsant, 18, 128, 135 Antidepressant, 76, 88, 89, 91, 128, 134, 137, 146 Antidote, 128, 142 Antiemetic, 76, 128 Antigen, 126, 127, 128, 136, 145, 146, 149, 150 Antigen-Antibody Complex, 128, 136 Antipsychotic, 128, 152, 161 Anxiety Disorders, 10, 11, 12, 15, 19, 20, 32, 44, 64, 77, 80, 95, 96, 128, 154 Anxiolytic, 12, 76, 77, 78, 87, 128, 150 Apathy, 128, 152 Aphasia, 97, 126, 128 Apnea, 128 Apraxia, 97, 128 Aqueous, 128, 130, 137 Arachidonic Acid, 129, 158 Arginine, 127, 129, 153 Aromatic, 90, 129 Arrhythmia, 14, 79, 90, 129, 150 Arterial, 129, 131, 133, 145, 147, 159, 166, 167 Arteries, 129, 131, 133, 137, 150, 151 Arteriovenous, 129, 133 Artery, 127, 129, 132, 133, 137, 160 Asphyxia, 83, 129 Astrocytes, 129, 150, 151 Asymptomatic, 129, 154 Atrial, 20, 129, 152 Atrial Natriuretic Factor, 129, 152 Atrium, 129, 150, 168 Atrophy, 129, 152 Atypical, 20, 29, 33, 129, 161 Auditory, 6, 15, 30, 86, 97, 129, 141, 144, 155 Autodigestion, 129, 154 Autogenic, 64, 129 Autogenic Training, 64, 129 Autonomic, 21, 79, 85, 125, 128, 129, 153, 155, 164, 165 Autonomic Nervous System, 79, 129, 155, 164, 165
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B Bacteria, 127, 128, 130, 138, 141, 142, 150, 164, 167 Bacterial Physiology, 125, 130 Bactericidal, 130, 141 Bacteriophage, 130, 167 Barbiturates, 130, 160 Barium, 4, 130, 141 Barium swallow, 4, 130, 141 Basal Ganglia, 84, 128, 130, 148, 153 Base, 64, 126, 130, 137, 148, 166, 168 Behavior Therapy, 17, 27, 43, 54, 64, 67, 130 Benign, 3, 130, 144 Benzene, 130 Benzodiazepines, 21, 70, 81, 130, 142 Bicuculline, 6, 130 Bile, 130, 142, 143, 148, 165 Bile Acids, 130, 143, 165 Biliary, 130, 154 Biliary Tract, 130, 154 Biochemical, 34, 40, 43, 60, 77, 126, 131, 162 Biotechnology, 16, 96, 103, 109, 131 Bipolar Disorder, 8, 9, 86, 131 Blood Coagulation, 131, 132 Blood Platelets, 86, 131, 162 Blood pressure, 3, 6, 34, 131, 133, 145, 146, 151, 157, 163 Blood vessel, 131, 132, 133, 134, 140, 144, 147, 163, 165, 166, 168 Body Fluids, 126, 131, 139, 163 Body Image, 131, 138 Bowel, 83, 131, 147 Bradykinin, 131, 153 Brain Ischemia, 131, 133 Brain Stem, 30, 131, 133 Branch, 121, 131, 155, 159, 164, 165, 166 Bromine, 76, 131 Bronchi, 131, 141, 147, 167 Bronchodilator, 131, 147 Bulimia, 86, 89, 131 C Cachexia, 83, 132 Caffeine, 12, 22, 84, 132 Calcium, 12, 132, 136, 145, 163 Calcium channel blocker, 12, 132 Calcium Channel Blockers, 12, 132 Carbon Dioxide, 15, 28, 32, 35, 36, 53, 54, 82, 132, 145, 161 Carcinogenic, 130, 132, 165
Cardiac, 4, 18, 67, 79, 132, 140, 141, 142, 150, 151, 165 Cardiorespiratory, 132, 150 Cardioselective, 132, 158 Cardiovascular, 86, 90, 132, 162, 164 Carotid Body, 132, 133 Case report, 4, 47, 56, 64, 65, 67, 132, 134 Case series, 132, 134 Catecholamines, 132, 139, 151 Caudal, 9, 132, 138, 146, 153 Caudate Nucleus, 133, 153 Cell Differentiation, 133, 163 Cell membrane, 132, 133, 138 Cell proliferation, 133, 163 Cell Respiration, 133, 161 Cerebellum, 133, 157 Cerebral, 77, 89, 130, 131, 133, 137, 141, 144, 159, 166, 167 Cerebral hemispheres, 130, 131, 133, 166 Cerebral Infarction, 133 Cerebrovascular, 90, 91, 132, 133 Cerebrovascular Disorders, 90, 91, 133 Cerebrum, 133, 166 Chemoreceptor, 14, 128, 133 Chemotactic Factors, 133, 136 Chemotherapy, 83, 134 Chest Pain, 4, 11, 134 Chin, 134, 150 Chlorine, 76, 134 Cholecystokinin, 13, 23, 30, 37, 76, 77, 84, 134 Cholesterol, 130, 134, 165 Cholinergic, 8, 9, 21, 128, 134, 153, 162 Chromatin, 134, 149 Chromosome, 77, 134, 145 Chronic, 9, 23, 24, 25, 46, 53, 84, 132, 134, 140, 141, 146, 154, 157, 162, 168 Chronic Disease, 132, 134 Chronic renal, 134, 157, 168 Circadian, 80, 134 Circadian Rhythm, 80, 134 Cirrhosis, 134, 157 Citalopram, 46, 91, 134 Clinical study, 64, 134 Clinical trial, 5, 16, 18, 102, 109, 134, 137, 139, 160 Clonazepam, 16, 22, 23, 28, 135 Clonic, 135 Cloning, 131, 135 Coca, 135 Cocaine, 24, 31, 41, 67, 84, 88, 135 Cofactor, 135, 159
Index 173
Cognition, 135, 152 Cognitive behavior therapy, 5, 66, 135 Cognitive Therapy, 56, 64, 135 Collagen, 126, 135, 156 Collapse, 135, 163 Communication Disorders, 97, 108, 135 Comorbidity, 6, 7, 38, 40, 135 Complement, 11, 16, 127, 136 Complementary and alternative medicine, 63, 71, 136 Complementary medicine, 63, 136 Complete remission, 136, 161 Compulsions, 136, 154 Computational Biology, 109, 136 Consciousness, 73, 127, 136, 137, 139, 159 Constipation, 90, 128, 136 Constriction, 136, 147 Consultation, 11, 16, 136 Contraindications, ii, 137 Controlled study, 29, 50, 68, 137 Contusions, 86, 137 Convulsions, 128, 130, 137 Coronary, 127, 137, 150, 151 Coronary Thrombosis, 137, 150, 151 Cortex, 128, 137, 140, 141 Cortical, 79, 85, 137, 142, 162 Cortisol, 51, 137 Cotinine, 13, 137 Cranial, 79, 133, 137, 144, 152, 155 Cues, 6, 97, 137 Curative, 137, 166 Cutaneous, 85, 137, 145 Cyclic, 82, 132, 137, 144, 153, 159 Cytoplasm, 133, 137, 140, 144, 149 Cytosine, 137, 160 Cytotoxic, 137, 163 D Deamination, 137, 151 Degenerative, 137, 149, 151 Delusions, 137, 154 Dementia, 90, 91, 128, 137, 149 Dendrites, 137, 138, 152 Dendritic, 138, 164 Dental Caries, 138, 142 Dentate Gyrus, 138, 145 Depersonalization, 56, 138, 154, 162 Depolarization, 79, 138, 163 Derealization, 26, 138, 154 Desipramine, 26, 41, 67, 138 Diabetes Mellitus, 89, 90, 138, 143, 144 Diagnostic procedure, 75, 103, 138 Diarrhea, 83, 138
Diastolic, 138, 145 Diencephalon, 133, 138, 141, 146, 166 Digestion, 126, 130, 131, 138, 139, 147, 148, 155, 165 Dilatation, 127, 138, 158, 168 Dilation, 82, 131, 138 Dimethyl, 78, 91, 138 Direct, iii, 135, 138, 139, 145, 160, 166 Disinfectant, 138, 141 Dissociation, 126, 138 Distal, 77, 139, 140, 143, 159 Diuresis, 132, 139 Dizziness, 3, 11, 82, 139, 154, 169 Dopamine, 128, 135, 139, 151, 153, 161 Double-blind, 16, 23, 28, 29, 139 Drive, ii, vi, 3, 6, 9, 59, 139 Drug Interactions, 139 Duct, 139, 142, 161 Duodenogastric Reflux, 83, 139 Duodenum, 130, 139, 140, 154, 165 Dyskinesia, 89, 90, 128, 134, 139 Dyspepsia, 4, 139 Dysphoria, 9, 139 Dyspnea, 28, 55, 139, 154 Dystonia, 36, 128, 139 E Eating Disorders, 88, 89, 90, 139 Effector, 125, 136, 139 Efficacy, 5, 11, 23, 66, 81, 102, 139, 168 Electric shock, 6, 139 Electrode, 79, 140 Electrolyte, 79, 140, 157, 163, 168 Embryo, 133, 140, 146 Encephalitis, 140, 149 Endemic, 140, 164 Endocrine Glands, 84, 140 Endocrine System, 140, 152 Endogenous, 8, 139, 140 Endorphins, 140, 153 Endoscopic, 140, 141, 150 Endothelium, 140, 153 Endothelium-derived, 140, 153 Endotoxins, 136, 140 End-stage renal, 134, 140, 157 Enkephalins, 140, 153 Entorhinal Cortex, 140, 145 Environmental Health, 108, 110, 140 Enzymatic, 126, 132, 136, 138, 140 Enzyme, 139, 140, 144, 151, 155, 159, 163 Epidemic, 140, 164 Epinephrine, 31, 125, 139, 141, 147, 153 Epithalamus, 138, 141, 148
174 Panic Attacks
Epithelium, 140, 141, 142, 154 Erythrocytes, 127, 141 Esophageal, 4, 141 Esophageal Manometry, 4, 141 Esophagitis, 4, 141 Esophagoscopy, 4, 141 Esophagram, 130, 141 Esophagus, 4, 130, 141, 143, 144, 149, 156, 160, 165 Estrogen, 31, 89, 90, 141 Ethanol, 88, 134, 141 Evacuation, 136, 141 Evoke, 141, 165 Evoked Potentials, 30, 141 Excitability, 141, 152 Excitation, 79, 85, 127, 133, 141, 153 Excitatory, 9, 142, 143 Exocrine, 83, 134, 142, 154 Exogenous, 140, 142 Expiration, 142, 161 Extracellular, 79, 129, 142, 163 F Family Planning, 109, 142 Fatigue, 11, 142 Fatty acids, 142, 158 Feces, 136, 142 Fenfluramine, 6, 25, 142 Fibrosis, 142, 162 Fistula, 3, 142 Flumazenil, 32, 53, 142 Fluorine, 76, 142 Fluvoxamine, 30, 142 Forearm, 87, 131, 142, 160 G GABA, 8, 12, 130, 135, 142, 163 Gallbladder, 125, 130, 134, 142 Ganglia, 125, 142, 152, 155, 165 Gas, 132, 134, 142, 145, 153, 160 Gastric, 4, 76, 84, 129, 142, 143, 144, 155 Gastric Juices, 142, 155 Gastric Mucosa, 142, 155 Gastrin, 84, 143, 145 Gastrinoma, 83, 143 Gastritis, 4, 143 Gastroenteritis, 131, 143 Gastroesophageal Reflux, 4, 83, 143 Gastrointestinal, 83, 84, 86, 131, 134, 141, 143, 162, 164, 165 Gastrointestinal tract, 84, 86, 141, 143, 162, 164 Gene, 77, 96, 126, 131, 143, 156, 157 Genetics, 14, 143
Genotype, 143, 156 Germ Cells, 143, 149, 154, 164 Gland, 125, 143, 145, 154, 162, 165, 166 Glucose, 29, 60, 138, 143, 144, 147, 161 Glucose Intolerance, 138, 143 Glutamate, 8, 13, 143 Glutamic Acid, 143, 153 Glycine, 126, 143, 153 Gonadal, 143, 165 Governing Board, 143, 157 Grafting, 144, 146 Granulocytes, 144, 163 Growth, 83, 125, 127, 133, 144, 150, 152, 156, 164, 167, 168 Guanylate Cyclase, 144, 153 Gyrus Cinguli, 144, 148 H Habituation, 86, 144 Haematoma, 144 Haemorrhage, 89, 144 Haptens, 126, 144 Headache, 41, 132, 144, 158 Hearing Disorders, 135, 144 Heartburn, 4, 144 Hemoglobin, 127, 141, 144 Hemorrhage, 137, 144, 160, 165 Hemostasis, 144, 162 Hereditary, 56, 144, 151, 152 Heredity, 143, 145 Heterogeneity, 126, 145 Heterozygote, 12, 145 Hippocampus, 13, 138, 145, 148, 162, 165 Homologous, 126, 145, 166 Hormonal, 19, 21, 129, 145 Hormone, 45, 83, 84, 134, 137, 141, 143, 145, 147, 152, 158, 163, 164, 166 Hydrogen, 130, 145, 151 Hydrogenation, 130, 145 Hydroxyproline, 126, 135, 145 Hypercalcemia, 83, 145 Hypercarbia, 18, 145 Hyperglycaemia, 89, 90, 145 Hyperlipidaemia, 89, 145 Hypersecretion, 84, 145 Hypersensitivity, 15, 35, 145 Hypertension, 20, 44, 83, 86, 90, 102, 132, 144, 145, 152, 157, 158, 168 Hyperthyroidism, 35, 145, 158 Hypertrophy, 9, 145 Hyperventilation, 3, 13, 14, 17, 31, 35, 36, 60, 67, 103, 145 Hypesthesia, 145, 152
Index 175
Hypnotherapy, 48, 68, 70, 146 Hypnotic, 64, 129, 146, 150 Hypoglycemia, 36, 38, 146 Hypotension, 3, 83, 128, 137, 146 Hypothalamus, 130, 138, 146, 148, 151, 162, 164, 166 Hypothermia, 8, 146 Hypoxia, 131, 133, 146 I Id, 61, 68, 114, 120, 122, 146 Illusion, 54, 146, 168 Imidazole, 76, 146 Imipramine, 20, 21, 23, 27, 29, 37, 47, 51, 64, 81, 146 Immunology, 126, 146 Impairment, 52, 133, 139, 146, 150 Implantation, 79, 146 Impotence, 146, 169 In vitro, 146 In vivo, 66, 146 Incompetence, 143, 146 Indicative, 6, 93, 146, 155, 168 Induction, 8, 10, 60, 64, 79, 128, 146 Infarction, 131, 133, 146 Infection, 134, 140, 143, 146, 152, 165 Inflammation, 140, 141, 142, 143, 146, 152, 154, 157, 168 Infusion, 6, 34, 39, 51, 60, 147 Ingestion, 4, 147, 157 Inhalation, 15, 23, 35, 53, 54, 147, 157 Innervation, 147, 159 Insight, 22, 147 Insomnia, 80, 147, 158 Insulin, 38, 83, 89, 90, 147 Insulin-dependent diabetes mellitus, 147 Intermittent, 81, 147 Intestinal, 86, 134, 147 Intestinal Mucosa, 134, 147 Intestine, 131, 147, 163 Intoxication, 147, 169 Intracellular, 8, 132, 146, 147, 153, 157, 159, 160, 163 Intracranial Embolism, 133, 147 Intracranial Embolism and Thrombosis, 133, 147 Intravenous, 6, 147 Intrinsic, 9, 126, 147 Ions, 130, 138, 140, 145, 147, 151 Ischemia, 28, 127, 129, 131, 147 Islet, 143, 147 Isoproterenol, 33, 39, 53, 147
J Jealousy, 147, 154 Joint, 77, 87, 147 K Kb, 108, 148 L Labile, 136, 148 Language Disorders, 135, 148 Least-Squares Analysis, 148, 161 Leukemia, 83, 148 Library Services, 120, 148 Ligands, 87, 148 Likelihood Functions, 148, 161 Limbic, 15, 47, 67, 127, 144, 148 Limbic System, 15, 127, 144, 148 Linear Models, 148, 161 Lipid, 147, 148, 150 Liver, 87, 125, 129, 130, 134, 142, 148, 151, 157 Lobe, 54, 133, 148 Localized, 79, 131, 138, 144, 146, 148, 151, 156, 162 Locomotion, 8, 148, 156 Lod, 78, 148 Logistic Models, 148, 161 Loneliness, 9, 149 Lower Esophageal Sphincter, 4, 143, 149 Lymphocytes, 78, 128, 149, 164 Lymphoid, 149 M Macula, 149 Macula Lutea, 149 Macular Degeneration, 83, 149 Malaise, 139, 149 Malignancy, 83, 149 Malnutrition, 129, 132, 149 Manic, 96, 128, 131, 149 Manifest, 82, 149 Mediator, 134, 149, 162 Medicament, 87, 91, 149 MEDLINE, 109, 149 Meiosis, 149, 166 Membrane, 9, 79, 129, 133, 136, 138, 141, 149, 161, 163, 164 Memory, 6, 86, 127, 137, 149 Memory Disorders, 86, 149 Meninges, 133, 149 Meningioma, 83, 149 Menopause, 90, 150, 155, 157, 158 Menstrual Cycle, 150, 158 Menstruation, 150, 158 Mental Disorders, 86, 150, 159
176 Panic Attacks
Mental Health, iv, 4, 6, 108, 110, 150, 160 Mental Retardation, 135, 150 Meta-Analysis, 51, 150 Metabolite, 21, 138, 150 Methionine, 138, 150 MI, 24, 123, 150 Microbiology, 125, 129, 150 Microglia, 129, 150, 151 Midazolam, 81, 150 Mitral Valve, 11, 30, 33, 44, 150 Mitral Valve Prolapse, 12, 33, 44, 150 Modeling, 22, 150 Modification, 28, 126, 151, 160 Molecular, 14, 21, 77, 109, 111, 129, 131, 136, 138, 151, 160, 168 Molecular Structure, 151, 168 Molecule, 128, 130, 136, 138, 139, 140, 142, 151, 160, 163, 168 Monitor, 10, 80, 151, 153 Monoamine, 56, 151, 168 Monoamine Oxidase, 56, 151, 168 Mood Disorders, 77, 96, 151 Motility, 4, 86, 151, 162 Motion Sickness, 151, 152 Movement Disorders, 79, 128, 151 Mucins, 151, 161 Muscle Relaxation, 7, 129, 151 Mydriatic, 138, 151, 169 Myocardial infarction, 137, 150, 151, 158 Myocardium, 127, 150, 151 N Naloxone, 30, 151 Narcolepsy, 8, 151 Natriuresis, 151 Natriuretic Hormone, 20, 151 Nausea, 76, 82, 128, 143, 152, 154, 158, 168 Need, 3, 4, 9, 82, 83, 89, 94, 97, 99, 115, 134, 152, 167 Neoplasia, 143, 152 Nerve, 79, 125, 127, 134, 137, 147, 149, 151, 152, 157, 159, 161, 162, 165, 168 Nervous System, 79, 80, 84, 85, 86, 90, 125, 127, 129, 130, 132, 133, 134, 135, 141, 142, 143, 144, 149, 150, 152, 155, 157, 162, 165, 166, 168 Nervousness, 22, 152 Neural, 5, 6, 79, 85, 125, 138, 150, 151, 152, 162 Neuritis, 3, 152 Neurodegenerative Diseases, 86, 152 Neuroendocrine, 90, 152 Neuroleptic, 43, 46, 128, 152
Neurologic, 33, 45, 152, 167 Neuronal, 89, 134, 152 Neurons, 6, 9, 135, 137, 138, 142, 152, 153, 165, 166 Neuropathy, 83, 152 Neuropeptide, 77, 152 Neurophysiology, 138, 152 Neurosis, 152, 156 Neurotic, 78, 91, 152, 153 Neurotic Disorders, 91, 153 Neurotransmitter, 12, 77, 86, 125, 126, 131, 139, 142, 143, 153, 163, 164, 165, 166, 168 Nicotine, 13, 43, 44, 84, 153 Nitric Oxide, 48, 153 Nitrogen, 90, 126, 153, 168 Nonverbal Communication, 135, 153, 159 Norepinephrine, 125, 138, 139, 153 Nuclear, 130, 148, 153, 166 Nuclei, 127, 141, 153, 157, 162 Nucleic acid, 137, 153, 160 Nucleus, 6, 8, 84, 134, 137, 149, 153, 158, 162, 164 Nucleus Accumbens, 84, 153 Nystagmus, 4, 153 O Obsessive-Compulsive Disorder, 5, 76, 78, 86, 114, 142, 154 Odour, 129, 154, 168 Opiate, 151, 154 Orthostatic, 3, 11, 83, 128, 154 Outpatient, 15, 154 Ovary, 83, 154 Oxygen Consumption, 154, 161 P Pain, Intractable, 79, 154 Palliative, 154, 166 Pancreas, 125, 143, 147, 154, 164 Pancreatic, 19, 83, 134, 143, 154 Pancreatic cancer, 19, 154 Pancreatic Juice, 143, 154 Pancreatic Pseudocyst, 83, 154 Pancreatitis, 83, 154 Paralysis, 128, 154, 155, 159 Paranoia, 49, 154 Paresis, 152, 155 Paresthesias, 152, 154, 155 Paroxysmal, 3, 15, 33, 36, 127, 155 Partial remission, 155, 161 Pathogenesis, 55, 155 Pathologic, 137, 145, 155 Pathologies, 9, 155 Pathophysiology, 14, 48, 155
Index 177
Pedigree, 15, 155 Pepsin, 155 Pepsin A, 155 Peptic, 4, 155 Peptic Ulcer, 4, 155 Peptide, 13, 84, 126, 129, 134, 155, 159 Perception, 97, 138, 144, 155, 162 Perceptual Disorders, 97, 155 Perimenopausal, 89, 90, 155 Peripheral Nervous System, 140, 152, 153, 155, 164, 165 Personality Disorders, 86, 156 Petechiae, 144, 156 Pharmacologic, 127, 156, 167 Pharynx, 143, 156 Phenotype, 12, 78, 156 Phenyl, 91, 156 Phobia, 5, 9, 14, 52, 73, 77, 82, 89, 90, 95, 96, 156 Phobic Disorders, 78, 156 Phospholipases, 156, 163 Phosphorus, 132, 156 Physiologic, 126, 150, 156, 158, 160 Pilot study, 5, 17, 37, 45, 156 Plants, 126, 130, 132, 135, 143, 153, 156, 161 Plasma, 133, 143, 144, 145, 151, 156 Plasticity, 6, 156 Platelet Activation, 156, 163 Platelet Aggregation, 127, 153, 156 Platelets, 8, 153, 156, 157, 166 Pleomorphic, 153, 157 Pneumonia, 137, 157 Poisoning, 143, 147, 152, 157 Polycystic, 83, 157 Polygenic Inheritance, 78, 157 Pons, 131, 157 Pontine, 8, 9, 157 Portal Hypertension, 83, 157 Portal Vein, 157 Postmenopausal, 101, 157 Postprandial, 83, 157 Postsynaptic, 157, 163, 166 Post-traumatic, 5, 11, 21, 151, 157 Post-traumatic stress disorder, 5, 11, 21, 157 Potassium, 152, 157 Potentiates, 138, 157 Potentiation, 157, 163 Practicability, 157, 168 Practice Guidelines, 110, 157 Precancerous, 4, 158
Premalignant, 158 Premenstrual, 39, 158 Premenstrual Syndrome, 39, 158 Presynaptic, 153, 158, 166 Prevalence, 6, 9, 44, 55, 78, 88, 158 Probe, 14, 80, 158 Problem Solving, 5, 158 Progesterone, 158, 165 Progression, 127, 158 Progressive, 7, 133, 134, 137, 144, 152, 156, 158 Prolapse, 11, 42, 158, 159 Prone, 76, 158 Prophase, 158, 166 Prophylaxis, 89, 158 Propranolol, 37, 158 Prospective study, 17, 19, 32, 158 Prostaglandin, 25, 158 Prostaglandins A, 159 Protective Agents, 132, 159 Protein S, 96, 131, 159 Proteins, 126, 128, 133, 134, 135, 136, 151, 153, 155, 156, 159, 160, 162 Proteolytic, 136, 159 Proximal, 77, 139, 158, 159, 162 Psychiatric, 5, 9, 15, 17, 20, 25, 26, 28, 31, 37, 38, 39, 43, 51, 56, 57, 60, 64, 80, 135, 150, 159 Psychic, 87, 150, 152, 159, 162 Psychoactive, 159, 169 Psychogenic, 38, 159 Psychomotor, 152, 159 Psychopathology, 10, 11, 18, 44, 52, 159 Psychotherapy, 5, 24, 49, 65, 129, 135, 159 Psychotropic, 81, 159 Ptosis, 85, 159 Public Health, 11, 14, 16, 110, 159 Public Policy, 109, 160 Pulmonary, 48, 131, 134, 145, 160, 168 Pulmonary Artery, 131, 160, 168 Pulmonary Edema, 134, 160 Pulmonary Ventilation, 145, 160 Pulse, 85, 151, 160 Pupil, 138, 151, 160 Purpura, 144, 160 Pyrimidines, 88, 160 Q Quality of Life, 10, 14, 16, 37, 160 R Race, 86, 160, 163 Racemic, 86, 160, 163 Radioactive, 145, 146, 153, 160
178 Panic Attacks
Radius, 87, 160 Randomized, 6, 16, 139, 160 Rape, 157, 160 Reagent, 134, 160 Receptors, Serotonin, 160, 162 Recurrence, 131, 134, 160 Refer, 1, 136, 139, 140, 148, 149, 152, 160, 169 Reflux, 4, 139, 143, 160 Refraction, 160, 164 Refractory, 16, 24, 57, 154, 160 Regimen, 139, 161 Regional lymph node, 143, 161 Regression Analysis, 12, 161 Regurgitation, 143, 144, 150, 161 Relapse, 7, 10, 13, 49, 161 Remission, 16, 34, 131, 160, 161 Respiration, 15, 50, 128, 132, 133, 151, 161 Retina, 149, 161 Retrospective, 51, 161 Risk factor, 10, 51, 148, 158, 161 Risperidone, 34, 161 S Saliva, 13, 161 Salivary, 51, 154, 161 Salivary glands, 161 Saponins, 161, 165 Schizoid, 161, 169 Schizophrenia, 8, 9, 23, 24, 25, 46, 77, 84, 86, 89, 90, 149, 154, 161, 162, 169 Schizotypal Personality Disorder, 138, 162, 169 Scleroderma, 83, 162 Sclerosis, 83, 162 Screening, 13, 134, 162 Secretion, 21, 76, 83, 134, 145, 147, 150, 151, 162 Sedative, 142, 146, 150, 162 Seizures, 27, 38, 79, 85, 89, 102, 135, 155, 162 Senile, 90, 162 Septal, 148, 162 Septal Nuclei, 148, 162 Serotonin, 12, 29, 30, 40, 51, 85, 86, 88, 91, 128, 134, 138, 142, 151, 153, 160, 161, 162, 168 Sertraline, 16, 52, 102, 162 Serum, 31, 60, 127, 136, 162 Sex Characteristics, 125, 162 Shock, 6, 162, 168 Side effect, 23, 97, 125, 128, 134, 162, 167 Signal Transduction, 8, 163
Signs and Symptoms, 161, 163, 168 Skeletal, 82, 147, 163 Skeleton, 147, 158, 163 Skull, 163, 166 Sleep apnea, 52, 76, 163 Small intestine, 139, 145, 147, 163 Smoking Cessation, 13, 89, 163 Smooth muscle, 127, 131, 132, 163, 165 Social Environment, 160, 163 Social Support, 12, 163 Sodium, 12, 23, 34, 44, 51, 60, 151, 152, 163 Sodium Bicarbonate, 60, 163 Sodium Lactate, 23, 34, 44, 51, 60, 163 Solitary Nucleus, 130, 164 Solvent, 130, 141, 164 Soma, 164 Somatic, 53, 81, 125, 148, 149, 155, 164 Somatostatin, 83, 164 Spasticity, 90, 164 Spatial disorientation, 139, 164 Specialist, 115, 138, 164 Species, 141, 143, 149, 160, 164, 169 Specificity, 15, 126, 164 Spectrum, 21, 150, 164 Sperm, 134, 164 Spike, 9, 47, 67, 85, 164 Spinal cord, 79, 129, 131, 133, 134, 149, 150, 152, 155, 164, 165 Spleen, 87, 143, 164 Sporadic, 78, 152, 164 Steel, 6, 165 Steroid, 38, 60, 137, 161, 165 Stimulant, 132, 137, 147, 165 Stimulus, 6, 139, 140, 141, 147, 155, 156, 165, 166 Stomach, 4, 9, 85, 87, 125, 129, 139, 141, 142, 143, 145, 149, 152, 155, 156, 160, 163, 164, 165 Striatum, 153, 165 Stroke, 37, 56, 83, 86, 89, 97, 108, 165 Subclinical, 35, 146, 162, 165 Subiculum, 145, 165 Subliminal, 85, 165 Substance P, 150, 162, 165 Suppression, 8, 15, 27, 165 Sympathetic Nervous System, 82, 129, 165 Sympathomimetic, 139, 141, 147, 153, 165, 168 Symptomatic, 16, 154, 165 Symptomatology, 25, 60, 165 Synapse, 125, 138, 158, 165, 166 Synapsis, 166
Index 179
Synaptic, 6, 9, 153, 163, 166 Synaptic Transmission, 153, 166 Systemic, 48, 83, 131, 141, 146, 162, 163, 164, 166 Systole, 66, 150, 166 Systolic, 145, 150, 166 T Tardive, 89, 90, 128, 134, 166 Telencephalon, 130, 166 Temporal, 18, 54, 127, 144, 145, 149, 166 Temporal Lobe, 18, 127, 166 Tendon, 164, 166 Thalamus, 9, 138, 141, 148, 166 Therapeutics, 16, 76, 151, 166 Third Ventricle, 141, 146, 166 Threshold, 9, 15, 141, 145, 165, 166 Thrombocytes, 157, 166 Thrombosis, 86, 147, 159, 165, 166 Thyroid, 42, 83, 145, 166 Tidal Volume, 15, 145, 167 Tolerance, 135, 143, 167 Tomography, 54, 167 Tone, 6, 141, 164, 167 Tonic, 85, 135, 167 Tonicity, 139, 167 Tonus, 167 Tooth Preparation, 125, 167 Topical, 141, 163, 167 Toxic, iv, 89, 130, 152, 153, 167 Toxicity, 139, 167 Toxicology, 77, 110, 167 Trace element, 142, 167 Trachea, 131, 156, 166, 167 Transcutaneous, 14, 36, 167 Transduction, 8, 163, 167 Transfection, 131, 167 Transient Ischemic Attacks, 3, 167 Translation, 126, 167 Trauma, 15, 21, 56, 83, 86, 89, 141, 144, 154, 168 Treatment Outcome, 7, 23, 168
Tricyclic, 33, 134, 138, 146, 168 Tryptophan, 135, 162, 168 Tubercle, 153, 168 Tyramine, 56, 151, 168 U Unconscious, 146, 168 Uracil, 160, 168 Uraemia, 154, 168 Urinary, 31, 57, 164, 168 Urine, 139, 151, 168 V Vascular, 58, 132, 133, 140, 146, 153, 168 Vasculitis, 133, 154, 168 Vasodilators, 153, 168 Vector, 167, 168 Vein, 38, 41, 127, 129, 147, 153, 157, 168 Venous, 45, 83, 129, 133, 147, 159, 168 Ventral, 146, 153, 157, 168 Ventricle, 127, 133, 145, 150, 153, 160, 166, 168 Vertebrae, 164, 168 Vertigo, 3, 70, 76, 168 Vestibular, 3, 169 Vestibule, 169 Veterinary Medicine, 109, 169 Viral, 140, 167, 169 Virus, 130, 167, 169 Visceral, 130, 148, 169 Visceral Afferents, 130, 169 Vivo, 169 W War, 157, 169 Windpipe, 156, 166, 169 Withdrawal, 13, 69, 84, 169 X Xenograft, 127, 169 X-ray, 130, 141, 153, 169 Y Yeasts, 156, 169 Yohimbine, 6, 43, 60, 169
180 Panic Attacks
