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

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

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RHABDOMYOLYSIS 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., 1960Rhabdomyolysis: 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: 0-597-84608-1 1. Rhabdomyolysis-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on rhabdomyolysis. 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 RHABDOMYOLYSIS .................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Rhabdomyolysis ............................................................................ 6 E-Journals: PubMed Central ......................................................................................................... 8 The National Library of Medicine: PubMed .................................................................................. 9 CHAPTER 2. NUTRITION AND RHABDOMYOLYSIS .......................................................................... 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Rhabdomyolysis ........................................................................... 53 Federal Resources on Nutrition ................................................................................................... 59 Additional Web Resources ........................................................................................................... 60 CHAPTER 3. DISSERTATIONS ON RHABDOMYOLYSIS ...................................................................... 63 Overview...................................................................................................................................... 63 Dissertations on Rhabdomyolysis ................................................................................................ 63 Keeping Current .......................................................................................................................... 63 CHAPTER 4. PATENTS ON RHABDOMYOLYSIS ................................................................................ 65 Overview...................................................................................................................................... 65 Patents on Rhabdomyolysis ......................................................................................................... 65 Patent Applications on Rhabdomyolysis...................................................................................... 69 Keeping Current .......................................................................................................................... 71 CHAPTER 5. BOOKS ON RHABDOMYOLYSIS .................................................................................... 73 Overview...................................................................................................................................... 73 Chapters on Rhabdomyolysis ....................................................................................................... 73 CHAPTER 6. PERIODICALS AND NEWS ON RHABDOMYOLYSIS ...................................................... 75 Overview...................................................................................................................................... 75 News Services and Press Releases................................................................................................ 75 Academic Periodicals covering Rhabdomyolysis.......................................................................... 77 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 79 Overview...................................................................................................................................... 79 U.S. Pharmacopeia....................................................................................................................... 79 Commercial Databases ................................................................................................................. 80 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 85 Overview...................................................................................................................................... 85 NIH Guidelines............................................................................................................................ 85 NIH Databases............................................................................................................................. 87 Other Commercial Databases....................................................................................................... 89 The Genome Project and Rhabdomyolysis ................................................................................... 89 APPENDIX B. PATIENT RESOURCES ................................................................................................. 93 Overview...................................................................................................................................... 93 Patient Guideline Sources............................................................................................................ 93 Finding Associations.................................................................................................................... 96 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 99 Overview...................................................................................................................................... 99 Preparation................................................................................................................................... 99 Finding a Local Medical Library.................................................................................................. 99 Medical Libraries in the U.S. and Canada ................................................................................... 99 ONLINE GLOSSARIES................................................................................................................ 105 Online Dictionary Directories ................................................................................................... 108

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RHABDOMYOLYSIS DICTIONARY ....................................................................................... 109 INDEX .............................................................................................................................................. 157

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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 rhabdomyolysis 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 rhabdomyolysis, 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 rhabdomyolysis, 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 rhabdomyolysis. 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 rhabdomyolysis, 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 rhabdomyolysis. 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 RHABDOMYOLYSIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on rhabdomyolysis.

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

Acute Renal Failure Caused by Nontraumatic Rhabdomyolysis Source: Renal Failure. 19(3): 439-442. May 1997. Contact: Available from Marcel Dekker. P.O. Box 5017, Monticello, NY 12701-5176. Summary: Nontraumatic rhabdomyolysis (nt-RML) is a clinical disorder arising from skeletal muscle injury without evidence of trauma or surgical intervention; it may be associated with severe metabolic disturbances and involvement of other organ systems. Previous literature has described an 8 to 20 percent incidence of acute renal failure in ntRML. This article reports on a study that evaluates the experience with 11 patients with acute renal failure (ARF) caused by nt-RML who were treated by high-efficiency daily hemodialysis. Of the 11 patients, the nt-RML was attributed to heroin overdose in 6, treatment with lipid-lowering drugs in 3, intense muscular activity in 1, and repetitive

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seizures in 1; 7 of the 11 were male, and mean age was 37 years (range 22 to 70 years). The dialysis schedule consisted of short treatment with high-efficiency bicarbonate hemodialysis performed daily, on a PAN membrane parallel-plate dialyzer. Hemodialysis (HD) was continued until a satisfactory renal function returned. During hospitalization and after hemodialysis treatment stoppage, the patients received medical therapy (dehydration and electrolyte imbalance correction, forced diuresis, urine alkalization). The authors conclude that early HD treatment makes it possible to obtain a prompt recovery of renal function and an immediate correction of hydroelectrolyte imbalance and of metabolic acidosis. In this study, 10 of 11 patients recovered renal function very quickly and did not experience major life-threatening complications; only 1 died, of severe pulmonary septic complications. This is in contrast to a reported mortality rate of 15 to 20 percent in patients with ARF. 1 table. 9 references. (AA-M). •

Acute, Exercise-Induced Compartment Syndrome, Rhabdomyolysis, and Renal Failure: A Case Report Source: Nutrition in Clinical Practice. 14(6): 296-298. December 1999. Contact: Available from American Society for Parenteral and Enteral Nutrition. 8630 Fenton Street, Suite 412, Silver Spring, MD 20910-3805. (301) 587-6315. Summary: Rhabdomylolysis is a potentially fatal disease of skeletal muscle characterized by myoglobinuria (myoglobin, a molecule of protein and iron, in the urine). Rhabdomyolysis is the damage of striated muscle fibers, which causes them to release their cellular contents into the surrounding tissue and plasma. Exertional rhabdomylolysis has been reported following such activities as military training and marathon running. Risks for developing rhabdomyolysis can include high ambient temperature, high humidity, and improper hydration. The most common reported sequelae of rhabdomyolysis is kidney (renal) failure, which occurs in 4 to 33 percent of cases. This article presents a case report illustrating severe sequelae following heat exhaustion and dehydration in an otherwise healthy adult. Compartment syndrome is often associated with the occurrence of rhabdomyolysis; compartment syndrome is a pathologic condition caused by the progressive development of arterial compression and reduction of blood supply (symptoms include swelling, restriction of movement, and severe pain). The authors detail the 60 day course of hospitalization for this patient, who was finally discharged to a rehabilitation facility. The article concludes with a brief summary of the American College of Sports Medicine guidelines for adequate hydration during exercise. 9 references.

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Rhabdomyolysis and Myoglobinuric Renal Failure in Trauma and Surgical Patients: A Review Source: Journal of the American College of Surgeons. 186(6): 693-716. June 1998. Summary: This article reviews the problems of rhabdomyolysis and myoglobinuric renal failure in trauma and surgical patients. Crush syndrome is the systemic manifestation of muscle injury after direct trauma or ischemia reperfusion injury. Rhabdomyolysis literally means 'striped muscle dissolution.' Rhabdomyolysis can be quantitated by measuring plasma levels of creatine kinase (CK), an enzyme released from injured myocytes. Renal failure after rhabdomyolysis is multifactorial. Myoglobin toxicity is related to mechanical plugging of the renal tubules, direct toxic effects, and alterations in renal blood flow. Hypovolemic shock can be a contributing factor. Prevention is the key, and the first step in treatment is the restoration of adequate intravascular volume replacement. Second, generation of an alkaline diuresis with

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mannitol and sodium bicarbonate appears to have benefit. So called pretreatment of injured muscle in an effort to minimize or avoid the ischemia reperfusion injury may be the most efficient way to protect the kidney. This mode of prophylactic therapy would have great utility in mass casualty situations (such as mine collapse, train accidents, and seismic events). 7 figures. 3 tables. 227 references. •

Rhabdomyolysis Source: American Family Physician. 65(5): 907-912. March 1, 2002. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article provides health professionals with information on the pathophysiology, etiology, clinical presentation, complications, and treatment of rhabdomyolysis. This potentially life threatening syndrome results from the breakdown of skeletal muscle fibers, with leakage of muscle contents into the circulation. The most common causes are crush injury, overexertion, alcohol abuse, and certain medications and toxic substances. Several inherited genetic disorders, such as McArdle's disease and Duchenne's muscular dystrophy, are predisposing factors for the syndrome. Clinical features are often nonspecific. Local signs and symptoms may include muscle pain, tenderness, and swelling. Systemic features may include tea-colored urine, which is usually the first sign, along with fever and malaise. Screening may be performed with a urine dipstick in combination with urine microscopy. A positive urine myoglobin test provides supportive evidence. Multiple complications can occur and are classified as early or late. Early complications include severe hyperkalemia that causes cardiac arrhythmia and arrest. The most serious late complication is acute renal failure, which occurs in approximately 15 percent of patients with the syndrome. The treatment of rhabdomyolysis is mainly directed at preserving renal function. Intravenous hydration must be initiated as early as possible. Hemodialysis may be a therapeutic modality. Early recognition of rhabdomyolysis and prompt management of complications are crucial to a successful outcome. 1 figure, 7 tables, and 29 references. (AA-M).

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Rhabdomyolysis: An Overview Source: American Journal of Nursing. AJN. 102(2): 75,77,79. February 2002. Summary: This journal article provides nurses with information on the etiology, clinical manifestations, management, and prevention of rhabdomyolysis. This pathologic syndrome is associated with the disintegration of striated muscle fibers that leads to the excretion of excessive myoglobin, an iron containing pigment, into the bloodstream. The massive amounts of myoglobin are filtered by the glomeruli, resulting in tubular obstruction and renal failure. The causes of rhabdomyolysis may be classified as traumatic, exercise induced, toxicologic, environmental, metabolic, infectious, immunologic, pharmacotherapeutic, and inherited. Initial symptoms of rhabdomyolysis include profound muscular weakness and pain, swelling, stiffness, and cramps. Darkened or reddish brown urine is the main sign of the syndrome. Elevated creatine kinase isoenzymes indicate rhabdomyolysis. The main therapy for rhabdomyolysis is aggressive intravenous fluid hydration with crystalloid solutions such as normal saline. Frequent assessment of electrolytes is needed to prevent potentially life threatening complications. In addition, compartment pressures should be monitored frequently to prevent the development of compartment syndrome. The main focus of patient

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education should be the prevention and minimization of side effects of rhabdomyolysis. 10 references.

Federally Funded Research on Rhabdomyolysis The U.S. Government supports a variety of research studies relating to rhabdomyolysis. 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 rhabdomyolysis. 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 rhabdomyolysis. The following is typical of the type of information found when searching the CRISP database for rhabdomyolysis: •

Project Title: DIET THERAPY OF LONG-CHAIN FATTY ACID OXIDATION DEFECTS Principal Investigator & Institution: Gillingham, Melanie B.; Molecular and Medical Genetics; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2004; Project Start 01-SEP-2004 Summary: (provided by applicant): Dietay therapy for long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) includes avoidance of fasting and a low longchain fatty acid (LCFA) diet supplemented with medium chain triglyceride (MCT). Acute episodes of hypoglycemia, acidosis, and cardiomyopathy are largely prevented with this therapy, but chronic complications, such as exercise-induced rhabdomyolysis, are not prevented. MCT may provide an alternate fuel source during exercise. Forty percent of a currently followed cohort is overweight or obese and most subjects are lipogenic at rest. The first objective of this study is to determine if a high protein, reduce carbohydrate diet will decrease anabolism, decrease lipogenesis at rest, and improve metabolic control in children with LCHADD. The second objective is to determine if MCT supplementation prior to exercise decreases the risk of rhabdomyolysis of subjects with LCHADD. The metabolic response to a high protein, reduced carbohydrate diet compared to a standard LCHADD diet and exercise tolerance with and without supplemental MCT prior to exercise testing will be assessed in a randomized crossover design. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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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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Project Title: HUMAN HEME OXYGENASE-1 GENE REGULATION IN RENAL INJURY Principal Investigator & Institution: Agarwal, Anupam; Associate Professor; Medicine; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant): Induction of heme oxygenase-1 is an adaptive response to injury and plays an important cytoprotective role in acute renal failure due to ischemia-reperfusion, nephrotoxins, transplant rejection and rhabdomyolysis. Heme oxygenase catalyzes the rate-limiting step in heme degradation producing biliverdin, iron and carbon monoxide. Recent studies have demonstrated that the beneficial effects of this enzyme is a consequence of important antioxidant, anti-inflammatory and antiapoptotic properties of the catalytic products. We, and others, have demonstrated that a number of factors (heme, nitric oxide, lipid and hydrogen peroxides, cytokines and growth factors), implicated in the pathogenesis of acute renal injury, are responsible for induction of heme oxygenase- 1. Our studies using human renal proximal tubular cells have recently discovered a novel enhancer region in the human heme oxygenase-1 gene that in conjunction with the promoter, specifically mediates gene regulation by heme and nitric oxide, but not by other known stimuli. The experiments outlined in this proposal will test the global hypothesis that specific trans-acting proteins interact with unique regulatory elements in the human heme oxygenase-l gene and mediate increased gene expression in response to heme and nitric oxide in human proximal tubular cells. Aim I of this proposal will involve characterization of the enhancer and promoter regions by deletion analysis and electrophoretic mobility shift assays. Aim II will evaluate DNA-protein interactions at the single nucleotide resolution by in vivo footprinting. The studies outlined in Aim III will evaluate the functional significance of potential DNA-protein binding regions in the enhancer element by-PCR-based sitedirected mutagenesis. Aim IV will involve studies to identify trans-acting proteins that bind to the enhancer element, using yeast one-hybrid screening. These studies will provide a basis for the development of specific molecular approaches to manipulate and fine tune heme oxygenase-l expression and thus exploit its cytoproteetive effects in renal pathophysiologic states. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: REGULATION OF RYANODINE RECEPTOR BY NITROGEN OXIDES Principal Investigator & Institution: Eu, Jerry Pc.; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 15-AUG-1999; Project End 31-JUL-2004 Summary: The long-term goal of this project is to improve our understanding of redox regulation of an intracellular calcium release channel (the ryanodine receptor) in skeletal muscle by reactive nitrogen species (RNS). All three isoforms of nitric oxide synthase (NOS) have been identified in skeletal muscle. Nitric oxide and related species (collectively termed reactive nitrogen species) produced endogenously in muscle have been shown to influence force generation. We hypothesize that the effects of RNS on muscle contractility occur in part through the ryanodine receptor, which contains regulatory thiols. The specific aims of this proposal are: 1) Define the subcellular locations of each isoform of NOS in relation to the ryanodine receptor 2) Assess the effects of reactive nitrogen species on channel activity in vitro and in muscle cell culture systems and 3) Determine the underlying molecular mechanism(s) of regulation. Our results may lead to new insights into regulation of Ca2+ homeostasis in muscle and to

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the dysregulation of Ca2+ characteristic of disease states such as respiratory failure and rhabdomyolysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STATIN LACTONES IN STATIN TOXICITY Principal Investigator & Institution: Christians, Uwe; Associate Professor; Anesthesiology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2003; Project Start 08-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): 3-Hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase inhibitors (statins) have emerged as the most valuable cholesterollowering drugs. Statins have wide therapeutic indeces and are generally well tolerated. However, the combination of statins with mainly triglyceride-lowering fibrates, especially nicotinic acid or gemfibrozil, or potent cytochrome P450/p-glycoprotein inhibitors significantly increases the risk to develop myopathy such as potentially fatal rhabdomyolysis. A recent example stressing the clinical importance of statin/fibrate drug interactions is the removal of cerivastatin from the market on August 8, 2001 after at least 40 fatal cases of rhabdomyolysis were reported when cerivastatin was coadministered with the fibrate gemfibrozil. Although for each statin an equilibrium between both acid and lactone form exists in vivo, very little attention has been paid to the potential role of the lactones of statins administered as open acids (atorvastatin, cerivastatin, fluvastatin, pravastatin) in pharmacokinetic and pharmacodynamic drug interactions and toxicity.This is surprising since the lactone forms are considerably more lipophilic than the acid forms, and it seems reasonable to assume that their access and affinities to cytochrome P450 enzymes, transporters and their tissue distribution, e.g. into muscle cells, differs significantly from the acids. It is our hypothesis that the statin lactones play a key role in statin pharmacokinetics and toxicity. To identify the role of statin lactones in statin toxicity, we will assess both lactone pharmacokinetics and their pharmacodynamic effects on liver and muscle cell metabolism using magnetic resonance spectroscopy (MRS). It will be our primary goal to assess the mechanistic role of statin lactones in the pharmacokinetics, toxicity and drug-drug interactions of statins in comparison to their corresponding acids. Our secondary goal will be to compare the lactones/acids of the different statins with each other. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “rhabdomyolysis” (or synonyms) into the search box. This search gives you access 3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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to full-text articles. The following is a sample of items found for rhabdomyolysis in the PubMed Central database: •

Rhabdomyolysis and cerivastatin: Was it a problem of dose? by Kalaria D, Wassenaar W.; 2002 Oct 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=126482

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Severe Rhabdomyolysis Associated with the Cerivastatin-Gemfibrozil Combination Therapy Report of a Case. by Lau TK, Leachman DR, Lufschanowski R.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=101156

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Treatment of cardiomyopathy and rhabdomyolysis in long-chain fat oxidation disorders using an anaplerotic odd-chain triglyceride. by Roe CR, Sweetman L, Roe DS, David F, Brunengraber H.; 2002 Jul 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151060

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

A 73-year-old woman with rhabdomyolysis induced by simvastatin (Zocor). Author(s): Havens-Verkler J, Lewis AM. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2004 February; 30(1): 9-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765076

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A case of acute renal failure due to rhabdomyolysis, associated with non-autoimmune fulminant type 1B diabetes mellitus. Author(s): Iyoda M, Kuroki A, Kato K, Kato N, Hirano T, Sugisaki T. Source: Clinical Nephrology. 2003 April; 59(4): 301-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12708572

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

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A case of acute renal failure, rhabdomyolysis and disseminated intravascular coagulation associated with scrub typhus. Author(s): Lee S, Kang KP, Kim W, Kang SK, Lee HB, Park SK. Source: Clinical Nephrology. 2003 July; 60(1): 59-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12872861

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A case of hypokalemia and rhabdomyolysis in a patient with short bowel syndrome. Author(s): Guardino JM, Hix JK, Seidner D. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2003 July-August; 27(4): 305. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12903898

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A case of rhabdomyolysis accompanying acute renal failure secondary to weight lifting. Author(s): Baysal O, Taskapan H, Taskapan C, Kaya E, Sahin I, Kirimlioglu H, Karakas N. Source: Clinical Nephrology. 2003 October; 60(4): 296-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14579948

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A fatal case of malignant hyperthermia complicated by generalized compartment syndrome and rhabdomyolysis. Author(s): Green G. Source: Acta Anaesthesiologica Scandinavica. 2003 May; 47(5): 619-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699524

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A novel missense mutation (1060G --> C) in the phosphoglycerate kinase gene in a Japanese boy with chronic haemolytic anaemia, developmental delay and rhabdomyolysis. Author(s): Morimoto A, Ueda I, Hirashima Y, Sawai Y, Usuku T, Kano G, Kuriyama K, Todo S, Sugimoto T, Kanno H, Fujii H, Imashuku S. Source: British Journal of Haematology. 2003 September; 122(6): 1009-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956773

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A novel sporadic mutation in cytochrome c oxidase subunit II as a cause of rhabdomyolysis. Author(s): McFarland R, Taylor RW, Chinnery PF, Howell N, Turnbull DM. Source: Neuromuscular Disorders : Nmd. 2004 February; 14(2): 162-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14733964

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A young woman with persistent hypoglycemia, rhabdomyolysis, and coma: recognizing fatty acid oxidation defects in adults. Author(s): Kluge S, Kuhnelt P, Block A, Merkel M, Gocht A, Lukacs Z, Kohlschutter A, Kreymann G. Source: Critical Care Medicine. 2003 April; 31(4): 1273-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12682504

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Acute renal failure due to rhabdomyolysis in a spastic man. Author(s): Sungur C, Akpolat T, Oymak O, Colakoglu M, Yasavul U, Turgan C. Source: Nephron. 1994; 67(2): 236. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8072616

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Acute renal failure in a hypothyroid patient with rhabdomyolysis. Author(s): Kar PM, Hirani A, Allen MJ. Source: Clinical Nephrology. 2003 December; 60(6): 428-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14690261

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Acute renal failure in rhabdomyolysis associated with hypokalemia. Author(s): Lucatello A, Sturani A, Di Nardo A, Fusaroli M. Source: Nephron. 1994; 67(1): 115-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8052353

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Acute renal failure secondary to rhabdomyolysis following near-drowning in sea water. Author(s): Hegde SN, Anupama YJ. Source: J Assoc Physicians India. 2003 May; 51: 512-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974438

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Acute reversible rhabdomyolysis during interferon alpha2B therapy for hepatitis C. Author(s): Gabrielli M, Santarelli L, Serricchio M, Leo D, Pola P, Gasbarrini A. Source: The American Journal of Gastroenterology. 2003 April; 98(4): 940. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12738487

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Acute rhabdomyolysis after bezafibrate re-exposure. Author(s): Terrovitou CT, Milionis HJ, Elisaf MS. Source: Nephron. 1998; 78(3): 336-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9546698

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Acute rhabdomyolysis and myoglobinuria associated with isotretinoin treatment. Author(s): Guttman-Yassky E, Hayek T, Muchnik L, Bergman R. Source: International Journal of Dermatology. 2003 June; 42(6): 499-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12786885

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Acute rhabdomyolysis and myonecrosis complicating aeromonas bacteremia in neutropenic patients with hematologic malignancies: report of two cases. Author(s): Martino R, Santamaria A, Pericas R, Sureda A, Brunet S. Source: Haematologica. 1997 November-December; 82(6): 692-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9499669

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Acute rhabdomyolysis due to prolonged exposure to the cold. Author(s): Korantzopoulos P, Papaioannides D, Sinapidis D, Kolios P. Source: Int J Clin Pract. 2003 April; 57(3): 243-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12723733

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Amiodarone's role in simvastatin-associated rhabdomyolysis. Author(s): de Denus S, Spinler SA. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 September 1; 60(17): 1791; Author Reply 1791-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14503117

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Antihistamine-induced rhabdomyolysis. Author(s): Khosla U, Ruel KS, Hunt DP. Source: Southern Medical Journal. 2003 October; 96(10): 1023-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570348

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Bacillus cereus septicemia associated with rhabdomyolysis and myoglobinuric renal failure. Author(s): Tomiyama J, Hasegawa Y, Nagasawa T, Abe T, Horiguchi H, Ogata T. Source: Jpn J Med. 1989 March-April; 28(2): 247-50. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2499725

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Bacterial sepsis-induced rhabdomyolysis. Author(s): Betrosian A, Thireos E, Kofinas G, Balla M, Papanikolaou M, Georgiadis G. Source: Intensive Care Medicine. 1999 May; 25(5): 469-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10401940

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Bezafibrate induced rhabdomyolysis. Author(s): Kanterewicz E, Sanmarti R, Riba J, Trias I, Autonell J, Brugues J. Source: Annals of the Rheumatic Diseases. 1992 April; 51(4): 536-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1586257

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Bezafibrate-induced rhabdomyolysis. Author(s): Malnick SD, Badir A, Landau Z. Source: Dicp. 1991 July-August; 25(7-8): 869-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1949949

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Bilateral, exercise-induced thigh compartment syndrome diagnosed as exertional rhabdomyolysis. A case report and review of the literature. Author(s): Wise JJ, Fortin PT. Source: The American Journal of Sports Medicine. 1997 January-February; 25(1): 126-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9006707

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Biochemical investigation of suspected rhabdomyolysis. Author(s): Beetham R. Source: Annals of Clinical Biochemistry. 2000 September; 37 ( Pt 5): 581-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11026512

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Body building and rhabdomyolysis. Author(s): Doriguzzi C, Palmucci L, Mongini T. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1990 September; 53(9): 806-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2246667

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Bone scan in rhabdomyolysis. Author(s): Sagar VV, Meckelnburg RL, Chaikin HL. Source: Clinical Nuclear Medicine. 1980 July; 5(7): 321-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7389232

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Bone scintigraphy of drug-induced rhabdomyolysis: antihyperlipidemia agent. Author(s): Takayama T, Tsuji S, Taki J, Michigishi T, Tonami N. Source: Clinical Nuclear Medicine. 1996 December; 21(12): 988-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8957627

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Can seizures and rhabdomyolysis be a potentially serious complication of hyponatremia due to polydipsia? Author(s): Tolan P, O'Loughlin D, Botha J. Source: The Australian and New Zealand Journal of Psychiatry. 2001 June; 35(3): 386. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11437815

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Cardiac arrest after succinylcholine: mortality greater with rhabdomyolysis than receptor upregulation. Author(s): Gronert GA. Source: Anesthesiology. 2001 March; 94(3): 523-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11374616

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Cerivastatin and gemfibrozil-associated rhabdomyolysis. Author(s): Bruno-Joyce J, Dugas JM, MacCausland OE. Source: The Annals of Pharmacotherapy. 2001 September; 35(9): 1016-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11573847

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Cerivastatin and gemfibrozil-induced cardiac rhabdomyolysis. Author(s): Su M, Hoffman RS, Flomenbaum M. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 2002 September; 23(3): 305-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12198364

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Cerivastatin induces rhabdomyolysis and acute renal failure. Author(s): Di Paolo N, Monaci G, Cappelletti F, Di Paolo M, Verzuri MS. Source: Nephron. 2002; 92(3): 751. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12372976

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Cerivastatin monotherapy-induced muscle weakness, rhabdomyolysis and acute renal failure. Author(s): Bakri R, Wang J, Wierzbicki AS, Goldsmith D. Source: International Journal of Cardiology. 2003 September; 91(1): 107-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957739

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Cerivastatin-induced rhabdomyolysis in a renal transplant on cyclosporin. Author(s): Mora C, Rodriguez ML, Navarro JF. Source: Transplantation. 2001 August 15; 72(3): 551. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11502997

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Chest pain during stenting of a native aortic coarctation: a case for acute intercostal muscle ischemia and rhabdomyolysis. Author(s): Sapin SO, Rosengart RM, Salem MM. Source: Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 2002 October; 57(2): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12357524

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Chronic salicylate intoxication and rhabdomyolysis in a patient with scleroderma and Sjogren's syndrome. Author(s): Nawata Y, Kagami M, Nakajima H, Matsumura R, Sugiyama T, Sueishi M, Hirasawa H, Iwamoto I, Yoshida S. Source: The Journal of Rheumatology. 1994 February; 21(2): 357-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8182651

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Clopidogrel and rhabdomyolysis after heart transplantation. Author(s): Uber PA, Mehra MR, Park MH, Scott RL. Source: The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation. 2003 January; 22(1): 107-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12531422

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Colchicine-induced rhabdomyolysis in a patient with chronic heart failure. Author(s): Debie K, Conraads V, Vrints C. Source: Acta Cardiol. 2003 December; 58(6): 561-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14713183

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Colchicine-induced rhabdomyolysis. Author(s): Phanish MK, Krishnamurthy S, Bloodworth LL. Source: The American Journal of Medicine. 2003 February 1; 114(2): 166-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12586247

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Colchicine-induced rhabdomyolysis: the whole is greater than the sum of its parts! Author(s): Vasudevan AR, Uthamalingam S, Kumar S, Tamarin F, Brensilver JM. Source: The American Journal of Medicine. 2003 August 15; 115(3): 249. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12935834

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Combination therapy with cerivastatin and gemfibrozil causing rhabdomyolysis: is the interaction predictable? Author(s): Tomlinson B, Lan IW. Source: The American Journal of Medicine. 2001 June 1; 110(8): 669-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11388340

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Comment: Rhabdomyolysis and acute renal failure following an ethanol and diphenhydramine overdose. Author(s): Mycyk MB, Mazor SS. Source: The Annals of Pharmacotherapy. 2003 September; 37(9): 1345; Author Reply 1345-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12921526

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Compartment syndrome in a patient with familial rhabdomyolysis: a case report. Author(s): Parvizi J, Shaughnessy WJ. Source: The Journal of Bone and Joint Surgery. American Volume. 2002 November; 84A(11): 2046-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12429768

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Continuous veno-venous hemofiltration for the immediate management of massive rhabdomyolysis after fulminant malignant hyperthermia in a bodybuilder. Author(s): Schenk MR, Beck DH, Nolte M, Kox WJ. Source: Anesthesiology. 2001 June; 94(6): 1139-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11465608

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Crush injury and rhabdomyolysis. Author(s): Malinoski DJ, Slater MS, Mullins RJ. Source: Critical Care Clinics. 2004 January; 20(1): 171-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14979336

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Cutaneous eruptions in coma patients with nontraumatic rhabdomyolysis. Author(s): Miyamoto T, Ikehara A, Kobayashi T, Kitada S, Hagari Y, Mihara M. Source: Dermatology (Basel, Switzerland). 2001; 203(3): 233-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11701977

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Cylindrical spirals of myofilamentous origin associated with exertional cramps and rhabdomyolysis. Author(s): Wolfe GI, Burns DK, Krampitz D, Barohn RJ. Source: Neuromuscular Disorders : Nmd. 1997 December; 7(8): 536-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9447613

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Delayed postoperative rhabdomyolysis in a patient subsequently diagnosed as malignant hyperthermia susceptible. Author(s): McKenney KA, Holman SJ. Source: Anesthesiology. 2002 March; 96(3): 764-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11873057

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Delayed rhabdomyolysis after ecstasy use. Author(s): Halachanova V, Sansone RA, McDonald S. Source: Mayo Clinic Proceedings. 2001 January; 76(1): 112-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11155406

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Delayed severe rhabdomyolysis after taking 'ecstasy'. Author(s): Lehmann ED, Thom CH, Croft DN. Source: Postgraduate Medical Journal. 1995 March; 71(833): 186-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7746785

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Detection of rhabdomyolysis associated with compartment syndrome by bone scintigraphy. Author(s): Hod N, Fishman S, Horne T. Source: Clinical Nuclear Medicine. 2002 December; 27(12): 885-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12607869

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Development of rhabdomyolysis after rapid opioid detoxification with subcutaneous naltrexone maintenance therapy. Author(s): Chanmugam AS, Hengeller M, Ezenkwele U. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2000 March; 7(3): 303-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10730843

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Diabetes and rhabdomyolysis. A rare complication of a common disease. Author(s): Lord GM, Scott J, Pusey CD, Rees AJ, Walport MJ, Davies KA, Bulpitt C, Bloom SR, Muntoni FM. Source: Bmj (Clinical Research Ed.). 1993 October 30; 307(6912): 1126-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8251814

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Diabetic ketoacidosis and rhabdomyolysis following excessive intake of a weight reducing diet. Author(s): Goyal SB, Goyal RS. Source: Renal Failure. 1998 July; 20(4): 645-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9713884

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Diabetic ketoacidosis associated with recurrent pulmonary edema and rhabdomyolysis in a patient with Turner's syndrome. Author(s): Terano T, Fukuda K, Nakamura M, Takiguchi Y, Sakai Y, Hirai A. Source: Intern Med. 2001 May; 40(5): 418-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11393414

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Diagnosing exertional rhabdomyolysis: a brief review and report of two cases. Author(s): Walsworth M, Kessler T. Source: Military Medicine. 2001 March; 166(3): 275-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11263034

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Diagnosis and treatment of acute exertional rhabdomyolysis. Author(s): Baxter RE, Moore JH. Source: The Journal of Orthopaedic and Sports Physical Therapy. 2003 March; 33(3): 1048. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12683685

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Dialytic treatment of rhabdomyolysis-induced acute renal failure: our experience. Author(s): Splendiani G, Mazzarella V, Cipriani S, Pollicita S, Rodio F, Casciani CU. Source: Renal Failure. 2001 March; 23(2): 183-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11417950

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Differential detection of skeletal troponin I isoforms in serum of a patient with rhabdomyolysis: markers of muscle injury? Author(s): Simpson JA, Labugger R, Hesketh GG, D'Arsigny C, O'Donnell D, Matsumoto N, Collier CP, Iscoe S, Van Eyk JE. Source: Clinical Chemistry. 2002 July; 48(7): 1112-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12089186

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Disseminated intravascular coagulation (DIC) and rhabdomyolysis in fulminant varicella infection--case report and review of the literature. Author(s): Hollenstein U, Thalhammer F, Burgmann H. Source: Infection. 1998 September-October; 26(5): 306-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9795791

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Diver with decompression injury, elevation of serum transaminase levels, and rhabdomyolysis. Author(s): Shank ES, Muth CM. Source: Annals of Emergency Medicine. 2001 May; 37(5): 533-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11326189

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Does creatine supplementation increase the risk of rhabdomyolysis? Author(s): Juhn MS. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 2000 March-April; 13(2): 150-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10764201

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Doxylamine overdose as a potential cause of rhabdomyolysis. Author(s): Leybishkis B, Fasseas P, Ryan KF. Source: The American Journal of the Medical Sciences. 2001 July; 322(1): 48-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11465247

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Drug induced rhabdomyolysis: case report. Author(s): Larbi EB. Source: East Afr Med J. 1997 December; 74(12): 829-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9557433

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Drug-induced hyperthermia and rhabdomyolysis during the perioperative period: report of three patients. Author(s): Vorrakitpokatorn P, Limsakul A. Source: J Med Assoc Thai. 2002 September; 85 Suppl 3: S884-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12452225

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Drug-induced rhabdomyolysis after concomitant use of clarithromycin, atorvastatin, and lopinavir/ritonavir in a patient with HIV. Author(s): Mah Ming JB, Gill MJ. Source: Aids Patient Care and Stds. 2003 May; 17(5): 207-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12816614

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Drug-interaction-induced rhabdomyolysis. Author(s): Segaert MF, De Soete C, Vandewiele I, Verbanck J. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1996 September; 11(9): 1846-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8918636

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EBV-associated nasal-type T/natural killer cell lymphoma presenting with polyserositis and rhabdomyolysis. Author(s): Vural F, Demirkan F, Ozsan GH, Kargi A, Cabuk M, Ozcan MA, Sayan M, Ozkal S, Cehreli C, Undar B. Source: Leukemia & Lymphoma. 2002 September; 43(9): 1859-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12685845

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Effect of polymyxin B-immobilized fiber hemoperfusion on sepsis-induced rhabdomyolysis with acute renal failure. Author(s): Nakamura T, Ushiyama C, Suzuki S, Shoji H, Shimada N, Sekizuka K, Ebihara I, Koide H. Source: Nephron. 2000 October; 86(2): 210. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11015003

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Elimination kinetics of myoglobin and creatine kinase in rhabdomyolysis: implications for follow-up. Author(s): Lappalainen H, Tiula E, Uotila L, Manttari M. Source: Critical Care Medicine. 2002 October; 30(10): 2212-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12394946

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Emotional distress induced rhabdomyolysis in an individual with carnitine palmitoly-transferase deficiency. Author(s): Wallace RA, Klestov AC, Kubler PA. Source: Clin Exp Rheumatol. 2001 September-October; 19(5): 583-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11579721

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Epidemiology, mechanisms and clinical features of rhabdomyolysis. Author(s): Bollaert PE, Frisoni A. Source: Minerva Anestesiol. 1999 May; 65(5): 245-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10389399

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Etiology and frequency of rhabdomyolysis. Author(s): Black C, Jick H. Source: Pharmacotherapy. 2002 December; 22(12): 1524-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12495162

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Evaluation of aminotransferase elevations in a bodybuilder using anabolic steroids: hepatitis or rhabdomyolysis? Author(s): Pertusi R, Dickerman RD, McConathy WJ. Source: J Am Osteopath Assoc. 2001 July; 101(7): 391-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11476029

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Evaluation of the severity of traumatic rhabdomyolysis using technetium-99m pyrophosphate scintigraphy. Author(s): Chang HR, Kao CH, Lian JD, Shu KH, Cheng CH, Wu MJ, Chen CH. Source: American Journal of Nephrology. 2001 May-June; 21(3): 208-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11423690

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Evidence for susceptibility to malignant hyperthermia in patients with exerciseinduced rhabdomyolysis. Author(s): Wappler F, Fiege M, Steinfath M, Agarwal K, Scholz J, Singh S, Matschke J, Schulte Am Esch J. Source: Anesthesiology. 2001 January; 94(1): 95-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11135728

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Exercise rhabdomyolysis in military aircrew: two cases and a review of aeromedical disposition. Author(s): Watson DB, Gray GW, Doucet JJ. Source: Aviation, Space, and Environmental Medicine. 2000 November; 71(11): 1137-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11086669

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Exercise rhabdomyolysis. Author(s): Shani Y, Heled Y, Moran DS. Source: Aviation, Space, and Environmental Medicine. 2001 September; 72(9): 856. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11565824

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Exercise-induced rhabdomyolysis in a woman. Author(s): Schimpf M, Queale WS, McFarland EG. Source: Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 1999 October; 9(4): 233-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10593220

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Exercise-induced rhabdomyolysis. Author(s): Sayers SP, Clarkson PM. Source: Curr Sports Med Rep. 2002 April; 1(2): 59-60. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12831713

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Exercise-induced rhabdomyolysis. Author(s): O'Donnell J, Gleeson AP. Source: European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine. 1998 September; 5(3): 325-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9827835

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Exercise-induced rhabdomyolysis: even the fit may suffer. Author(s): Sharma N, Winpenny H, Heymann T. Source: Int J Clin Pract. 1999 September; 53(6): 476-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10622078

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Exertional rhabdomyolysis following excessive exercise of university freshman cheertraining. Author(s): Mahakkanukrauh A, Sangchan A, Mootsikapun P. Source: J Med Assoc Thai. 2003 August; 86(8): 789-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12948279

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Exertional rhabdomyolysis in a body builder abusing anabolic androgenic steroids. Author(s): Braseth NR, Allison EJ Jr, Gough JE. Source: European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine. 2001 June; 8(2): 155-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11436915

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Exertional rhabdomyolysis in an adolescent athlete. Author(s): Moghtader J, Brady WJ Jr, Bonadio W. Source: Pediatric Emergency Care. 1997 December; 13(6): 382-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9434995

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Exertional rhabdomyolysis. Potentially life-threatening consequence of intense exercise. Author(s): Santos J Jr. Source: Jaapa. 1999 July; 12(7): 46-9, 53-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10728056

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Extensive rhabdomyolysis after streptokinase therapy for acute myocardial infarction demonstrated by Tc-99m PYP scintigraphy. Author(s): Emmett LM, Patel NC, Thanakrishnan K, Van der Wall H, Magee M, Allman KC. Source: Clinical Nuclear Medicine. 1999 December; 24(12): 991-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10595490

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False elevation of serum creatinine following skin absorption of nitromethane complicates the clinical diagnosis of rhabdomyolysis. Author(s): Gabrielli A, Hammett-Stabler C. Source: Chest. 1998 May; 113(5): 1419-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9596331

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Familial phosphoglycerate kinase deficiency associated with rhabdomyolysis and acute renal failure: abnormality in mRNA splicing? Author(s): Spanu C, Oltean S. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 February; 18(2): 445-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12543909

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Fanconi-like syndrome and rhabdomyolysis in a person with HIV infection on highly active antiretroviral treatment including tenofovir. Author(s): Callens S, De Roo A, Colebunders R. Source: The Journal of Infection. 2003 October; 47(3): 262-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12963392

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Fatal inherited rhabdomyolysis and malignant hyperthermia. Author(s): Denborough MA, McLean A, Morgan G, Hopkinson KC. Source: Lancet. 1994 January 22; 343(8891): 236-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7904690

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Fatal malignant hyperthermia-like syndrome with rhabdomyolysis complicating the presentation of diabetes mellitus in adolescent males. Author(s): Hollander AS, Olney RC, Blackett PR, Marshall BA. Source: Pediatrics. 2003 June; 111(6 Pt 1): 1447-52. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12777570

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Fatal rhabdomyolysis after acute sodium monensin (Rumensin) toxicity: case report. Author(s): Kouyoumdjian JA, Morita MP, Sato AK, Pissolatti AF. Source: Arquivos De Neuro-Psiquiatria. 2001 September; 59(3-A): 596-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11588643

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Fatal rhabdomyolysis associated with simvastatin in a renal transplant patient. Author(s): Weise WJ, Possidente CJ. Source: The American Journal of Medicine. 2000 March; 108(4): 351-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11014734

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Fatal rhabdomyolysis caused by lipid-lowering therapy. Author(s): Federman DG, Hussain F, Walters AB. Source: Southern Medical Journal. 2001 October; 94(10): 1023-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11702815

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Fatal rhabdomyolysis in a flame burn patient. Author(s): Lazarus D, Hudson DA. Source: Burns : Journal of the International Society for Burn Injuries. 1997 August; 23(5): 446-50. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9426917

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Fatal rhabdomyolysis in arsenic trioxide poisoning. Author(s): Fanton L, Duperret S, Guillaumee F, Miras A, Vallon JJ, Malicier D. Source: Human & Experimental Toxicology. 1999 October; 18(10): 640-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10557017

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Fatal rhabdomyolysis presenting as mild heat illness in military training. Author(s): Gardner JW, Kark JA. Source: Military Medicine. 1994 February; 159(2): 160-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8202248

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Fatal rhabdomyolysis with bilateral gluteal, thigh, and leg compartment syndrome after the Army Physical Fitness Test. A case report. Author(s): Kuklo TR, Tis JE, Moores LK, Schaefer RA. Source: The American Journal of Sports Medicine. 2000 January-February; 28(1): 112-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10653554

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Fatal sepsis complicating rhabdomyolysis on the extremities. Author(s): Kataoka H, Shinozaki S, Nagata S, Sato Y, Hanai H. Source: Intensive Care Medicine. 2000 July; 26(7): 1007. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10990120

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Fenofibrate monotherapy induced rhabdomyolysis. Author(s): Barker BJ, Goodenough RR, Falko JM. Source: Diabetes Care. 2003 August; 26(8): 2482-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12882895

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Fenofibrate-induced rhabdomyolysis in two dialysis patients with hypothyroidism. Author(s): Clouatre Y, Leblanc M, Ouimet D, Pichette V. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1999 April; 14(4): 1047-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10328516

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Fluvastatin-induced rhabdomyolysis. Author(s): Modi JR, Cratty MS. Source: The Annals of Pharmacotherapy. 2002 December; 36(12): 1870-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12452746

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Focal exertional rhabdomyolysis associated with a hemangioma steal syndrome. Author(s): Trimarchi HM, Muryan A, Schropp J, Colombo O, Garcia A, Pereyra H, Sarachian B, Freixas EA. Source: The American Journal of Medicine. 2000 May; 108(7): 577-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10806288

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Focal rhabdomyolysis and brachial plexopathy: an association with heroin and chronic ethanol use. Author(s): Riggs JE, Schochet SS Jr, Hogg JP. Source: Military Medicine. 1999 March; 164(3): 228-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10091499

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Found down: compartment syndrome, rhabdomyolysis, and renal failure. Author(s): Carriere SR, Elsworth T. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 1998 June; 24(3): 214-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9775796

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From profound hypokalemia to fatal rhabdomyolysis after severe head injury. Author(s): Tse HF, Yeung CK. Source: The American Journal of Medicine. 2000 November; 109(7): 599-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11185478

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Gallium scanning in rhabdomyolysis. Author(s): Tenenzapf MJ, Thanawala S, Dunn EK, Solomon NA. Source: Clinical Nuclear Medicine. 1981 September; 6(9): 425. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7273545

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Gasoline vapors induce severe rhabdomyolysis. Author(s): Anetseder M, Hartung E, Klepper S, Reichmann H. Source: Neurology. 1994 December; 44(12): 2393-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7991133

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General convulsions and rhabdomyolysis. Case reports. Author(s): Os I, Lyngdal PT. Source: Acta Neurologica Scandinavica. 1989 March; 79(3): 246-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2497620

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Gluteal compartment syndrome due to rhabdomyolysis after heroin abuse. Author(s): Klockgether T, Weller M, Haarmeier T, Kaskas B, Maier G, Dichgans J. Source: Neurology. 1997 January; 48(1): 275-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9008535

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Haloperidol-induced rhabdomyolysis without neuroleptic malignant syndrome in a handicapped child. Author(s): Yoshikawa H, Watanabe T, Abe T, Oda Y, Ozawa K. Source: Brain & Development. 2000 June; 22(4): 256-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10838114

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Hand-assisted laparoscopic radical nephrectomy-associated rhabdomyolysis with ARF. Author(s): Kozak KR, Shah S, Ishihara KK, Schulman G. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2003 January; 41(1): E5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12500214

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Hemangioma steal syndrome: another cause of exertional rhabdomyolysis. Author(s): Knochel JP. Source: The American Journal of Medicine. 2000 May; 108(7): 594-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10806294

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Hemolytic anemia and severe rhabdomyolysis caused by compound heterozygous mutations of the gene for erythrocyte/muscle isozyme of aldolase, ALDOA(Arg303X/Cys338Tyr). Author(s): Yao DC, Tolan DR, Murray MF, Harris DJ, Darras BT, Geva A, Neufeld EJ. Source: Blood. 2004 March 15; 103(6): 2401-3. Epub 2003 November 13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14615364

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Heroin-induced rhabdomyolysis as a cause of reflex sympathetic dystrophy. Author(s): Lee BF, Chiu NT, Chen WH, Liu GC, Yu HS. Source: Clinical Nuclear Medicine. 2001 April; 26(4): 289-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11290885

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High-dose simvastatin and rhabdomyolysis. Author(s): Wratchford P, Ponte CD. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 April 1; 60(7): 698-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12701554

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High-dose verapamil-trandolapril induced rhabdomyolysis and acute renal failure. Author(s): Gokel Y, Paydas S, Duru M. Source: The American Journal of Emergency Medicine. 2000 October; 18(6): 738-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11043636

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Hornet sting induced systemic allergic reaction and large local reaction with bulle formation and rhabdomyolysis. Author(s): Lin CC, Chang MY, Lin JL. Source: Journal of Toxicology. Clinical Toxicology. 2003; 41(7): 1009-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14705851

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Hypercalcemia during resolution of acute renal failure associated with rhabdomyolysis: evidence for suppression of parathyroid hormone and calcitriol. Author(s): Prince RL, Hutchison BG, Bhagat CI. Source: Aust N Z J Med. 1986 August; 16(4): 506-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3467694

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Hypernatremia and rhabdomyolysis. Author(s): Abramovici MI, Singhal PC, Trachtman H. Source: J Med. 1992; 23(1): 17-28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1573339

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Hyperosmolar non-ketotic diabetic coma and rhabdomyolysis. Author(s): Trump D, O'Hanlon S, Rinsler M, Sharp P. Source: Postgraduate Medical Journal. 1994 January; 70(819): 44-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8140020

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Hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation associated with baclofen pump catheter failure. Author(s): Reeves RK, Stolp-Smith KA, Christopherson MW. Source: Archives of Physical Medicine and Rehabilitation. 1998 March; 79(3): 353-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9523793

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Hypocalcemia and hypercalcemia in patients with rhabdomyolysis with and without acute renal failure. Author(s): Akmal M, Bishop JE, Telfer N, Norman AW, Massry SG. Source: The Journal of Clinical Endocrinology and Metabolism. 1986 July; 63(1): 137-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3011837

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Hypokalemia causing rhabdomyolysis and precordialgia. Author(s): Prat G, Petrognani R, Diatta B, Dufau JP, Theobald X. Source: Intensive Care Medicine. 2001 June; 27(6): 1096. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11497146

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Hypokalemic muscular paralysis causing acute respiratory failure due to rhabdomyolysis with renal tubular acidosis in a chronic glue sniffer. Author(s): Kao KC, Tsai YH, Lin MC, Huang CC, Tsao CY, Chen YC. Source: Journal of Toxicology. Clinical Toxicology. 2000; 38(6): 679-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11185978

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Hypokalemic quadriplegia and rhabdomyolysis in a HIV-positive patient. Author(s): Betrosian AP. Source: Intensive Care Medicine. 1997 November; 23(11): 1189-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9434934

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Hypokalemic rhabdomyolysis aggravated by diuretics complicating Conn's syndrome without acute renal failure. Author(s): Ozgur B, Kursat S. Source: Clinical Nephrology. 2002 January; 57(1): 89-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11837808

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Hypomagnesemia and mild rhabdomyolysis in living related donor renal transplant recipient treated with cyclosporine A. Author(s): Cavdar C, Sifil A, Sanli E, Gulay H, Camsari T. Source: Scandinavian Journal of Urology and Nephrology. 1998 December; 32(6): 415-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9925008

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Hyponatremia-associated rhabdomyolysis. Author(s): Trimarchi H, Gonzalez J, Olivero J. Source: Nephron. 1999; 82(3): 274-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10396001

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Hypothyroidism as a cause of rhabdomyolysis. Author(s): Barahona MJ, Mauri A, Sucunza N, Paredes R, Wagner AM. Source: Endocrine Journal. 2002 December; 49(6): 621-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12625411

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Identification of rhabdomyolysis with technetium-99m HDP bone imaging. Author(s): Menendez IC, Lin DS, Kutka N. Source: Clinical Nuclear Medicine. 1985 November; 10(11): 823. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4075678

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Idiopathic rhabdomyolysis. Author(s): Fenton TH. Source: Journal of the Royal Society of Medicine. 1997 May; 90(5): 299. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9204035

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Idiopathic rhabdomyolysis. Author(s): Fraser J, Fang S, Barfoot R, Clayton PT. Source: Journal of the Royal Society of Medicine. 1996 December; 89(12): 706-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9014885

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Inappropriate antidiuretic hormone secretion and rhabdomyolysis associated with citalopram. Author(s): Zullino D, Brauchli S, Horvath A, Baumann P. Source: Therapie. 2000 September-October; 55(5): 651-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11201982

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Increased lipid peroxidation in patients with rhabdomyolysis. Author(s): Holt S, Reeder B, Wilson M, Harvey S, Morrow JD, Roberts LJ 2nd, Moore K. Source: Lancet. 1999 April 10; 353(9160): 1241. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10217088

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Index of Suspicion. Case 1. Rhabdomyolysis. Author(s): Amin S. Source: Pediatrics in Review / American Academy of Pediatrics. 1998 October; 19(10): 333-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9785930

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Index of suspicion. Case 3. Diagnosis: rhabdomyolysis. Author(s): Menna VJ. Source: Pediatrics in Review / American Academy of Pediatrics. 1994 December; 15(12): 495-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7845874

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Infectious etiologies of rhabdomyolysis: three case reports and review. Author(s): Singh U, Scheld WM. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1996 April; 22(4): 642-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8729203

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Influenza A induced rhabdomyolysis resulting in extensive compartment syndrome. Author(s): Swaringen JC, Seiler JG 3rd, Bruce RW Jr. Source: Clinical Orthopaedics and Related Research. 2000 June; (375): 243-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10853175

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Influenza A pneumonia with rhabdomyolysis. Author(s): Morton SE, Mathai M, Byrd RP Jr, Fields CL, Roy TM. Source: Southern Medical Journal. 2001 January; 94(1): 67-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11213946

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Influenza myositis and rhabdomyolysis in an HIV positive man: was zidovudine a co-factor? Author(s): Guha I, Brook MG. Source: Sexually Transmitted Infections. 1999 June; 75(3): 204-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10448412

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Influenza vaccine--a possible trigger of rhabdomyolysis induced acute renal failure due to the combined use of cerivastatin and bezafibrate. Author(s): Plotkin E, Bernheim J, Ben-Chetrit S, Mor A, Korzets Z. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2000 May; 15(5): 7401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10809833

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Influenza-induced rhabdomyolysis after autologous peripheral blood stem cell transplantation for malignant lymphoma. Author(s): Nozoe M, Iino T, Nagafuji K, Miyamoto T, Ito H, Gondo H, Harada M. Source: Intern Med. 2003 November; 42(11): 1127-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14686755

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Intense muscle uptake of Tc-99m MDP and Ga-67 citrate in massive rhabdomyolysis. Author(s): Provan I, Murray C, Mansberg VJ, Rossleigh MA. Source: Clinical Nuclear Medicine. 1997 July; 22(7): 463-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9227868

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Intraoperative rhabdomyolysis in a patient receiving pravastatin, a 3-hydroxy-3methylglutaryl coenzyme A (HMG CoA) reductase inhibitor. Author(s): Rosenberg AD, Neuwirth MG, Kagen LJ, Singh K, Fischer HD, Bernstein RL. Source: Anesthesia and Analgesia. 1995 November; 81(5): 1089-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7486053

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Invasive Group C Streptococcus infection associated with rhabdomyolysis and disseminated intravascular coagulation in a previously healthy adult. Author(s): Ojukwu IC, Newton DW, Luque AE, Kotb MY, Menegus M. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(3): 227-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11303816

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Is rhabdomyolysis an additional factor in the pathogenesis of acute renal failure in leptospirosis? Author(s): Martinelli R, Luna MA, Rocha H. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 1994 March-April; 36(2): 111-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7997784

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Isoniazid-associated rhabdomyolysis. Author(s): Blowey DL, Johnson D, Verjee Z. Source: The American Journal of Emergency Medicine. 1995 September; 13(5): 543-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7662061

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Isotretinoin induced rhabdomyolysis? A case report. Author(s): Trauner MA, Ruben BS. Source: Dermatology Online Journal [electronic Resource]. 1999 November; 5(2): 2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10673455

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Itraconazole-induced rhabdomyolysis and acute renal failure in a heart transplant recipient treated with simvastatin and cyclosporine. Author(s): Vlahakos DV, Manginas A, Chilidou D, Zamanika C, Alivizatos PA. Source: Transplantation. 2002 June 27; 73(12): 1962-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12131698

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Jet-ski rhabdomyolysis. Author(s): Ziskind A, Huang P. Source: Jama : the Journal of the American Medical Association. 1986 April 11; 255(14): 1879-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3951110

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Kikuchi-Fujimoto disease complicated by severe rhabdomyolysis. Author(s): Kuipers EJ, Timens W, Daenen S. Source: Annals of Hematology. 1992 December; 65(6): 278-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1457591

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Legionella causing rhabdomyolysis and renal failure. Author(s): Smeal WE, Schenfeld LA, Hauger W. Source: Postgraduate Medicine. 1985 August; 78(2): 42, 44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4022852

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Legionella pneumonia: an unusual cause of rhabdomyolysis and acute renal failure. Author(s): Kaufman D, Weber K, Gradon JD. Source: Southern Medical Journal. 2002 June; 95(6): 660. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12081226

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Legionnaire's disease and rhabdomyolysis. Author(s): Malvy D, Dessalles PH, Monseau Y, Bonhoure JB. Source: Intensive Care Medicine. 1992; 18(2): 132-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1613198

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Legionnaires' disease associated with rhabdomyolysis and myoglobinuria. Author(s): Posner MR, Caudill MA, Brass R, Ellis E. Source: Archives of Internal Medicine. 1980 June; 140(6): 848-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7387285

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Legionnaires' disease with rhabdomyolysis and acute renal failure. Author(s): van Tol KM, Sluiter HE. Source: The Netherlands Journal of Medicine. 1998 July; 53(1): 43-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9718942

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Rhabdomyolysis

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Legionnaires' disease with rhabdomyolysis and acute reversible myoglobinuric renal failure. Author(s): Johnson DA, Etter HS. Source: Southern Medical Journal. 1984 June; 77(6): 777-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6729559

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Leptospire-induced acute rhabdomyolysis in a patient with previously undiagnosed mitochondrial myopathy. Author(s): Duran S, Hardiman O, Farrell M, O'Connor KG. Source: Ir Med J. 2000 September; 93(6): 182-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11105443

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Letter: Ischemic rhabdomyolysis. Author(s): Haimovici H. Source: Jama : the Journal of the American Medical Association. 1976 May 31; 235(22): 2388. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=946633

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Livedo reticularis, rhabdomyolysis, massive intestinal infarction, and death after carbon dioxide arteriography. Author(s): Rundback JH, Shah PM, Wong J, Babu SC, Rozenblit G, Poplausky MR. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1997 August; 26(2): 337-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9279324

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Long-term relationship between acute rhabdomyolysis and abnormal high-energy phosphate metabolism potentiated by ischemic exercise. Author(s): Legros P, Jehenson P, Gascard JP, Kozak-Reiss G. Source: Medicine and Science in Sports and Exercise. 1992 March; 24(3): 298-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1549023

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Lovastatin and rhabdomyolysis. Author(s): Ayanian JZ, Fuchs CS, Stone RM. Source: Annals of Internal Medicine. 1988 October 15; 109(8): 682-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3421582

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Lovastatin, nicotinic acid, and rhabdomyolysis. Author(s): Reaven P, Witztum JL. Source: Annals of Internal Medicine. 1988 October 1; 109(7): 597-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3421570

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Lovastatin-associated rhabdomyolysis. Author(s): Sylvain-Moore H, Worden JP Jr. Source: Heart & Lung : the Journal of Critical Care. 1991 September; 20(5 Pt 1): 464-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1894526

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Lovastatin-induced acute rhabdomyolysis. Author(s): Kogan AD, Orenstein S. Source: Postgraduate Medical Journal. 1990 April; 66(774): 294-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2385552

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Lovastatin-induced rhabdomyolysis in the absence of concomitant drugs. Author(s): Wallace CS, Mueller BA. Source: The Annals of Pharmacotherapy. 1992 February; 26(2): 190-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1554929

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Lovastatin-induced rhabdomyolysis possibly associated with clarithromycin and azithromycin. Author(s): Grunden JW, Fisher KA. Source: The Annals of Pharmacotherapy. 1997 July-August; 31(7-8): 859-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9220046

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Loxapine-associated rhabdomyolysis and acute renal failure. Author(s): Tam CW, Olin BR 3rd, Ruiz AE. Source: Archives of Internal Medicine. 1980 July; 140(7): 975-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6770772

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Lumbar muscle rhabdomyolysis after abdominal aortic surgery. Author(s): Bertrand M, Godet G, Fleron MH, Bernard MA, Orcel P, Riou B, Kieffer E, Coriat P. Source: Anesthesia and Analgesia. 1997 July; 85(1): 11-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9212115

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Lumbar muscle rhabdomyolysis as a cause of acute renal failure after Roux-en-Y gastric bypass. Author(s): Wiltshire JP, Custer T. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 306-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740145

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Lumbar paraspinal rhabdomyolysis and compartment syndrome after abdominal aortic aneurysm repair. Author(s): Ferreira J, Galle C, Aminian A, Michel P, Guyot S, De Wilde JP, Motte S, Wautrecht JC, Dereume JP. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 January; 37(1): 198-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12514601

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Major urologic surgery and rhabdomyolysis in two obese patients. Author(s): Iser I C, Senkul T, Reddy PK. Source: International Journal of Urology : Official Journal of the Japanese Urological Association. 2003 October; 10(10): 558-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14516407

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Malignant hyperthermia as a cause for postoperative rhabdomyolysis. Author(s): Wappler F, Fiege M. Source: Anesthesiology. 2000 April; 92(4): 1206-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10754651

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Malignant hyperthermia associated with exercise-induced rhabdomyolysis or congenital abnormalities and a novel RYR1 mutation in New Zealand and Australian pedigrees. Author(s): Davis M, Brown R, Dickson A, Horton H, James D, Laing N, Marston R, Norgate M, Perlman D, Pollock N, Stowell K. Source: British Journal of Anaesthesia. 2002 April; 88(4): 508-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12066726

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Malignant hyperthermia susceptibility revealed by myalgia and rhabdomyolysis during fluoroquinolone treatment. Author(s): Guis S, Jouglard J, Kozak-Ribbens G, Figarella-Branger D, Vanuxem D, Pellissier JF, Cozzone PJ. Source: The Journal of Rheumatology. 2001 June; 28(6): 1405-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11409139

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Malignant lymphoma in skeletal muscle with rhabdomyolysis: a report of two cases. Author(s): Masaoka S, Fu T. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2002; 7(6): 688-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12486474

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Marinesco Sjogren syndrome with rhabdomyolysis. A new subtype of the disease. Author(s): Muller-Felber W, Zafiriou D, Scheck R, Patzke I, Toepfer M, Pongratz DE, Walther U. Source: Neuropediatrics. 1998 April; 29(2): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9638664

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Marked hypokalaemic rhabdomyolysis due to purgative abuse. Author(s): Kallmeyer JC, Macleod IN, Bhagwan B. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1994 January; 84(1): 50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8197504

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Massive postoperative rhabdomyolysis after uneventful surgery: a case report of subclinical malignant hyperthermia. Author(s): Harwood TN, Nelson TE. Source: Anesthesiology. 1998 January; 88(1): 265-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9447881

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Massive postoperative rhabdomyolysis following combined CABG/abdominal aortic replacement: a possible association with HMG-CoA reductase inhibitors. Author(s): Wilhelmi M, Winterhalter M, Fischer S, Walles T, Zuk J, Struber M, Haverich A. Source: Cardiovascular Drugs and Therapy / Sponsored by the International Society of Cardiovascular Pharmacotherapy. 2002 September; 16(5): 471-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12652117

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Massive rhabdomyolysis and acute renal failure after acetonitrile exposure. Author(s): Muraki K, Inoue Y, Ohta I, Kondo K, Matayoshi Y, Kamei T. Source: Intern Med. 2001 September; 40(9): 936-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11579960

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Massive rhabdomyolysis and life threatening hyperkalaemia in a patient with the combination of cerivastatin and gemfibrozil. Author(s): Hendriks F, Kooman JP, van der Sande FM. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2001 December; 16(12): 2418-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11733637

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Massive rhabdomyolysis and multiple organ dysfunction syndrome caused by leptospirosis. Author(s): Coursin DB, Updike SJ, Maki DG. Source: Intensive Care Medicine. 2000 June; 26(6): 808-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10945403

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Massive rhabdomyolysis in cirrhosis of liver. Author(s): Khokhar N. Source: J Pak Med Assoc. 2001 September; 51(9): 331-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11715909

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Metabolic acidosis, rhabdomyolysis, and cardiovascular collapse after prolonged propofol infusion. Author(s): Cannon ML, Glazier SS, Bauman LA. Source: Journal of Neurosurgery. 2001 December; 95(6): 1053-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11765823

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Metabolic causes of recurrent rhabdomyolysis. Author(s): Lofberg M, Jankala H, Paetau A, Harkonen M, Somer H. Source: Acta Neurologica Scandinavica. 1998 October; 98(4): 268-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9808277

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Metabolic response to light exercise after exercise-induced rhabdomyolysis. Author(s): Sayers SP, Clarkson P, Patel JJ. Source: European Journal of Applied Physiology. 2002 January; 86(3): 280-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990739

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Methamphetamine abuse and rhabdomyolysis in the ED: a 5-year study. Author(s): Richards JR, Johnson EB, Stark RW, Derlet RW. Source: The American Journal of Emergency Medicine. 1999 November; 17(7): 681-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10597089

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Mild rhabdomyolysis in a child with fever and "hematuria". Author(s): Tasic V, Avramoski V, Korneti P. Source: Pediatric Nephrology (Berlin, Germany). 2003 May; 18(5): 462-4. Epub 2003 March 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12736809

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Minocycline hypersensitivity syndrome manifesting with rhabdomyolysis. Author(s): Rahman Z, Weinberg J, Scheinfeld N. Source: International Journal of Dermatology. 2002 August; 41(8): 530-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12207780

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Myopathy and rhabdomyolysis with lipid-lowering drugs. Author(s): Hodel C. Source: Toxicology Letters. 2002 March 10; 128(1-3): 159-68. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869826

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Narcotic overdose and acute rhabdomyolysis. Author(s): Weston MD, Hirsch NP, Jones JA. Source: Anaesthesia. 1986 December; 41(12): 1269. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3812959

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Neonatal rhabdomyolysis as a presentation of muscular dystrophy. Author(s): Breningstall GN, Grover WD, Barbera S, Marks HG. Source: Neurology. 1988 August; 38(8): 1271-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3399077

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Neurogenic bladder, lumbosacral plexus neuropathy and drug-associated rhabdomyolysis. Author(s): Jacome DE. Source: The Journal of Urology. 1982 May; 127(5): 994-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7087009

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Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea. Author(s): Lalloo DG, Trevett AJ, Black J, Mapao J, Saweri A, Naraqi S, Owens D, Kamiguti AS, Hutton RA, Theakston RD, Warrell DA. Source: Qjm : Monthly Journal of the Association of Physicians. 1996 January; 89(1): 2535. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8730340

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Non-traumatic acute rhabdomyolysis. Author(s): Taly AB, Nair KP, Arunodaya GR, Das S, Christopher R, Mohan C, Swamy HS. Source: Neurology India. 1999 March; 47(1): 51-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10339709

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Nontraumatic rhabdomyolysis and acute renal failure associated with oral phenmetrazine hydrochloride. Author(s): Black WD, Murphy WM. Source: J Tenn Med Assoc. 1984 February; 77(2): 80-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6727334

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Nontraumatic rhabdomyolysis and acute renal failure. Author(s): Forwell MA, Hallworth MJ. Source: Scott Med J. 1986 October; 31(4): 246-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3563466

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Nontraumatic rhabdomyolysis and acute renal failure. Author(s): Grossman RA, Hamilton RW, Morse BM, Penn AS, Goldberg M. Source: The New England Journal of Medicine. 1974 October 17; 291(16): 807-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4423658

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Non-traumatic rhabdomyolysis and acute renal failure. Author(s): Chang CY, Fang JT, Huang CC. Source: Changgeng Yi Xue Za Zhi. 1996 March; 19(1): 10-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8935369

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Non-traumatic rhabdomyolysis complicating antihistamine overdose. Author(s): Frankel D, Dolgin J, Murray BM. Source: Journal of Toxicology. Clinical Toxicology. 1993; 31(3): 493-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8355326

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Nontraumatic rhabdomyolysis during diabetic ketoacidosis. Author(s): Chanson P, de Rohan-Chabot P, Loirat P, Lubetzki J. Source: Diabetologia. 1986 September; 29(9): 674-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3098615

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Nontraumatic rhabdomyolysis during diabetic ketoacidosis. Author(s): Moller-Petersen J, Andersen PT, Hjorne N, Ditzel J. Source: Diabetologia. 1986 April; 29(4): 229-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3086167

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Non-traumatic rhabdomyolysis with acute renal failure. Author(s): Sandhu JS, Sood A, Midha V, Singh AD, Jain D, Sandhu P. Source: Renal Failure. 2000 January; 22(1): 81-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10718284

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Non-traumatic rhabdomyolysis with gluteal ulcer. Author(s): Yotsuyanagi T, Nihei Y, Sawada Y. Source: Clinical and Experimental Dermatology. 1998 May; 23(3): 113-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9861738

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Nuclear medicine imaging in rhabdomyolysis. Author(s): Cornelius EA. Source: Clinical Nuclear Medicine. 1982 October; 7(10): 462-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6754202

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Occult elevation of CK as a manifestation of rhabdomyolysis in the elderly. Author(s): Marcus EL, Rudensky B, Sonnenblick M. Source: Journal of the American Geriatrics Society. 1992 May; 40(5): 454-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1634696

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Olanzapine and rhabdomyolysis. Author(s): Shuster J. Source: Nursing. 2000 September; 30(9): 87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11022553

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Olanzapine-induced rhabdomyolysis. Author(s): Rosebraugh CJ, Flockhart DA, Yasuda SU, Woosley RL. Source: The Annals of Pharmacotherapy. 2001 September; 35(9): 1020-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11573848

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Opiate-induced rhabdomyolysis. Author(s): Blain PG, Lane RJ, Bateman DN, Rawlins MD. Source: Hum Toxicol. 1985 January; 4(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3988309

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Organophosphate poisoning complicated by rhabdomyolysis. Author(s): Yeh TS, Wang CR, Wen CL, Chuang CY, Chen CY. Source: Journal of Toxicology. Clinical Toxicology. 1993; 31(3): 497-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8355327

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Other reports of cerivastatin-induced rhabdomyolysis. Author(s): Gabay M, Lodolce A. Source: Archives of Internal Medicine. 2001 November 26; 161(21): 2629. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11718614

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Pancytopenia, hyperglycemia, shock, coma, rhabdomyolysis, and pancreatitis associated with acetaminophen poisoning. Author(s): Yang CC, Deng JF, Lin TJ. Source: Vet Hum Toxicol. 2001 December; 43(6): 344-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11757993

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Pathogenesis and treatment of renal dysfunction in rhabdomyolysis. Author(s): Korantzopoulos P, Galaris D, Papaioannides D. Source: Intensive Care Medicine. 2002 August; 28(8): 1185; Author Reply 1186. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12400515

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Pathogenesis and treatment of renal dysfunction in rhabdomyolysis. Author(s): Holt SG, Moore KP. Source: Intensive Care Medicine. 2001 May; 27(5): 803-11. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11430535

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Pathogenesis and treatment of rhabdomyolysis. Author(s): Rupert SA. Source: Journal of the American Academy of Nurse Practitioners. 2002 February; 14(2): 82-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11892540

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Pathogenesis of renal failure in rhabdomyolysis: the role of myoglobin. Author(s): Holt S, Moore K. Source: Experimental Nephrology. 2000 March-April; 8(2): 72-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10729745

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Pedal consequences of rhabdomyolysis: a case report. Author(s): Jones RO, Borden EL, Nava S, Baer MD, Friedberg-Alster H. Source: The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. 2000 September-October; 39(5): 341-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11055026

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Perioperative severe rhabdomyolysis revealing susceptibility to malignant hyperthermia. Author(s): Fierobe L, Nivoche Y, Mantz J, Elalaoui Y, Veber B, Desmonts JM. Source: Anesthesiology. 1998 January; 88(1): 263-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9447880

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Peripheral venopuncture as temporary vascular access in rhabdomyolysis-induced acute renal failure related to frog leaps: case report. Author(s): Chang CT, Fang JT, Chen YC, Chang MY. Source: Changgeng Yi Xue Za Zhi. 2000 October; 23(10): 619-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11126154

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Photo quiz. Oblivion at the kitchen table. Rhabdomyolysis due to drug abuse. Author(s): Schouwenberg BJ, Deinum J. Source: The Netherlands Journal of Medicine. 2003 May; 61(5): 173, 182. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12916544

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Postoperative acute renal failure secondary to rhabdomyolysis from exaggerated lithotomy position. Author(s): Gabrielli A, Caruso L. Source: Journal of Clinical Anesthesia. 1999 May; 11(3): 257-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10434226

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Postoperative rhabdomyolysis following laparoscopic gastric bypass in the morbidly obese. Author(s): Khurana RN, Baudendistel TE, Morgan EF, Rabkin RA, Elkin RB, Aalami OO. Source: Archives of Surgery (Chicago, Ill. : 1960). 2004 January; 139(1): 73-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14718280

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Postoperative rhabdomyolysis in patients with end-stage renal failure. Author(s): Ori Y, Korzets A, Gruzman C, Chagnac A, Zevin D, Weinstein T, Herman M, Gafter U. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1998 March; 31(3): 539-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9506695

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Potassium depletion and rhabdomyolysis. Author(s): Larner AJ. Source: Bmj (Clinical Research Ed.). 1994 January 8; 308(6921): 136. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8166818

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Potential drug interaction between simvastatin and danazol causing rhabdomyolysis. Author(s): Andreou ER, Ledger S. Source: Can J Clin Pharmacol. 2003 Winter; 10(4): 172-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14712320

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Pressure-induced rhabdomyolysis after bariatric surgery. Author(s): Torres-Villalobos G, Kimura E, Mosqueda JL, Garcia-Garcia E, DominguezCherit G, Herrera MF. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 297-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740143

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Rhabdomyolysis

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Pressure-induced rhabdomyolysis and acute renal failure. Author(s): Szewczyk D, Ovadia P, Abdullah F, Rabinovici R. Source: The Journal of Trauma. 1998 February; 44(2): 384-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9498517

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Prevalence of rhabdomyolysis in drug deaths. Author(s): Welte T, Bohnert M, Pollak S. Source: Forensic Science International. 2004 January 6; 139(1): 21-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14687769

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Preventable rhabdomyolysis in prison inmates. Author(s): Schoondyke JW, Ridgeway NA, Hubbs DT. Source: Tenn Med. 2001 September; 94(9): 337-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11550400

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Primary human immunodeficiency virus type 1 infection in a patient with acute rhabdomyolysis. Author(s): McDonagh CA, Holman RP. Source: Southern Medical Journal. 2003 October; 96(10): 1027-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570349

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Propofol-associated rhabdomyolysis with cardiac involvement in adults: chemical and anatomic findings. Author(s): Stelow EB, Johari VP, Smith SA, Crosson JT, Apple FS. Source: Clinical Chemistry. 2000 April; 46(4): 577-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10759487

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Resident's corner. Answer to case of the month #93. Exercise-induced rhabdomyolysis. Author(s): Clarke JC, Nolan RL. Source: Canadian Association of Radiologists Journal = Journal L'association Canadienne Des Radiologistes. 2003 December; 54(5): 310-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14689807

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Rhabdomyolysis and hemolysis after use of Coutarea latiflora. Author(s): Roca B. Source: The American Journal of Medicine. 2003 December 1; 115(8): 677. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14656627

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Rhabdomyolysis and paraneoplastic stiff-man syndrome with amphiphysin autoimmunity. Author(s): Petzold GC, Marcucci M, Butler MH, van Landeghem FK, Einhaupl KM, Solimena M, Valdueza JM, De Camilli P. Source: Annals of Neurology. 2004 February; 55(2): 286-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14755734

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Rhabdomyolysis as a result of Streptococcus pneumoniae: report of a case and review. Author(s): Blanco JR, Zabalza M, Salcedo J, San Roman J. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2003 September; 9(9): 944-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616683

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Rhabdomyolysis associated with laparoscopic live donor nephrectomy and concomitant surgery: a note of caution. Author(s): Troppmann C, Perez RV. Source: American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2003 November; 3(11): 1457-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14525614

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Rhabdomyolysis associated with probable SARS. Author(s): Wang JL, Wang JT, Yu CJ, Chen YC, Hsueh PR, Hsiao CH, Kao CL, Chang SC, Yang PC. Source: The American Journal of Medicine. 2003 October 1; 115(5): 421-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14553890

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Rhabdomyolysis associated with simvastatin-nefazodone therapy. Author(s): Skrabal MZ, Stading JA, Monaghan MS. Source: Southern Medical Journal. 2003 October; 96(10): 1034-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570351

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Rhabdomyolysis caused by distigmine bromide. Author(s): Tsutsumi Y, Tanaka J, Miura T, Yamato H, Kanamori H, Kawamura T, Obara S, Asaka M, Imamura M, Masauzi N. Source: Intern Med. 2003 November; 42(11): 1156. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14686764

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Rhabdomyolysis following a gunshot wound and one trauma center's protocol and guidelines. Author(s): Terpilowski J, Criddle L. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2004 February; 30(1): 36-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765080

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Rhabdomyolysis in a patient with Kawasaki disease. Author(s): Watanabe T, Iwabuchi H, Abe T. Source: European Journal of Pediatrics. 2003 December; 162(12): 891-2. Epub 2003 October 21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14569397

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Rhabdomyolysis in a patient with MELAS syndrome. Author(s): Kwon JH, Kim JS. Source: European Neurology. 2003; 50(2): 123-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12944725

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Rhabdomyolysis in diabetic ketoacidosis. Author(s): Casteels K, Beckers D, Wouters C, Van Geet C. Source: Pediatric Diabetes. 2003 March; 4(1): 29-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655521

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Rhabdomyolysis in lumbar spine surgery: a case report. Author(s): Foster MR. Source: Spine. 2003 July 15; 28(14): E276-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12865863

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Rhabdomyolysis in the acutely cocaine- intoxicated patient sustaining maxillofacial trauma: report of a case and review of the literature. Author(s): Doctora JS, Williams CW, Bennett CR, Howlett BK. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2003 August; 61(8): 964-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12905452

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Rhabdomyolysis induced by a single dose of a statin. Author(s): Jamil S, Iqbal P. Source: Heart (British Cardiac Society). 2004 January; 90(1): E3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14676266

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Rhabdomyolysis secondary to interaction of fusidic acid and simvastatin. Author(s): Yuen SL, McGarity B. Source: The Medical Journal of Australia. 2003 August 4; 179(3): 172. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12885276

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Rhabdomyolysis, hepatitis and multiple hematological disorders associated with alcohol abuse: a case report. Author(s): Yoshida Y, Take H, Kurabayashi H, Tamura K, Kubota K. Source: J Med. 2002; 33(1-4): 3-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12939102

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Rhabdomyolysis. Author(s): Lane R, Phillips M. Source: Bmj (Clinical Research Ed.). 2003 July 19; 327(7407): 115-6. Erratum In: Bmj. 2003 August 30; 327(7413): 500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12869426

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Rhabdomyolysis. Pathophysiology, recognition, and management. Author(s): Criddle LM. Source: Critical Care Nurse. 2003 December; 23(6): 14-22, 24-6, 28 Passim; Quiz 31-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14692169

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Rhabdomyolysis: an overview and study of outcomes in smoking and non-smoking patients at WVU hospitals. Author(s): Hancox JG, Welch J, Schmidt R, Ogershok P. Source: W V Med J. 2003 July-August; 99(4): 148-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14650900

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Seizures, ventricular tachycardia, and rhabdomyolysis as a result of ingestion of venlafaxine and lamotrigine. Author(s): Peano C, Leikin JB, Hanashiro PK. Source: Annals of Emergency Medicine. 1997 November; 30(5): 704-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9360588

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Selective serotonin reuptake inhibitor-induced rhabdomyolysis associated with irinotecan. Author(s): Richards S, Umbreit JN, Fanucchi MP, Giblin J, Khuri F. Source: Southern Medical Journal. 2003 October; 96(10): 1031-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570350

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Serum cardiac troponins I and T in early posttraumatic rhabdomyolysis. Author(s): Lavoinne A, Hue G. Source: Clinical Chemistry. 1998 March; 44(3): 667-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9510880

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Serum creatine kinase as predictor of clinical course in rhabdomyolysis: a 5-year intensive care survey. Author(s): de Meijer AR, Fikkers BG, de Keijzer MH, van Engelen BG, Drenth JP. Source: Intensive Care Medicine. 2003 July; 29(7): 1121-5. Epub 2003 May 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12768237

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Serum gelsolin and rhabdomyolysis. Author(s): Lofberg M, Paunio T, Tahtela R, Kiuru S, Somer H. Source: Journal of the Neurological Sciences. 1998 May 7; 157(2): 187-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9619644

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Severe dermatomyositis with rhabdomyolysis and paralytic ileus: a case successfully treated with plasmapheresis and intravenous immunoglobulin. Author(s): Fukunaga E, Kunishige M, Mitsui T, Endo I, Oshima Y, Ohnishi Y, Kuroda Y, Hara S, Matsumoto T. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2002 November; 9(6): 697-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12453096

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Severe hypokalemia and rhabdomyolysis associated with itraconazole therapy. Author(s): Ruiz-Contreras J, Rodriguez R, Gomez de Quero P, Gonzalez Tome MI, Sanchez Diaz JI. Source: The Pediatric Infectious Disease Journal. 2003 November; 22(11): 1024-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14628780

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Severe rhabdomyolysis and acute renal failure due to multiple wasp stings. Author(s): Kim YO, Yoon SA, Kim KJ, Lee BO, Kim BS, Chang YS, Bang BK. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 June; 18(6): 1235. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12748373

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Severe rhabdomyolysis and acute renal failure following recent Coxsackie B virus infection. Author(s): Fodili F, van Bommel EF. Source: The Netherlands Journal of Medicine. 2003 May; 61(5): 177-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12916546

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Severe rhabdomyolysis related to cerivastatin without gemfibrozil. Author(s): Hyman DJ, Henry A, Taylor A. Source: Annals of Internal Medicine. 2002 July 2; 137(1): 74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12093260

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Severe rhabdomyolysis with renal failure after intranasal cocaine use. Author(s): Horowitz BZ, Panacek EA, Jouriles NJ. Source: The Journal of Emergency Medicine. 1997 November-December; 15(6): 833-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9404801

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Simvastatin-fluconazole causing rhabdomyolysis. Author(s): Shaukat A, Benekli M, Vladutiu GD, Slack JL, Wetzler M, Baer MR. Source: The Annals of Pharmacotherapy. 2003 July-August; 37(7-8): 1032-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12841814

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Simvastatin-induced rhabdomyolysis in a CsA-treated renal transplant recipient. Author(s): Gumprecht J, Zychma M, Grzeszczak W, Kuzniewicz R, Burak W, Zywiec J, Karasek D, Otulski I, Mosur M. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2003 September; 9(9): Cs89-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12960932

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Snake bite, rhabdomyolysis, and renal failure. Author(s): Sitprija V, Gopalakrishnakone P. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1998 June; 31(6): L-Lii. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9631832

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Subarachnoid hemorrhage and rhabdomyolysis induced acute renal failure complicating organophosphate intoxication. Author(s): Gokel Y. Source: Renal Failure. 2002 November; 24(6): 867-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12472209

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Susceptibility to malignant hyperthermia manifested as delayed return of increased serum creatine kinase activity and episodic rhabdomyolysis after exercise. Author(s): Kojima Y, Oku S, Takahashi K, Mukaida K. Source: Anesthesiology. 1997 December; 87(6): 1565-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9416741

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Suspected chromium picolinate-induced rhabdomyolysis. Author(s): Martin WR, Fuller RE. Source: Pharmacotherapy. 1998 July-August; 18(4): 860-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9692662

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Tc-99m MDP imaging in rhabdomyolysis after military disciplinary punishment. Author(s): Kim EN, Sohn HS, Kim SH, Jung YA, Yoo IeR, Chung SK. Source: Clinical Nuclear Medicine. 2002 November; 27(11): 795-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12394128

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The absence of rhabdomyolysis-induced renal failure following the World Trade Center collapse. Author(s): Goldfarb DS, Chung S. Source: The American Journal of Medicine. 2002 August 15; 113(3): 260. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12208396

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The other medical causes of rhabdomyolysis. Author(s): Allison RC, Bedsole DL. Source: The American Journal of the Medical Sciences. 2003 August; 326(2): 79-88. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12920439

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The relationship between proinflammatory mediators and heat stress induced rhabdomyolysis in exercising marines. Author(s): Phillips RA. Source: Critical Care Nursing Clinics of North America. 2003 June; 15(2): 163-70, Vii. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755182

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Toxicity of myoglobin and haemoglobin: oxidative stress in patients with rhabdomyolysis and subarachnoid haemorrhage. Author(s): Reeder BJ, Sharpe MA, Kay AD, Kerr M, Moore K, Wilson MT. Source: Biochemical Society Transactions. 2002 August; 30(4): 745-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12196184

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Traumatic rhabdomyolysis resulting from continuous compression in the exaggerated lithotomy position for radical perineal prostatectomy. Author(s): Kikuno N, Urakami S, Shigeno K, Kishi H, Shiina H, Igawa M. Source: International Journal of Urology : Official Journal of the Japanese Urological Association. 2002 September; 9(9): 521-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12410935

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Treatment of cardiomyopathy and rhabdomyolysis in long-chain fat oxidation disorders using an anaplerotic odd-chain triglyceride. Author(s): Roe CR, Sweetman L, Roe DS, David F, Brunengraber H. Source: The Journal of Clinical Investigation. 2002 July; 110(2): 259-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12122118

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Tsutsugamushi infection-associated acute rhabdomyolysis and acute renal failure. Author(s): Young PC, Hae CC, Lee KH, Hoon CJ. Source: Korean J Intern Med. 2003 December; 18(4): 248-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14717236

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Two cases of exertional rhabdomyolysis precipitated by personal trainers. Author(s): Springer BL, Clarkson PM. Source: Medicine and Science in Sports and Exercise. 2003 September; 35(9): 1499-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12972868

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Two cases of rhabdomyolysis associated with high-dose simvastatin. Author(s): Skrabal MZ, Stading JA, Cannella CA, Monaghan MS. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 March 15; 60(6): 578-81. Erratum In: Am J Health Syst Pharm. 2003 September 1; 60(17): 1733. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12659062

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Ultrasonic appearance of rhabdomyolysis. Author(s): Kaplan GN. Source: Ajr. American Journal of Roentgenology. 1980 February; 134(2): 375-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6766249

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Unexpected rhabdomyolysis with myoglobinuria in a patient in the supine position. Author(s): Choufane S, Lemogne M, Jacob L. Source: European Journal of Anaesthesiology. 1998 July; 15(4): 493-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9699109

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Unusual cause of rhabdomyolysis in a head injury patient: case report. Author(s): Wrobel CJ, Taubman K. Source: The Journal of Trauma. 2001 May; 50(5): 939-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11371858

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Unusual causes of calf swelling--2. Rhabdomyolysis mimicking deep vein thrombosis. Author(s): Small M, Alzaid A, Gray HW. Source: Postgraduate Medical Journal. 1987 August; 63(742): 653-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3422866

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Unusual consequences of heroin overdose: rhabdomyolysis, acute renal failure, paraplegia and hypercalcaemia. Author(s): Kumar R, West DM, Jingree M, Laurence AS. Source: British Journal of Anaesthesia. 1999 September; 83(3): 496-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10655932

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Unusual lactate dehydrogenase isoenzyme pattern in rhabdomyolysis. Author(s): Nanji AA, Pudek MR. Source: Clinical Chemistry. 1983 August; 29(8): 1562. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6872231

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Urban-cowboy rhabdomyolysis. Author(s): Powers RD, Lamb GC, Matyasz RC, Spilane MT, van Iyn RA. Source: The New England Journal of Medicine. 1981 February 12; 304(7): 427. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7453764

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Urinary red blood-cells in rhabdomyolysis. Author(s): Sengers RC. Source: Lancet. 1977 January 22; 1(8004): 192. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=64718

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Valproic acid triggers acute rhabdomyolysis in a patient with carnitine palmitoyltransferase type II deficiency. Author(s): Kottlors M, Jaksch M, Ketelsen UP, Weiner S, Glocker FX, Lucking CH. Source: Neuromuscular Disorders : Nmd. 2001 November; 11(8): 757-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11595519

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Varicella zoster infection associated rhabdomyolysis demonstrated by Tc-99m MDP imaging. Author(s): Bhargava P, Bhutani C, Feng Q, Alavi A, Zhuang H. Source: Clinical Nuclear Medicine. 2003 July; 28(7): 594-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12819419

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Varicella zoster infection, massive rhabdomyolysis, myoglobinuria, and renal failure. Author(s): Roberts DE. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1995 January-February; 8(1): 52-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7701961

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Visualization of alcohol-induced rhabdomyolysis: a correlative radiotracer, histochemical, and electron-microscopic study. Author(s): Silberstein EB, Bove KE. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1979 February; 20(2): 127-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=430186

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Water hemlock poisoning complicated by rhabdomyolysis and renal failure. Author(s): Carlton BE, Tufts E, Girard DE. Source: Clin Toxicol. 1979; 14(1): 87-92. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=35306

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Water intoxication and rhabdomyolysis. Author(s): Tomiyama J, Kametani H, Kumagai Y, Adachi Y, Tohri K. Source: Jpn J Med. 1990 January-February; 29(1): 52-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2214346

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Water intoxication in a schizophrenic patient with rhabdomyolysis. Author(s): Akasaki Y, Nagatomo I, Akasaki Y, Nomaguchi M, Akasaki Y, Matsumoto K. Source: Jpn J Psychiatry Neurol. 1993 December; 47(4): 843-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201794

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Water intoxication, hyperpyrexia and rhabdomyolysis in a patient with psychogenic polydipsia. Author(s): Sidi Y, Gassner S, Sandbank U, Keren G, Pinkhas J. Source: N Y State J Med. 1984 September; 84(9): 462-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6593615

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When exercise goes awry: exertional rhabdomyolysis. Author(s): Hamer R. Source: Southern Medical Journal. 1997 May; 90(5): 548-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9160079

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CHAPTER 2. NUTRITION AND RHABDOMYOLYSIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and rhabdomyolysis.

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

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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 “rhabdomyolysis” (or a synonym): •

Acute pancreatitis and rhabdomyolysis: a new association. Author(s): Department of Medicine, Royal Newcastle Hospital, Newcastle, NSW, Australia. Source: Nankivell, B J Gillies, A H Aust-N-Z-J-Med. 1991 August; 21(4): 414-7 0004-8291

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Acute renal failure secondary to rhabdomyolysis following self-poisoning with aminophylline. Author(s): Department of Renal Medicine, Princess Mary's RAF Hospital, Halton, Aylesbury, Bucks. Source: Stevens, P E De Verteuil, J A Rainford, D J J-R-Army-Med-Corps. 1988 June; 134(2): 79-80 0035-8665

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Acute rhabdomyolysis associated with acute cocaine intoxication. A case report. Author(s): 2a Divisione di Neurologia, Ospedali Riuniti, Bergamo. Source: Censori, B Camerlingo, M Casto, L Ferraro, B Gazzaniga, G C Partziguian, T Mamoli, A Ital-J-Neurol-Sci. 1993 May; 14(4): 325-7 0392-0461

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An autopsy case of licorice-induced hypokalemic rhabdomyolysis associated with acute renal failure: special reference to profound calcium deposition in skeletal and cardiac muscle. Author(s): b1p4rtment of Medicine, Jichi Medical School, Tochigi, Japan. Source: Saito, T Tsuboi, Y Fujisawa, G Sakuma, N Honda, K Okada, K Saito, K Ishikawa, S Saito, T Nippon-Jinzo-Gakkai-Shi. 1994 November; 36(11): 1308-14 0385-2385

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Calcium sensitivity of force production and myofibrillar ATPase activity in muscles from Thoroughbreds with recurrent exertional rhabdomyolysis. Author(s): Department of Clinical and Population Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul 55108, USA. Source: Mlekoday, J A Mickelson, J R Valberg, S J Horton, J H Gallant, E M Thompson, L V Am-J-Vet-Res. 2001 October; 62(10): 1647-52 0002-9645

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Cerivastatin and gemfibrozil-associated rhabdomyolysis. Author(s): Pharmacy Department, Wentworth-Douglass Hospital, Dover, NH 038203535, USA. [email protected] Source: Bruno Joyce, J Dugas, J M MacCausland, O E Ann-Pharmacother. 2001 September; 35(9): 1016-9 1060-0280

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Cerivastatin-induced rhabdomyolysis: 11 case reports. Author(s): University of the Pacific Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California, USA. [email protected] Source: Ravnan, S L Locke, C Yee, W P Haase, K Pharmacotherapy. 2002 April; 22(4): 533-7 0277-0008

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Computed tomographic detection of skeletal muscle calcifications in rhabdomyolysis. Author(s): Department of Diagnostic Radiology, Montreal General Hospital, Que. Source: Petit, P Atri, M Rosenthall, L Bret, P M Senterman, M K Can-Assoc-Radiol-J. 1992 December; 43(6): 443-6 0846-5371

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Effect of diet on thoroughbred horses with recurrent exertional rhabdomyolysis performing a standardised exercise test. Author(s): Department of Clinical and Population Sciences, University of Minnesota, St. Paul 55108, USA. Source: MacLeay, J M Valberg, S J Pagan, J D de laCorte, F Roberts, J Billstrom, J McGinnity, J Kaese, H Equine-Vet-J-Suppl. 1999 July; 30458-62

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Emotional distress induced rhabdomyolysis in an individual with carnitine palmitoly-transferase deficiency. Author(s): Rheumatology Department, Royal Brisbane Hospital, Queensland, Australia. Source: Wallace, R A Klestov, A C Kubler, P A Clin-Exp-Rheumatol. 2001 Sep-October; 19(5): 583-6 0392-856X

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Equine exertional rhabdomyolysis: activity of the mitochondrial respiratory chain and the carnitine system in skeletal muscle [see comment] Author(s): Department of Biochemistry I, Erasmus University Rotterdam, The Netherlands. Source: Scholte, H R Verduin, M H Ross, J D Van den Hoven, R Wensing, T Breuking, H J Meijer, A E Equine-Vet-J. 1991 March; 23(2): 142-4 0425-1644

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Equine rhabdomyolysis syndrome. Source: Harris, P.A. Metabolic and endocrine problems of the horse /. London : New York : W.B. Saunders, c1998. page 75-99. ISBN: 0702022411

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Evidence against oxidant injury and endotoxin underlying glycerol-induced fatal rhabdomyolysis in rats. Author(s): Department of Life Sciences, Bar-Ilan University, Ramat Gan, Israel. Source: Zurovsky, Y Grossman, S J-Basic-Clin-Physiol-Pharmacol. 1992 Jul-September; 3(3): 239-51 0792-6855

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Evidence for susceptibility to malignant hyperthermia in patients with exerciseinduced rhabdomyolysis. Author(s): Department of Anesthesiology, University Hospital Eppendorf, Hamburg, Germany. [email protected] Source: Wappler, F Fiege, M Steinfath, M Agarwal, K Scholz, J Singh, S Matschke, J Schulte Am Esch, J Anesthesiology. 2001 January; 94(1): 95-100 0003-3022

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Exertional rhabdomyolysis and polysaccharide storage myopathy in horses. Source: Valberg, S.J. MacLeay, J.M. Mickelson, J.R. Compend-contin-educ-pract-vet. Trenton, N.J. : Veterinary Learning Systems. Sept 1997. volume 19 (9) page 1077-1086. 0193-1903

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Fatal rhabdomyolysis after acute sodium monensin (Rumensin) toxicity: case report. Author(s): Neuromuscular and Electromyography Division, Department of Neurological Sciences, Faculdade de Medicina de Ribeirao Preto, Sao Jose do Rio Preto, SP, Brazil. [email protected] Source: Kouyoumdjian, J A Morita, M P Sato, A K Pissolatti, A F Arq-Neuropsiquiatr. 2001 September; 59(3-A): 596-8 0004-282X

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Heroin-induced rhabdomyolysis as a cause of reflex sympathetic dystrophy. Author(s): Department of Nuclear Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan. Source: Lee, B F Chiu, N T Chen, W H Liu, G C Yu, H S Clin-Nucl-Med. 2001 April; 26(4): 289-92 0363-9762

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Hypokaliemic rhabdomyolysis associated with liquorice ingestion: report of an atypical case. Author(s): Clinica Neurologica, Universita di Ferrara, Italy. Source: Barrella, M Lauria, G Quatrale, R Paolino, E Ital-J-Neurol-Sci. 1997 August; 18(4): 217-20 0392-0461

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Isoniazid-induced seizures with secondary rhabdomyolysis and associated acute renal failure in a dog. Author(s): Ocean Avenue Veterinary Hospital, San Francisco, CA 94112, USA.

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Source: Haburjak, J J Spangler, W L J-Small-Anim-Pract. 2002 April; 43(4): 182-6 00224510 •

Isotretinoin induced rhabdomyolysis? A case report. Author(s): Department of Dermatology, Univeristy of California Davis, USA. Source: Trauner, M A Ruben, B S Dermatol-Online-J. 1999 November; 5(2): 2 1087-2108

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Massive myocardial calcification of right and left ventricles following acute myocarditis complicated with rhabdomyolysis-induced acute renal failure. Author(s): Second Department of Internal Medicine, Sapporo Medical College, Japan. Source: Wada, A Nakata, T Tsuchihashi, K Aoyama, S Nanba, M Murakami, H Shimamoto, K Iimura, O Jpn-Circ-J. 1993 June; 57(6): 567-72 0047-1828

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Massive rhabdomyolysis and life threatening hyperkalaemia in a patient with the combination of cerivastatin and gemfibrozil. Author(s): Department of Internal Medicine, Horacio Oduber Ziekenhuis, Aruba, The Netherlands. Source: Hendriks, F Kooman, J P van der Sande, F M Nephrol-Dial-Transplant. 2001 December; 16(12): 2418-9 0931-0509

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Myoplasmic calcium regulation in myotubes from horses with recurrent exertional rhabdomyolysis. Author(s): Department of Clinical and Population Sciences, University of Minnesota, St Paul, MN 55108, USA. Source: Lentz, L R Valberg, S J Herold, L V Onan, G W Mickelson, J R Gallant, E M AmJ-Vet-Res. 2002 December; 63(12): 1724-31 0002-9645

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Normal resting values of plasma free carnitine and acylcarnitine in horses predisposed to exertional rhabdomyolysis. Author(s): Clinic of Large Animal Medicine, University of Utrecht, The Netherlands. Source: van den Hoven, R Breukink, H J Vaandrager Verduin, M H Scholte, H R Meijer, A E Equine-Vet-J. 1989 July; 21(4): 307-8 0425-1644

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Pancytopenia, hyperglycemia, shock, coma, rhabdomyolysis, and pancreatitis associated with acetaminophen poisoning. Author(s): Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Source: Yang, C C Deng, J F Lin, T J Vet-Hum-Toxicol. 2001 December; 43(6): 344-8 01456296

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Plasma and urine electrolyte and mineral concentrations in Thoroughbred horses with recurrent exertional rhabdomyolysis after consumption of diets varying in cation-anion balance. Author(s): Department of Clinical and Population Sciences, College of Veterinary Medicine, University of Minnesota, St Paul 55108, USA. Source: McKenzie, E C Valberg, S J Godden, S M Pagan, J D Carlson, G P MacLeay, J M DeLaCorte, F D Am-J-Vet-Res. 2002 July; 63(7): 1053-60 0002-9645

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Renal failure and exercise-induced rhabdomyolysis in patients taking performanceenhancing compounds. Author(s): R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore 21201, USA. Source: Sandhu, R S Como, J J Scalea, T S Betts, J M J-Trauma. 2002 October; 53(4): 761-3; discussion 763-4 0022-5282

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Repeat MRI in acute rhabdomyolysis: correlation with clinicopathological findings. Author(s): Department of Neurology, Toride Kyodo General Hospital, Ibaraki, Japan.

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Source: Shintani, S Shiigai, T J-Comput-Assist-Tomogr. 1993 Sep-October; 17(5): 786-91 0363-8715 •

Rhabdomyolysis after concomitant use of cyclosporine, simvastatin, gemfibrozil, and itraconazole. Author(s): Baylor University Medical Center, 3500 Gaston Avenue, Dallas, TX 752462088, USA. [email protected] Source: Maxa, J L Melton, L B Ogu, C C Sills, M N Limanni, A Ann-Pharmacother. 2002 May; 36(5): 820-3 1060-0280

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Rhabdomyolysis and acute renal failure following a switchover of therapy between two fibric acid derivatives. Author(s): Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan. [email protected] Source: Kamaliah, M D Sanjay, L D Singapore-Med-J. 2001 August; 42(8): 368-72 00375675

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Rhabdomyolysis and hyperthermia after cocaine abuse: a variant of the neuroleptic malignant syndrome? Author(s): Department of Neurology, New York Medical College, Metropolitan Hospital, New York 10029, USA. Source: Daras, M Kakkouras, L Tuchman, A J Koppel, B S Acta-Neurol-Scand. 1995 August; 92(2): 161-5 0001-6314

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Rhabdomyolysis and renal failure secondary to combination therapy of hyperlipidemia with lovastatin and gemfibozil. Author(s): St. Francis Hospital, Hartford. Source: Knoll, R W Ciafone, R Galen, M Conn-Med. 1993 September; 57(9): 593-4 00106178

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Rhabdomyolysis associated with cerivastatin: six cases within 3 months at one hospital. Author(s): Department of Pharmacy, Saint Thomas Hospital, Nashville, Tennessee 37205, USA. [email protected] Source: Lucas, R A Weathersby, B B Rocco, V K Pepper, J M Butler, K L Pharmacotherapy. 2002 June; 22(6): 771-4 0277-0008

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Rhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient. Author(s): Division of Nephrology, Department of Medicine, St. Michael's Hospital, University of Toronto, 61 Queen Street East, 9th Floor, Toronto, Ontario M5C 2T2 Canada. [email protected] Source: Prasad, G V Wong, T Meliton, G Bhaloo, S Transplantation. 2002 October 27; 74(8): 1200-1 0041-1337

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Rhabdomyolysis from the combination of a statin and gemfibrozil: an uncommon but serious adverse reaction. Author(s): Massachusetts General Hospital, USA. Source: Kind, A H Zakowski, L J McBride, P E WMJ. 2002; 101(7): 53-6

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Rhabdomyolysis in housed, fine-woolled merino sheep, associated with low plasma alpha-tocopherol concentrations. Author(s): Animal Health Laboratories, Department of Agriculture, South Perth, Western Australia. Source: Peet, R L Dickson, J Aust-Vet-J. 1988 December; 65(12): 398-9 0005-0423

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Rhabdomyolysis in isoniazid poisoning. Author(s): National Poison Control and Information Service, University of the Philippines-College of Medicine, Philippine General Hospital, Manila. [email protected] Source: Panganiban, L R Makalinao, I R Corte Maramba, N P J-Toxicol-Clin-Toxicol. 2001; 39(2): 143-51 0731-3810

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Rhabdomyolysis in two foals with polysaccharide storage myopathy. Source: Byrne, E. Cohen, N. Jones, S.L. Zimmel, D.N. Valberg, S. Compend-contin-educpract-vet. Trenton, N.J. : Veterinary Learning Systems. May 2000. volume 22 (5) page 503-507, 509-510. 0193-1903

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Rhabdomyolysis with hyperkalaemia after aminophylline overdose. Source: Wight, J P Laurence, J Holt, S Forrest, A R Med-Sci-Law. 1987 April; 27(2): 103-5 0025-8024

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Rhabdomyolysis, acute renal failure, and death after monensin ingestion. Author(s): Division of Nephrology, Intensive Care Unit, Service of Toxicology, and Department of Pathology, Hospital de Base, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto, SP, Brazil. Source: Caldeira, C Neves, W S Cury, P M Serrano, P Baptista, M A Burdmann, E A AmJ-Kidney-Dis. 2001 November; 38(5): 1108-12 1523-6838

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Rhabdomyolysis, oedema and arterial hypertension: different syndromes related to topical use of 9-alpha-fluoroprednisolone. Author(s): Nephrology Department, Hospital de Badalona Germans Trias I Pujol, Spain. Source: Lauzurica, R Bonal, J Bonet, J Romero, R Teixido, J Serra, A Caralps, A J-HumHypertens. 1988 October; 2(3): 183-6 0950-9240

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Rhabdomyolysis: need for high index of suspicion. Author(s): Department of Surgery (Division of Urology), Georgetown University Hospital, Washington, D.C. Source: Reha, W C Mangano, F A Zeman, R K Pahira, J J Urology. 1989 November; 34(5): 292-6 0090-4295

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Rhabdomyolysis-induced acute renal failure after morphine overdose--a case report. Author(s): Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan, R.O.C. Source: Shen, C H Hung, C J Wu, C C Huang, H W Ho, W M Acta-Anaesthesiol-Sin. 1999 September; 37(3): 159-62 0529-5769

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Rhabdomyolysis-related renal tubular damage studied by proton nuclear magnetic resonance spectroscopy of urine. Author(s): Laboratory of Biochemistry, University Hospital, University of Ioannina, Medical School, 455 00 Ioannina, Greece. [email protected] Source: Bairaktari, Eleni Seferiadis, Konstantin Liamis, George Psihogios, Nikolaos Tsolas, Orestes Elisaf, Moses Clin-Chem. 2002 July; 48(7): 1106-9 0009-9147

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Severe hemolytic uremic syndrome associated with rhabdomyolysis and insulindependent diabetes mellitus. Author(s): JHM Health Center, University of Florida, Gainesville. Source: Pena, D R Vaccarello, M Neiberger, R E Child-Nephrol-Urol. 1991; 11(4): 223-7 1012-6694

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Severe hypokalemic rhabdomyolysis due to ingestion of liquorice during Ramadan. Author(s): Medical Department, Amiri Hospital (Teaching), Kuwait, (Gulf).

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Source: Achar, K N Abduo, T J Menon, N K Aust-N-Z-J-Med. 1989 August; 19(4): 365-7 0004-8291 •

Severe rhabdomyolysis after doxylamine overdose. Author(s): Northeastern Ohio Universities College of Medicine. Source: Soto, L F Miller, C H Ognibere, A J Postgrad-Med. 1993 June; 93(8): 227-9, 232 0032-5481

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Sonography in the diagnosis of rhabdomyolysis. Author(s): Rotherham District General Hospital, Moorgate Road, Rotherham, South Yorkshire S60 2UD, United Kingdom. Source: Steeds, R P Alexander, P J Muthusamy, R Bradley, M J-Clin-Ultrasound. 1999 Nov-December; 27(9): 531-3 0091-2751

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The use of creatinine clearance ratios in the prevention of equine rhabdomyolysis: a report of four cases. Author(s): Physiology Unit, Animal Health Trust, Balaton Lodge, Newmarket, Suffolk. Source: Harris, P Colles, C Equine-Vet-J. 1988 November; 20(6): 459-63 0425-1644

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Theophylline toxicity causing rhabdomyolysis and acute compartment syndrome. Author(s): Department of Surgery, Leicester Royal Infirmary, UK. Source: Titley, O G Williams, N Intensive-Care-Med. 1992; 18(2): 129-30 0342-4642

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Treatment of cardiomyopathy and rhabdomyolysis in long-chain fat oxidation disorders using an anaplerotic odd-chain triglyceride. Author(s): Institute of Metabolic Disease, Baylor University Medical Center, Dallas, Texas 75226, USA. [email protected] Source: Roe, Charles R Sweetman, Lawrence Roe, Diane S David, France Brunengraber, Henri J-Clin-Invest. 2002 July; 110(2): 259-69 0021-9738

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Valproic acid triggers acute rhabdomyolysis in a patient with carnitine palmitoyltransferase type II deficiency. Author(s): Department of Neurology, University of Freiburg, 79106 Freiburg, Germany. [email protected] Source: Kottlors, M Jaksch, M Ketelsen, U P Weiner, S Glocker, F X Lucking, C H Neuromuscul-Disord. 2001 November; 11(8): 757-9 0960-8966

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Wild-mushroom intoxication as a cause of rhabdomyolysis. Author(s): Poison Center, University Hospital Pellegrin, Bordeaux, France. Source: Bedry, R Baudrimont, I Deffieux, G Creppy, E E Pomies, J P Ragnaud, J M Dupon, M Neau, D Gabinski, C De Witte, S Chapalain, J C Godeau, P Beylot, J N-Engl-JMed. 2001 September 13; 345(11): 798-802 0028-4793

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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WebMDHealth: 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 rhabdomyolysis; 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 Atorvastatin Source: Healthnotes, Inc.; www.healthnotes.com Chromium Source: Healthnotes, Inc.; www.healthnotes.com Fluvastatin Source: Healthnotes, Inc.; www.healthnotes.com

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Lovastatin Source: Healthnotes, Inc.; www.healthnotes.com Pravastatin Source: Healthnotes, Inc.; www.healthnotes.com Simvastatin Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. DISSERTATIONS ON RHABDOMYOLYSIS Overview In this chapter, we will give you a bibliography on recent dissertations relating to rhabdomyolysis. 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 “rhabdomyolysis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on rhabdomyolysis, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Rhabdomyolysis 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 rhabdomyolysis. 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: •

The Nutritional and Pharmacological Management of Recurrent Exertional Rhabdomyolysis in Thoroughbred Horses by McKenzie, Erica Claire; PhD from University of Minnesota, 2003, 174 pages http://wwwlib.umi.com/dissertations/fullcit/3092771

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 4. PATENTS ON RHABDOMYOLYSIS 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.8 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 “rhabdomyolysis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on rhabdomyolysis, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Rhabdomyolysis By performing a patent search focusing on rhabdomyolysis, 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. 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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

Combination of pravastatin and nicotinic acid or related acid and method for lowering serum cholesterol using such combination Inventor(s): Dennick; Leonard G. (Princeton, NJ) Assignee(s): E. R. Squibb & Sons, Inc. (princeton, Nj) Patent Number: 5,260,305 Date filed: June 18, 1992 Abstract: A pharmaceutical combination is provided which includes an inhibitor of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, which is pravastatin and a pharmaceutical which reduces serum cholesterol and/or inhibits cholesterol biosynthesis by a mechanism other than inhibiting production of the enzyme HMG CoA reductase, namely, nicotinic acid (niacin) or related acid. A method for reducing serum cholesterol or inhibiting formation of or treating atherosclerosis using the above combination without causing drug-induced myopathy or rhabdomyolysis, is also provided. Excerpt(s): The present invention relates to a combination of an inhibitor of 3-hydroxy-3methylglutaryl coenzyme A (HMG CoA) reductase which is pravastatin and nicotinic acid or related acid which reduces serum cholesterol other than by inhibiting the enzyme HMG CoA reductase, and to methods for lowering serum cholesterol and triglycerides and/or preventing or treating atherosclerosis and/or elevated triglycerides by administering such combination. The above methods may be carried out without causing drug- induced myopathy or rhabdomyolysis. There are several different classes of compounds which have serum cholesterol lowering properties. Some of these compounds are inhibitors of the enzyme HMG CoA reductase which is essential in the production of cholesterol, such as mevastatin (disclosed in U.S. Pat. No. 3,983,140), lovastatin also referred to as mevinolin (disclosed in U.S. Pat. No. 4,231,938), pravastatin (disclosed in U.S. Pat No. 4,346,227) and velostatin also referred to as synvinolin (disclosed in U.S. Pat. Nos. 4,448,784 and 4,450,171). Other compounds which lower serum cholesterol may do so by an entirely different mechanism than the HMG CoA reductase inhibitors. For example, serum cholesterol may be lowered through the use of bile acid sequestrants such as cholestyramine, colestipol, DEAE-Sephadex and poly(diallylmethylamine) derivatives (such as disclosed in U.S. Pat. Nos. 4,759,923 and 4,027,009) or through the use of antihyperlipoproteinemics such as probucol and gemfibrozil which apparently lower serum lower density lipoproteins (LDL) and/or converts LDL into high density lipoproteins (HDL). Web site: http://www.delphion.com/details?pn=US05260305__

•

Medicament for improvement of duration of muscle function or treatment of muscle disorders or diseases Inventor(s): Lignell; Ake (Varmdo, SE) Assignee(s): Astacarotene AB (gustavsberg, Se) Patent Number: 6,245,818 Date filed: February 29, 2000

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Abstract: Medicament for the prophylactic and/or therpeutic improvement of the duration of mammalian muscle function and/or treatment of mammalian muscle disorders or diseases, e.g. equine Exertional Rhabdomyolysis, comprising at least one type of xanthophylles, e.g. astaxanthin, is described. Further, the use of xanthophylles in the preparation of such medicaments, and a method of prophylactic and/or therapeutic improvement of the duration of mammalian muscle function and/or treatment of mammalian muscle disorders or diseases, are disclosed. Excerpt(s): The present invention relates to a medicament for the prophylactic and/or therapeutic improvement of the duration of mammalian muscle function and/or treatment of mammalian muscle disorders or diseases, comprising at least one type of xanthophylles, especially astaxanthin. The invention also relates to the use of at least one type of xanthophylles for the production of such a medicament and to a method of prophylactic and/or therapeutic improvement of the duration of mammalian muscle function and/or treatment of mammalian muscle disorders or diseases, e.g. equine Exertional Rhabdomyolysis. Exertional rhabdomyolysis, also referred to as exertional myopathy, tying-up syndrome, azoturia, or Monday morning disease, is probably the most common muscle disorder in horses. Predisposing or associated factors that have been implicated in the pathogenesis of this condition include electrolyte imbalances, hypothyroidism, and vitamin E-selenium deficiency. Therefore, treatment of horses affected by exertional rhabdomyolysis have included pain relief, rehydration and correction of electrolyte abnormalities (See e.g. The Horse: Diseases and Clinical Management, edited by C. N. Kolbluk, T. R. Ames, R. J. Geor, W. B. Saunders Company, Philadelphia, 1995, pp. 809-810). Xanthophylles, including astaxanthin, is a large group of carotenoids containing oxygen in the molecule in addition to carbon and hydrogen. The carotenoids are produced de novo by plants, fungi and some bacteria. Astaxanthin, in the form of naturally produced algal meal of cultured Haematococcus sp., has been marketed as antioxidant for mammals, especially humans. Web site: http://www.delphion.com/details?pn=US06245818__ •

Method of treating rhabdomyolysis by administering hepatocyte growth factor Inventor(s): Kudo; Ikue (c/o Sumitomo Pharmaceuticals Co., Ltd., 1-98, Kasugade Naka 3-chome, Osaka-shi, Osaka 554-0022, JP), Nagano; Tomokazu (c/o Sumitomo Pharmaceuticals Co., Ltd., 1-98, Kasugade Naka 3-chome, Osaka-shi, Osaka 554-0022, JP) Assignee(s): None Reported Patent Number: 6,436,388 Date filed: February 24, 2000 Abstract: The present invention is drawn to a method of treating acute renal failure caused by rhabdomyolysis by administering a therapeutically effective amount of hepatocyte growth factor (HGF). The present invention is further drawn to a method of treating rhabdomyolysis by administering a therapeutically effective amount of hepatocyte growth factor (HGF). Excerpt(s): Acute renal failure is defined as having symptoms of azotemia, electrolyte imbalance, uremia and the like caused by acute renal dysfunction. Acute renal failure is classified into prerenal acute renal failure, renal acute renal failure and postrenal acute renal failure caused by renal dysfunction. Renal acute renal failure is classified into (1) vasculitis, glomerular lesion, (2) acute interstitial nephritis, (3) tubule obstruction and (4)

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acute renal failure in a narrow sense. Acute renal failure in a narrow sense is caused by acute tubular necrosis. The acute renal failure in a narrow sense results from (1) ischemia, (2) nephrotoxic substance, or (3) myolytic substance (e.g. myoglobin) and so on. Ischemic acute renal failure is caused by bleeding from surgery, shock, external injury, burn and the like. Experimental animal model for ischemic acute renal failure is exemplified by renal artery ligation. In the rat model, BUN (blood urea nitrogen) and serum creatinine are increased, HGF (Hepatocyte Growth Factor) mRNA expression is enhanced 6 to 12 hours after ischemia, and then HGF bioactivity in rat kidney and plasma is activated (American Journal of Physiology, 1993; 265; 61-69). Acute renal failure is also caused by a nephrotoxic substance such as anti-biotic agent, antitumor agent, contrast medium. An experimental animal model of acute renal failure caused by a nephrotoxic substance is made by administration of a compound such as mercurous chloride, cisplatin, and contrast medium to rats. Mercurous chloride administered rats show an increase of BUN and creatinine, enhancement of HGF mRNA expression and activity of HGF (Nephron 1996; 73: 735), as reported on ischemia model. It is suggested that HGF be involved in restoring a patient from renal failure. Web site: http://www.delphion.com/details?pn=US06436388__ •

Protection against rhabdomyolysis-induced nephrotoxicity Inventor(s): Shah; Sudhir V. (Metairie, LA), Walker; Patrick D. (New Orleans, LA) Assignee(s): Administrators of the Tulane Educational Fund (la) Patent Number: 5,091,180 Date filed: November 30, 1990 Abstract: The present invention is directed to the in vivo use of compounds which prevent the generation of, effectively scavenge, or detoxify a reactive oxygen metabolite that mediates a toxic effect of rhabdomyolysis and myoglobinuria. The compounds of the invention can be used to prevent or reduce rhabdomyolysis-induced renal damage, and include but are not limited to free radical scavengers, iron chelators, oxidizable compounds, enzymes which metabolize reactive oxygen metabolites or their precursors, and biosynthetic precursors thereof. Excerpt(s): The present invention is directed to the in vivo use of compounds that prevent the generation of, effectively scavenge, or detoxify a reactive oxygen metabolite that mediates a toxic effect of rhabdomyolysis or myoglobinuria. The compounds of the invention include agents which prevent the generation of, effectively scavenge, or detoxify free radicals such as the hydroxyl radical, or their metabolic precursors such as hydrogen peroxide and superoxide radical. In a specific embodiment of the invention, compounds that are hydroxyl radical scavengers can provide protection against the nephrotoxicity resulting from rhabdomyolysis or myoglobinuria. In another embodiment of the invention, compounds which are iron chelators can reduce renal damage due to the effects of rhabdomyolysis or myoglobinuria. In 1941, it was first noted that an association existed between skeletal muscle injury and the release of muscle cell contents into plasma (Bywaters and Beall, Br. J. Med. 1:427-432, 1941). This release of muscle cell contents (rhabdomyolysis) includes myoglobin, resulting in myoglobinemia and myoglobinuria, or myoglobin in the urine. In its most serious manifestation, rhabdomyolysis may ultimately result in acute renal failure (ARF). Rhabdomyolysis is not solely associated with direct muscle trauma or renal failure; the condition may be associated as well with non-traumatic causes such as prolonged strenuous exercise. Thus, myoglobinuria has also been shown to be connected with non-

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pathological conditions. It is estimated that about one-third of the patients with rhabdomyolysis will develop acute renal failure (Gaben et al. Medicine 61: 141-152, 1982). A list of a number of the possible causes for rhabdomyolysis provided in Table 1. The exact mechanism by which ARF results from rhabdomyolysis has not yet been elucidated. The observed clinical association of ARF with intravascular hemolysis and skeletal muscle necrosis has led to the suggestion that the constituents of these tissues are toxic to the kidneys. Studies of the heme components in particular, i.e., myoglobin, hemoglobin and their derivations, have shown them to be extremely nephrotoxic when renal ischemia or systemic acidosis occurs. Web site: http://www.delphion.com/details?pn=US05091180__

Patent Applications on Rhabdomyolysis As of December 2000, U.S. patent applications are open to public viewing.9 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 rhabdomyolysis: •

COMBINATIONS OF HMG-COA REDUCTASE INHIBITORS AND NICOTINIC ACID AND METHODS FOR TREATING HYPERLIPIDEMIA ONCE A DAY AT NIGHT Inventor(s): BOVA, (PLANTATION, FL)

DAVID

J.;

(HOLLYWOOD,

FL),

DUNNE,

JOSEPHINE;

Correspondence: Peter J Manso; Akerman, Senterfitt, Eidson; Las Olas Centre, Suite 950; 450 East Las Olas Boulevard; Fort Lauderdale; FL; 333012227 Patent Application Number: 20010006644 Date filed: July 31, 1997 Abstract: The present invention relates to solid pharmaceutical combinations for oral administration comprising nicotinic acid or a nicotinic acid compound or mixtures thereof in an extended release form and an HMG-CoA reductase inhibitor, which are useful for altering lipid levels in subjects suffering from, for example, hyperlipidemia and atherosclerosis, without causing drug-induced hepatotoxicity, myopathy or rhabdomyolysis. The present invention also relates to methods of altering serum lipids in subjects to treat, for example, hyperlipidemia in hyperlipidemics, lipidemia in normolipidemics diagnosed with or predisposed to cardiovascular disease, and atherosclerosis, by administering such oral solid pharmaceutical combinations once per day as a single dose during the evening hours, without causing drug-induced hepatotoxicity, myopathy or rhabdomyolysis, or without causing in at least an appreciable number of individuals drug-induced hepatotoxicity, myopathy or rhabdomyolysis to such a level that discontinuation of such therapy would be required. More particularly, the present invention concerns oral solid pharmaceutical combinations comprised of, for example, (1) an HMG-CoA reductase inhibitor for immediate or extended release, (2) nicotinic acid, a nicotinic acid compound or mixtures thereof, and (3) a swelling agent to form a sustained release composition for extended release of the nicotinic acid or nicotinic acid compound or mixtures thereof for nocturnal or evening dosing for reducing serum lipids and increasing HDL-cholesterol. In 9

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

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accordance with the present invention, and by way of example, a composition for oral administration during the evening hours to alter serum lipids comprised of nicotinic acid and hydroxypropyl methylcellulose in the form of an extended or sustained release tablet or caplet coated with a coating comprising an HMG-CoA reductase inhibitor in immediate release form is disclosed. Also in accordance with the present invention, the pharmaceutical combinations may include a nonsteroidal anti-inflammatory agent for reducing the capacity of nicotinic acid or nicotinic acid compounds to provoke flushing reactions in individuals. Excerpt(s): This invention generally relates to pharmaceutical combinations for oral administration comprising nicotinic acid or a nicotinic acid compound or mixtures thereof in an extended release form and 3-hydroxy-3-methylglutaryl co-enzyme A (HMG-CoA) reductase inhibitor in an immediate or extended release form, which are useful for altering serum lipid levels in subjects when given once per day as a single dose during the evening hours, without causing drug-induced hepatotoxicity, myopathy or rhabdomyolysis. The present invention also relates to methods of orally dosing subjects with such pharmaceutical combinations once per day as a single dose during the evening hours for altering their serum lipid levels to treat, for example, hyperlipidemia and atherosclerosis, without causing drug-induced hepatotoxicity, myopathy or rhabdomyolysis. Hyperlipidemia or an elevation in serum lipids is associated with an increase incidence of cardiovascular disease and atherosclerosis. Specific forms of hyperlipidemia include, for example, hypercholesteremia, familial dysbetalipoproteinemia, diabetic dyslipidemia, nephrotic dyslipidemia and familial combined hyperlipidemia. Hypercholesteremia is characterized by an elevation in serum low density lipoprotein-cholesterol and serum total cholesterol. Low density lipoprotein (LDL-cholesterol) transports cholesterol in the blood. Familial dysbetalipoproteinemia, also known as Type III hyperlipidemia, is characterized by an accumulation of very low density lipoprotein-cholesterol (VLDL-cholesterol) particles called beta-VLDLs in the serum. Also associated with this condition, there is a replacement of normal apolipoprotein E3 with abnormal isoform apolipoprotein E2. Diabetic dyslipidemia is characterized by multiple lipoprotein abnormalities, such as an overproduction of VLDL-cholesterol, abnormal VLDL triglyceride lipolysis, reduced LDL-cholesterol receptor activity and, on occasion, Type III hyperlipidemia. Nephrotic dyslipidemia is difficult to treat and frequently includes hypercholesteremia and hypertriglyceridemia. Familial combined hyperlipidemia is characterized by multiple phenotypes of hyperlipidemia, i.e., Type IIa, IIb, IV, V or hyperapobetalipoproteinemia. It is well known that the likelihood of cardiovascular disease can be decreased, if the serum lipids, and in particular LDL-cholesterol, can be reduced. It is also well known that the progression of atherosclerosis can be retarded or the regression of atherosclerosis can be induced if serum lipids can be lowered. In such cases, individuals diagnosed with hyperlipidemia or hypercholesteremia should consider lipid-lowering therapy to retard the progression or induce the regression of atherosclerosis for purposes of reducing their risk of cardiovascular disease, and in particular coronary artery disease. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents

•

71

HGF FOR TREATING ACUTE RENAL FAILURE Inventor(s): KUDO, IKUE; (OSAKA-SHI, JP), NAGANO, TOMOKAZU; (OSAKA-SHI, JP) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20010047079 Date filed: February 24, 2000 Abstract: The present invention provides a pharmaceutical composition for treating acute renal failure caused by rhabdomyolysis comprising an effective amount of HGF.The present invention provides a method of treating acute renal failure caused by rhabdomyolysis comprising administering an effective amount of HGF to a patient in need thereof. Excerpt(s): Acute renal failure is defined as having symptoms of azotemia, electrolyte imbalance, uremia and the like caused by acute renal dysfunction. Acute renal failure is classified into prerenal acute renal failure, renal acute renal failure and postrenal acute renal failure caused by renal dysfunction. Renal acute renal failure is classified into (1) vasculitis, glomerular lesion, (2) acute interstitial nephritis, (3) tubule obstruction and (4) acute renal failure in a narrow sense. Acute renal failure in a narrow sense is caused by acute tubular necrosis. The acute renal failure in a narrow sense results from (1) ischemia, (2) nephrotoxic substance, or (3) myolytic substance (e.g. myoglobin) and so on. Ischemic acute renal failure is caused by bleeding from surgery, shock, external injury, burn and the like. Experimental animal model for ischemic acute renal failure is exemplified by renal artery ligation. In the rat model, BUN (blood urea nitrogen) and serum creatinine are increased, HGF (Hepatocyte Growth Factor) mRNA expression is enhanced 6 to 12 hours after ischemia, and then HGF bioactivity in rat kidney and plasma is activated (American Journal of Physiology, 1993; 265; 61-69). Acute renal failure is also caused by a nephrotoxic substance such as anti-biotic agent, antitumor agent, contrast medium. An experimental animal model of acute renal failure caused by a nephrotoxic substance is made by administration of a compound such as mercurous chloride, cisplatin, and contrast medium to rats. Mercurous chloride administered rats show an increase of BUN and creatinine, enhancement of HGF mRNA expression and activity of HGF (Nephron 1996; 73; 735), as reported on ischemia model. It is suggested that HGF be involved in restoring a patient from renal failure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with rhabdomyolysis, 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 “rhabdomyolysis” (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 rhabdomyolysis.

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You can also use this procedure to view pending patent applications concerning rhabdomyolysis. 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 5. BOOKS ON RHABDOMYOLYSIS Overview This chapter provides bibliographic book references relating to rhabdomyolysis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on rhabdomyolysis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Renal Disease in Patients with Substance Abuse Source: in Schena, F.P., ed. Nephrology. New York, NY: McGraw-Hill, Inc. 2001. p. 237243. Contact: Available from McGraw-Hill, Inc. Shoppenhangers Road, Maidenhead, Berkshire SL6 2QL. 44 (0)1628 502700. Fax: +44 (0)1628 635895 E-mail: [email protected]. Website: www.mcgraw-hill.co.uk. PRICE: $79.95; plus shipping and handling. ISBN: 0077095251. Summary: The use of various different prescription and nonprescription drugs that may lead to dependency or that may have recreational or psychological effects can cause renal (kidney) disease. This chapter on renal disease in patients with substance abuse is from a book on nephrology (the study of the kidney and kidney diseases) designed for general practitioners and family care providers that offers strategies for the management of patients with renal (kidney) damage. The authors suggest a syndrome analytic

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approach as the easiest first step in differentiating these renal diseases. Patients who use alcohol or cocaine may develop acute renal failure (ARF) from rhabdomyolysis (a potentially fatal disease of skeletal muscle) and myoglobinuria (myoglobin, responsible for the red color of muscle tissue and its ability to store oxygen, in the urine), which may be traumatic or nontraumatic, the latter often a direct effect of muscle injury caused by alcohol. The authors caution that any drug that causes central nervous system depression may be critical in the pathogenesis of rhabdomlyolysis, since muscular compression and seizures may be associated with the outpouring of intracellular contents that causes the nephropathy (kidney disease). Compression of muscles may be the critical factor in producing rhabdomyolysis in patients with drug-related coma or stupor. Rhabdomyolysis may present with weakness and myalgia (pain in the muscles), nausea and vomiting, disorientation, stupor or coma, and hard swollen muscles. This chapter also discusses nephrotic syndrome associated with intravenous drug use, including infective endocarditis, vasculitis, hepatitis B or C infections, and HIV infection; and chronic renal disease, including amyloidosis (accumulation of a waxy, glycoprotein in tissues and organs), problems arising from nonsteroidal antiinflammatory drugs (NSAIDs), heroin nephropathy, HIV associated nephropathy, and lead nephropathy. 1 table. 14 references.

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CHAPTER 6. PERIODICALS RHABDOMYOLYSIS

AND

NEWS

ON

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

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

Grapefruit consumption implicated in case of statin-related rhabdomyolysis Source: Reuters Medical News Date: March 01, 2004

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•

Rhabdomyolysis complicates multidrug treatment of HIV-infected patient Source: Reuters Medical News Date: June 25, 2003

•

Cerivastatin-gemfibrozil interaction may explain rhabdomyolysis problems Source: Reuters Industry Breifing Date: December 27, 2002

•

Mushroom poisoning causes rhabdomyolysis Source: Reuters Medical News Date: September 13, 2001

•

Risk factors identified for rhabdomyolysis in HIV patients Source: Reuters Medical News Date: December 07, 2000

•

Possible rhabdomyolysis and pleuritic chest pain after chloropicrin exposure reported Source: Reuters Medical News Date: February 16, 1999 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “rhabdomyolysis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or

Periodicals and News 77

you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “rhabdomyolysis” (or synonyms). If you know the name of a company that is relevant to rhabdomyolysis, 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 “rhabdomyolysis” (or synonyms).

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

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CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to rhabdomyolysis: Cyclosporine •

Systemic - U.S. Brands: Neoral; Sandimmune; SangCya http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202176.html

Gemfibrozil •

Systemic - U.S. Brands: Lopid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202256.html

Hmg-Coa Reductase Inhibitors •

Systemic - U.S. Brands: Baycol; Lescol; Lipitor; Mevacor; Pravachol; Zocor http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202284.html

Phenothiazines •

Systemic - U.S. Brands: Chlorpromazine Hydrochloride Intensol; Compazine; Compazine Spansule; Mellaril; Mellaril Concentrate; Mellaril-S; Permitil; Permitil Concentrate; Prolixin; Prolixin Concentrate; Prolixin Decanoate; Prolixin Enanthate; Serentil; Serentil Concentrate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202457.html

Sodium Bicarbonate •

Systemic - U.S. Brands: Bell/ans; Citrocarbonate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202525.html

Tetanus Immune Globulin •

Systemic - U.S. Brands: BayTet http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202908.html

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

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information

Researching Medications 81

adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

85

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 Institute10: •

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/

10

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.11 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:12 •

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

11

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). 12 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 Gateway13 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.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “rhabdomyolysis” (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 4442 7 18 11 582 5060

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 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.17 Simply search by “rhabdomyolysis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

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

14

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). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

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 Biologists18 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.19 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.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Rhabdomyolysis In the following section, we will discuss databases and references which relate to the Genome Project and rhabdomyolysis. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).21 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 18 Adapted 19

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. 20 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. 21 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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

Rhabdomyolysis, Acute Recurrent Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=268200 Genes and Disease (NCBI - Map)

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

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

•

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

•

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

•

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

•

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

Physician Resources 91

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “rhabdomyolysis” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database22 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database23 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “rhabdomyolysis” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

22

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 23 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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

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Amyotrophic Lateral Sclerosis http://www.nlm.nih.gov/medlineplus/amyotrophiclateralsclerosis.html Heart Attack http://www.nlm.nih.gov/medlineplus/heartattack.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Myasthenia Gravis http://www.nlm.nih.gov/medlineplus/myastheniagravis.html Myositis http://www.nlm.nih.gov/medlineplus/myositis.html Neuromuscular Disorders http://www.nlm.nih.gov/medlineplus/neuromusculardisorders.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 National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “rhabdomyolysis” (or synonyms). The following was recently posted: •

AACE medical guidelines for clinical practice for the diagnosis and treatment of dyslipidemia and prevention of atherogenesis Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 2000 Mar-April; 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2199&nbr=1425&a mp;string=rhabdomyolysis

•

Cardiovascular disease in women: a guide to risk factor screening, prevention and management Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3487&nbr=2713&a mp;string=rhabdomyolysis

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•

Lipids Source: National Committee on Cardiac Care (Singapore) - National Government Agency [Non-U.S.]; 2001 July; 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3075&nbr=2301&a mp;string=rhabdomyolysis

•

Lipids and the primary prevention of coronary heart disease. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 1999 September; 60 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2909&nbr=2135&a mp;string=rhabdomyolysis

•

Management of chronic kidney disease and pre-ESRD in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 2000 November; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3099&nbr=2325&a mp;string=rhabdomyolysis

•

Management of type 2 diabetes mellitus Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 March (revised 2002 Sep); 77 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3499&nbr=2725&a mp;string=rhabdomyolysis

•

Screening and management of lipids Source: University of Michigan Health System - Academic Institution; 2000 May (revised 2003 Apr); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4114&nbr=3159&a mp;string=rhabdomyolysis

•

Standards of medical care for patients with diabetes mellitus Source: American Diabetes Association - Professional Association; 1988 (revised 2002 October; republished 2003 Jan); 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3567&nbr=2793&a mp;string=rhabdomyolysis

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•

Treatment for stimulant use disorders Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2540&nbr=1766&a mp;string=rhabdomyolysis 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 rhabdomyolysis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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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 “rhabdomyolysis” (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 “rhabdomyolysis”. 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 “rhabdomyolysis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “rhabdomyolysis” (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.24

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

24

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)25: •

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/

25

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

Finding Medical Libraries 101

•

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

•

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

•

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

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries 103

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

104 Rhabdomyolysis

•

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

•

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

•

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

•

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

105

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Rhabdomyolysis ARF Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000501.htm Rhabdomyolysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000473.htm

•

Signs & Symptoms for Rhabdomyolysis Abnormal urine color Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003139.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm

106 Rhabdomyolysis

Flushing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm Heat intolerance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003094.htm Joint pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Myalgia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003178.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Weight gain (unintentional) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003084.htm •

Diagnostics and Tests for Rhabdomyolysis Aldolase Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003566.htm ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Casts Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003586.htm Cocaine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm CPK Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003503.htm CPK isoenzymes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003504.htm Creatinine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003475.htm

Online Glossaries 107

Creatinine - urine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003610.htm Granular casts Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003586.htm Hemoglobin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003645.htm Heroin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Lactic dehydrogenase Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003471.htm Serum myoglobin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003663.htm Serum potassium Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003484.htm Uric acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003476.htm Urinalysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm Urine myoglobin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003664.htm •

Background Topics for Rhabdomyolysis Cardiovascular Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002310.htm Genetics Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002048.htm Heatstroke Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000056.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Necrosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002266.htm Necrotic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002266.htm Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm

108 Rhabdomyolysis

Symptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002293.htm

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

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

•

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

•

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

•

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

109

RHABDOMYOLYSIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] 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] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aeromedical: Pertaining to aviation medicine. [NIH] Aeromonas: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that occurs singly, in pairs, or in short chains. Its organisms are found in fresh water and sewage and are pathogenic to humans, frogs, and fish. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element,

110 Rhabdomyolysis

organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] 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] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allium: A genus of liliaceous herbs containing onions (Allium cepa), garlic (Allium sativum), and others; many produce pungent, often bacteriostatic and physiologically active compounds and are used as food, condiment, and medicament, the latter in traditional medicine. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino acid: 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]

Dictionary 111

Aminophylline: A drug combination that contains theophylline and ethylenediamine. It is more soluble in water than theophylline but has similar pharmacologic actions. It's most common use is in bronchial asthma, but it has been investigated for several other applications. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anabolic Steroids: Chemical derivatives of testosterone that are used for anabolic promotion of growth and repair of body tissues and the development of male sexual characteristics. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [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] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food

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supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antidiuretic: Suppressing the rate of urine formation. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipruritic: Relieving or preventing itching. [EU] 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.

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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] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antispasmodic: An agent that relieves spasm. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [NIH] Aortic Coarctation: Narrowing of the lumen of the aorta, caused by deformity of the aortic media. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arsenic trioxide: An anticancer drug that induces programmed cell death (apoptosis) in certain cancer cells. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriography: A procedure to x-ray arteries. The arteries can be seen because of an injection of a dye that outlines the vessels on an x-ray. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH]

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Aspergillosis: Infections with fungi of the genus Aspergillus. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] 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] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autopsy: Postmortem examination of the body. [NIH] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] Azotemia: An excess of urea or other nitrogenous compounds in the blood. [EU] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [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] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical

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manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bezafibrate: Antilipemic agent that lowers cholesterol and triglycerides. It decreases low density lipoproteins and increases high density lipoproteins. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotic: Pertaining to living organisms in their ecological rather than their physiological relations. [NIH] Bladder: The organ that stores urine. [NIH] Blastomycosis: A fungal infection that may appear in two forms: 1) a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2) chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH]

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Blood Glucose: Glucose in blood. [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 urea: A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases. [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] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [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 Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [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]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU] Calcifediol: The major circulating metabolite of vitamin D3 produced in the liver and the

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best indicator of the body's vitamin D stores. It is effective in the treatment of rickets and osteomalacia, both in azotemic and non-azotemic patients. Calcifediol also has mineralizing properties. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcitriol: The physiologically active form of vitamin D. It is formed primarily in the kidney by enzymatic hydroxylation of 25-hydroxycholecalciferol (calcifediol). Its production is stimulated by low blood calcium levels and parathyroid hormone. Calcitriol increases intestinal absorption of calcium and phosphorus, and in concert with parathyroid hormone increases bone resorption. [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] Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA topoisomerase. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart

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and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carotenoids: Substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. May reduce the risk of developing cancer. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catalyse: To speed up a chemical reaction. [EU] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [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 motility: The ability of a cell to move. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called

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the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [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] 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] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Cholestyramine: Strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium as Cl(-) anion. It exchanges chloride ions with bile salts, thus decreasing their concentration and that of cholesterol. It is used as a hypocholesteremic in diarrhea and biliary obstruction and as an antipruritic. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] 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]

Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH]

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Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] 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] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colestipol: Highly crosslinked and insoluble basic anion exchange resin used as anticholesteremic. It may also may reduce triglyceride levels. [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] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [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] Concomitant: Accompanying; accessory; joined with another. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU]

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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] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] 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] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [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 heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Creatinine clearance: A test that measures how efficiently the kidneys remove creatinine and other wastes from the blood. Low creatinine clearance indicates impaired kidney function. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [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] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the

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transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH]

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Diabetic Ketoacidosis: Complication of diabetes resulting from severe insulin deficiency coupled with an absolute or relative increase in glucagon concentration. The metabolic acidosis is caused by the breakdown of adipose stores and resulting increased levels of free fatty acids. Glucagon accelerates the oxidation of the free fatty acids producing excess ketone bodies (ketosis). [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotestosterone: Anabolic agent. [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] Diphenhydramine: A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. It has some undesired antimuscarinic and sedative effects. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disposition: A tendency either physical or mental toward certain diseases. [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] 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] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Doxylamine: Histamine H1 antagonist with pronounced sedative properties. It is used in allergies and as an antitussive, antiemetic, and hypnotic. Doxylamine has also been

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administered in veterinary applications and was formerly used in parkinsonism. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous)

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production. [NIH] Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [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] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [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] Enhancer: Transcriptional element in the virus genome. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] 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] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [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]

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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] Excrete: To get rid of waste from the body. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an exercise test. [NIH]

Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracorporeal: Situated or occurring outside the body. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Free Radical Scavengers: Substances that influence the course of a chemical reaction by ready combination with free radicals. Among other effects, this combining activity protects pancreatic islets against damage by cytokines and prevents myocardial and pulmonary perfusion injuries. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH]

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Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelsolin: A 90-kD protein produced by macrophages that severs actin filaments and forms a cap on the newly exposed filament end. Gelsolin is activated by calcium ions and participates in the assembly and disassembly of actin, thereby increasing the motility of some cells. [NIH] Gemfibrozil: A lipid-regulating agent that lowers elevated serum lipids primarily by decreasing serum triglycerides with a variable reduction in total cholesterol. These decreases occur primarily in the VLDL fraction and less frequently in the LDL fraction. Gemfibrozil increases HDL subfractions HDL2 and HDL3 as well as apolipoproteins A-I and A-II. Its mechanism of action has not been definitely established. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [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] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH]

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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] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

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

Glycols: A generic grouping for dihydric alcohols with the hydroxy groups (-OH) located on different carbon atoms. They are viscous liquids with high boiling points for their molecular weights. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [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] 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] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Transplantation: The transference of a heart from one human or animal to another. [NIH]

Heat Exhaustion: Condition which results from a failure to adjust to the shift in blood volume as a result of dilation of skin blood vessels, caused by dehydration following profuse sweating and insufficient replacement of water and salt. [NIH] Heat Stroke: A condition characterized by cessation of sweating, hot dry skin, delirium,

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collapse, and coma and resulting from prolonged exposure to high environmental temperature. [NIH] Hematologic malignancies: Cancers of the blood or bone marrow, including leukemia and lymphoma. Also called hematologic cancers. [NIH] Hematuria: Presence of blood in the urine. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemlock: Any of several poisonous plants commonly called the poison hemlock (Conium maculatum and Cicuta major) and the water hemlock (Cicuta maculata). Conium maculatum is a large toxic umbelliferous plant herb, which contains the poisonous alkaloid coniine which affects the nervous system. The dried, fully grown, unripe fruit has sedative, anodyne, and antispasmodic effects. Cicuta maculata is also toxic. Its foliage contains a complex unsaturated alcohol that causes convulsions. The hemlock tree, genus Tsuga, unrelated to poison hemlock, is an evergreen coniferous tree of the pine family. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [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] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemoperfusion: Removal of toxins or metabolites from the circulation by the passing of blood, within a suitable extracorporeal circuit, over semipermeable microcapsules containing adsorbents (e.g., activated charcoal) or enzymes, other enzyme preparations (e.g., gel-entrapped microsomes, membrane-free enzymes bound to artificial carriers), or other adsorbents (e.g., various resins, albumin-conjugated agarose). [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.

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[NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatocyte: A liver cell. [NIH] Hepatocyte Growth Factor: Multifunctional growth factor which regulates both cell growth and cell motility. It exerts a strong mitogenic effect on hepatocytes and primary epithelial cells. Its receptor is proto-oncogene protein C-met. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] 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] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydration: Combining with water. [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] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxides: Inorganic compounds that contain the OH- group. [NIH]

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Hydroxyl Radical: The univalent radical OH that is present in hydroxides, alcohols, phenols, glycols. [NIH] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperkalaemia: Pathology: an abnormally high concentration of potassium in the blood. [EU]

Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperpyrexia: Exceptionally high fever either in comparison of the fever usually accompanying a particular disease or absolutely (as in heat stroke). [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] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileus: Obstruction of the intestines. [EU] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue

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(thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] 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]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] 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]

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Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Intercostal: Situated between the ribs. [EU] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irinotecan: An anticancer drug that belongs to a family of anticancer drugs called topoisomerase inhibitors. It is a camptothecin analogue. Also called CPT 11. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isoniazid: Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] 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]

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Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Lactate Dehydrogenase: A tetrameric enzyme that, along with the coenzyme NAD+, catalyzes the interconversion of lactate and pyruvate. In vertebrates, genes for three different subunits (LDH-A, LDH-B and LDH-C) exist. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Leptospirosis: Infections with bacteria of the genus Leptospira. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows

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strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lithotomy: A position in which the patient lies on his back with legs flexed and his thighs on his abdomen and abducted. [NIH] Lithotomy position: A position in which the patient lies on his back with legs flexed and his thighs on his abdomen and abducted. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lovastatin: A fungal metabolite isolated from cultures of Aspergillus terreus. The compound is a potent anticholesteremic agent. It inhibits 3-hydroxy-3-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It also stimulates the production of low-density lipoprotein receptors in the liver. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbosacral Plexus: The lumbar and sacral plexuses taken together. The fibers of the lumbosacral plexus originate in the lumbar and upper sacral spinal cord (L1 to S3) and innervate the lower extremities. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in

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which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Maculopapular: Both macular and papular, as an eruption consisting of both macules and papules; sometimes erroneously used to designate a papule that is only slightly elevated. [EU]

Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant Hyperthermia: Rapid and excessive rise of temperature accompanied by muscular rigidity following general anesthesia. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] 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] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU]

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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] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methylcellulose: Methylester of cellulose. Methylcellulose is used as an emulsifying and suspending agent in cosmetics, pharmaceutics and the chemical industry. It is used therapeutically as a bulk laxative. [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] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monensin: An antiprotozoal agent produced by Streptomyces cinnamonensis. It exerts its effect during the development of first-generation trophozoites into first-generation schizonts within the intestinal epithelial cells. It does not interfere with hosts' development of acquired immunity to the majority of coccidial species. Monensin is a sodium and proton selective ionophore and is widely used as such in biochemical studies. [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] Monotherapy: A therapy which uses only one drug. [EU] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness,

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and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the drugs less effective. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myalgia: Pain in a muscle or muscles. [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] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]

Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Myopathy: Any disease of a muscle. [EU]

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Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] 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] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nephrotoxic: Toxic or destructive to kidney cells. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] 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

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normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Diseases: A general term encompassing lower motor neuron disease; peripheral nervous system diseases; and certain muscular diseases. Manifestations include muscle weakness; fasciculation; muscle atrophy; spasm; myokymia; muscle hypertonia, myalgias, and musclehypotonia. [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] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] 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] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU]

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Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [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] 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] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store

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and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perineal: Pertaining to the perineum. [EU] Perineal prostatectomy: Surgery to remove the prostate through an incision made between the scrotum and the anus. [NIH] Perineum: The area between the anus and the sex organs. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] P-Glycoprotein: A 170 kD transmembrane glycoprotein from the superfamily of ABC

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transporters. It serves as an ATP-dependent efflux pump for a variety of chemicals, including many antineoplastic agents. Overexpression of this glycoprotein is associated with multidrug resistance. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenmetrazine: A sympathomimetic drug used primarily as an appetite depressant. Its actions and mechanisms are similar to dextroamphetamine. [NIH] Phenotypes: An organism as observed, i. e. as judged by its visually perceptible characters resulting from the interaction of its genotype with the environment. [NIH] Phosphoglycerate Kinase: An enzyme catalyzing the transfer of a phosphate group from 3phospho-D-glycerate in the presence of ATP to yield 3-phospho-D-glyceroyl phosphate and ADP. EC 2.7.2.3. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [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] Phosphorylated: Attached to a phosphate group. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been

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investigated as a thrombolytic agent. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [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] Polydipsia: Chronic excessive thirst, as in diabetes mellitus or diabetes insipidus. [EU] Polymyxin: Basic polypeptide antibiotic group obtained from Bacillus polymyxa. They affect the cell membrane by detergent action and may cause neuromuscular and kidney damage. At least eleven different members of the polymyxin group have been identified, each designated by a letter. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [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] 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] Pravastatin: An antilipemic fungal metabolite isolated from cultures of Nocardia autotrophica. It acts as a competitive inhibitor of HMG CoA reductase (hydroxymethylglutaryl CoA reductases). [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or

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populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [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] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Propofol: A widely used anesthetic. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] 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] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

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Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Punishment: The application of an unpleasant stimulus or penalty for the purpose of eliminating or correcting undesirable behavior. [NIH] Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH] Quadriplegia: Severe or complete loss of motor function in all four limbs which may result from brain diseases; spinal cord diseases; peripheral nervous system diseases; neuromuscular diseases; or rarely muscular diseases. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper brain stem which injures the descending cortico-spinal and cortico-bulbar tracts. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] 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] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [EU]

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Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] 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] Renal Artery: A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal tubular: A defect in the kidneys that hinders their normal excretion of acids. Failure to excrete acids can lead to weak bones, kidney stones, and poor growth in children. [NIH] Renal tubular acidosis: A rare disorder in which structures in the kidney that filter the blood are impaired, producing using that is more acid than normal. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] 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] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Rod: A reception for vision, located in the retina. [NIH] Ryanodine: Insecticidal alkaloid isolated from Ryania speciosa; proposed as a myocardial depressant. [NIH]

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Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Salivary: The duct that convey saliva to the mouth. [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] Scrotum: In males, the external sac that contains the testicles. [NIH] Scrub Typhus: An acute infectious disease caused by Orientia tsutsugamushi. It is limited to eastern and southeastern Asia, India, northern Australia, and the adjacent islands. Characteristics include the formation of a primary cutaneous lesion at the site of the bite of an infected mite, fever lasting about two weeks, and a maculopapular rash. [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] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Septicemia: Systemic disease associated with the presence and persistence of pathogenic microorganisms or their toxins in the blood. Called also blood poisoning. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

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Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Simvastatin: A derivative of lovastatin and potent competitive inhibitor of 3-hydroxy-3methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL receptors, it increases breakdown of LDL-cholesterol (lipoproteins, LDL cholesterol). [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] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [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] 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] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] 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]

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Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [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] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterile: Unable to produce children. [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] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptokinase: Streptococcal fibrinolysin . An enzyme produced by hemolytic streptococci. It hydrolyzes amide linkages and serves as an activator of plasminogen. It is used in thrombolytic therapy and is used also in mixtures with streptodornase (streptodornase and streptokinase). EC 3.4.-. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other

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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] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] 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]

Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. [NIH]

Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Supine: Having the front portion of the body upwards. [NIH] Supine Position: The posture of an individual lying face up. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraspinal: Above the spinal column or any spine. [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] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of

152 Rhabdomyolysis

formation or development : condition of a monster). [EU] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [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] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombolytic Therapy: Use of infusions of fibrinolytic agents to destroy or dissolve thrombi in blood vessels or bypass grafts. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH]

Dictionary 153

Tic: An involuntary compulsive, repetitive, stereotyped movement, resembling a purposeful movement because it is coordinated and involves muscles in their normal synergistic relationships; tics usually involve the face and shoulders. [EU] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [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] Tonicity: The normal state of muscular tension. [NIH] Topical: On the surface of the body. [NIH] Topoisomerase inhibitors: A family of anticancer drugs. The topoisomerase enzymes are responsible for the arrangement and rearrangement of DNA in the cell and for cell growth and replication. Inhibiting these enzymes may kill cancer cells or stop their growth. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicologic: Pertaining to toxicology. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transaminase: Aminotransferase (= a subclass of enzymes of the transferase class that catalyse the transfer of an amino group from a donor (generally an amino acid) to an acceptor (generally 2-keto acid). Most of these enzymes are pyridoxal-phosphate-proteins. [EU]

Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH]

154 Rhabdomyolysis

Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tropomyosin: A protein found in the thin filaments of muscle fibers. It inhibits contraction of the muscle unless its position is modified by troponin. [NIH] Troponin: One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculostatic: Inhibiting the growth of Mycobacterium tuberculosis. [EU] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in dialysis separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as hemofiltration or hemodiafiltration (if combined with hemodialysis). [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Univalent: Pertaining to an unpaired chromosome during the zygotene stage of prophase to first metaphase in meiosis. [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]

Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are

Dictionary 155

not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Varicella: Chicken pox. [EU] 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] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] 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] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Weight Lifting: A sport in which weights are lifted competitively or as an exercise. [NIH] 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]

156 Rhabdomyolysis

Zidovudine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIVinduced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leukopenia. [NIH] Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH]

157

INDEX A Abdominal, 33, 34, 35, 109, 136, 141, 142, 147 Acceptor, 109, 135, 141, 153 Acetaminophen, 39, 56, 109 Acetylcholine, 109, 140 Acidity, 109, 143 Acidosis, 4, 6, 36, 69, 109, 123, 134 Acne, 109, 133 Acne Vulgaris, 109, 133 Actin, 109, 127, 139, 154 Acute renal, 3, 5, 7, 9, 10, 11, 14, 15, 18, 19, 22, 26, 27, 29, 30, 31, 33, 35, 37, 38, 40, 41, 42, 46, 47, 49, 50, 54, 55, 56, 57, 58, 67, 68, 71, 74, 109, 129 Adenosine, 109, 143, 152 Adrenal Glands, 109, 111, 147 Adverse Effect, 109, 133, 149 Aerobic, 109, 126 Aeromedical, 20, 109 Aeromonas, 12, 109 Affinity, 109, 110, 135, 149 Agarose, 110, 129 Age of Onset, 110, 154 Agonist, 110, 114, 123, 139 Albumin, 110, 129 Algorithms, 110, 115 Alkaline, 4, 109, 110, 111, 117, 152 Alkaloid, 110, 117, 120, 129, 137, 147, 152 Allium, 25, 110 Alternative medicine, 76, 110 Amino acid, 110, 112, 113, 121, 125, 142, 145, 148, 151, 153, 154 Aminophylline, 54, 58, 111 Ammonia, 111, 154 Amphetamines, 111, 120 Amyloidosis, 74, 111 Anabolic, 20, 21, 111, 123 Anabolic Steroids, 20, 111 Anaemia, 10, 111 Anaerobic, 109, 111 Anaesthesia, 34, 37, 50, 111, 132 Anal, 73, 111 Analgesic, 109, 111, 137, 141 Anastomosis, 111, 127 Anatomical, 111, 119, 148 Androgenic, 21, 111, 122 Anemia, 26, 91, 111, 156

Anesthesia, 30, 33, 41, 111, 136 Animal model, 68, 71, 111 Antagonism, 111, 152 Antibiotic, 112, 114, 119, 125, 144 Antibodies, 112, 129 Antibody, 110, 112, 122, 132, 136, 149 Anticoagulant, 37, 112, 145 Antidepressant, 112, 119, 155 Antidiuretic, 28, 112 Antiemetic, 112, 113, 123 Antifungal, 112, 126, 133 Antigen, 110, 112, 131, 132, 136 Antihistamine, 12, 38, 112 Anti-infective, 112, 130 Anti-inflammatory, 7, 70, 109, 112, 148 Antineoplastic, 112, 143 Antineoplastic Agents, 112, 143 Antioxidant, 7, 67, 112, 141 Antipruritic, 112, 119 Antipsychotic, 112, 139 Antipyretic, 109, 113 Antispasmodic, 113, 129, 141 Antitussive, 113, 123, 141 Anus, 111, 113, 120, 133, 142 Aorta, 113, 147, 155 Aortic Aneurysm, 34, 113 Aortic Coarctation, 14, 113 Apathy, 113, 139 Apolipoproteins, 113, 127, 135 Apoptosis, 113 Aqueous, 113, 115, 130 Arginine, 113, 140 Arrhythmia, 5, 113, 155 Arsenic trioxide, 23, 113 Arterial, 4, 58, 113, 119, 131, 145, 151 Arteries, 113, 116, 121, 135, 137, 138 Arteriography, 32, 113 Arteriosclerosis, 113, 131 Artery, 68, 70, 71, 113, 116, 121, 124, 138, 147, 155 Aspergillosis, 114, 133 Asymptomatic, 114, 141 Ataxia, 90, 91, 114, 118, 152 Atrophy, 90, 114, 140 Atypical, 55, 114 Autodigestion, 114, 141 Autoimmune disease, 114 Autoimmunity, 43, 114

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Autologous, 30, 114 Autopsy, 54, 114 Azithromycin, 33, 114 Azotemia, 67, 71, 114, 154 B Baclofen, 27, 114 Bacteremia, 12, 114 Bacteria, 67, 109, 112, 114, 115, 119, 124, 125, 128, 129, 134, 137, 148, 150, 153, 155 Bactericidal, 114, 125 Bacteriostatic, 110, 114, 125 Bacterium, 114, 129 Basal Ganglia, 113, 114, 116, 127 Basal Ganglia Diseases, 114 Base, 58, 115, 122, 133, 154 Benign, 115, 122, 127 Bezafibrate, 11, 12, 13, 29, 115 Bilateral, 13, 23, 115, 141 Bile, 66, 115, 119, 127, 135, 150 Bile Acids, 115, 150 Bile Acids and Salts, 115 Biliary, 115, 119, 141 Biliary Tract, 115, 141 Biochemical, 13, 48, 115, 137, 148 Biological response modifier, 115, 133 Biological therapy, 115, 128 Biotechnology, 8, 9, 76, 87, 89, 90, 91, 115 Biotic, 68, 71, 115 Bladder, 37, 115, 145, 155 Blastomycosis, 115, 133 Blood Coagulation, 115, 116, 117 Blood Glucose, 116, 129, 132 Blood Platelets, 116, 148 Blood pressure, 116, 118, 131, 137, 149 Blood urea, 68, 71, 116 Blood vessel, 116, 117, 118, 119, 125, 127, 128, 129, 133, 142, 143, 149, 150, 151, 152, 155 Blood Volume, 116, 128 Body Fluids, 116, 149 Body Mass Index, 116, 141 Bone Marrow, 116, 121, 129, 132, 135, 150, 156 Bowel, 111, 116, 134, 149, 150 Brachial, 24, 116 Bradykinin, 116, 140 Brain Diseases, 116, 141, 146 Brain Stem, 116, 146 Branch, 103, 116, 127, 142, 147, 149, 152 Breakdown, 5, 116, 123, 127, 149 Bronchi, 116, 152 Bronchial, 111, 116, 130, 152

Bulbar, 116, 146 C Calcifediol, 116, 117 Calcification, 56, 113, 117 Calcitriol, 26, 117 Calcium, 7, 54, 56, 117, 127, 131, 137, 138, 141, 142, 152, 154, 155 Calcium channel blocker, 117, 155 Camptothecin, 117, 133 Candidiasis, 117, 126 Carbohydrate, 6, 117, 128, 144 Carbon Dioxide, 32, 117, 127, 147 Carcinogenic, 117, 145, 150 Carcinogens, 117, 119, 140 Cardiac, 5, 14, 42, 44, 46, 54, 95, 117, 124, 129, 138, 150 Cardiomyopathy, 6, 9, 49, 59, 117 Cardiovascular, 14, 32, 34, 35, 36, 69, 70, 94, 107, 117, 126, 148 Cardiovascular disease, 69, 70, 94, 117 Carnitine, 20, 50, 55, 56, 59, 118 Carotenoids, 67, 118 Case report, 4, 13, 16, 18, 19, 23, 25, 29, 30, 35, 40, 44, 45, 49, 54, 55, 56, 58, 118 Catalyse, 118, 153 Catheter, 27, 118 Causal, 118, 129 Cell, 7, 8, 68, 90, 91 Cell Death, 113, 118 Cell Division, 90, 114, 118, 128, 143 Cell membrane, 118, 143, 144 Cell motility, 118, 130 Cell Survival, 118, 128 Cell Transplantation, 118 Cellulose, 118, 137, 143 Central Nervous System, 74, 109, 111, 116, 118, 120, 122, 127, 137, 148, 152 Cerebellar, 114, 118, 146, 154 Cerebellar Diseases, 114, 118, 154 Cerebral, 114, 116, 118, 119, 121, 146, 149 Cerebral Cortex, 114, 116, 118 Cerebral Palsy, 118, 149 Cerebrovascular, 115, 118, 152 Cerebrum, 118, 154 Chest Pain, 76, 119 Chin, 119, 137 Cholesterol, 8, 66, 69, 70, 115, 119, 121, 124, 127, 131, 135, 149, 150 Cholesterol Esters, 119, 135 Cholestyramine, 66, 119 Chromium, 48, 60, 119

159

Chronic, 6, 10, 15, 24, 27, 74, 90, 95, 109, 115, 119, 122, 125, 132, 134, 141, 144, 148, 150, 154 Chronic renal, 74, 119, 144, 154 Chylomicrons, 119, 135 Cirrhosis, 36, 119 Cisplatin, 68, 71, 119 Citalopram, 28, 119 Clarithromycin, 19, 33, 119 Clinical trial, 6, 87, 119, 121, 145, 146 Cloning, 115, 119 Coagulation, 10, 18, 27, 30, 115, 120, 129, 152 Coca, 120 Cocaine, 44, 47, 54, 57, 74, 106, 120 Coenzyme, 8, 30, 66, 120, 134, 135, 149 Cofactor, 120, 145 Cognition, 120, 139 Colestipol, 66, 120 Collapse, 5, 36, 48, 116, 120, 129 Colon, 90, 120 Combination Therapy, 9, 57, 120 Computational Biology, 87, 89, 120 Concomitant, 19, 33, 43, 57, 120 Conjugated, 115, 120, 122, 129, 138 Connective Tissue, 116, 120, 126, 127, 135 Constriction, 120, 133 Consumption, 56, 75, 120, 141 Contamination, 120, 130 Contractility, 7, 120 Contraindications, ii, 121 Contrast medium, 68, 71, 121 Convulsions, 25, 121, 129 Cornea, 121, 156 Coronary, 70, 95, 118, 121, 137, 138 Coronary heart disease, 95, 118, 121 Coronary Thrombosis, 121, 137, 138 Cortical, 121, 126, 148, 152 Cranial, 121, 142, 146 Creatine, 4, 5, 18, 19, 46, 47, 121 Creatine Kinase, 4, 5, 19, 46, 47, 121 Creatinine, 22, 59, 68, 71, 106, 107, 121, 154 Creatinine clearance, 59, 121 Cryptosporidiosis, 114, 121 Curative, 121, 140, 152 Cutaneous, 16, 115, 117, 121, 148 Cyclic, 121, 128, 140, 152 Cyclosporine, 28, 31, 57, 80, 121 Cytochrome, 8, 10, 121 Cytokines, 7, 122, 126 Cytotoxicity, 119, 122

D Danazol, 41, 122 De novo, 67, 122 Deamination, 122, 154 Decompression, 18, 122 Degenerative, 122, 130 Dehydration, 4, 122, 128 Deletion, 7, 113, 122 Density, 66, 70, 115, 116, 122, 124, 135, 140 Detoxification, 17, 122 Deuterium, 122, 130 Dextroamphetamine, 122, 143 Diabetes Insipidus, 122, 144 Diabetes Mellitus, 9, 23, 58, 95, 122, 128, 129, 144 Diabetic Ketoacidosis, 38, 44, 123 Diagnostic procedure, 65, 76, 123 Dialysate, 123 Dialyzer, 4, 123, 129 Diarrhea, 119, 121, 123, 136 Diastolic, 123, 131 Digestion, 115, 116, 123, 135, 150 Dihydrotestosterone, 123, 146 Dilation, 116, 123, 128 Diphenhydramine, 15, 123 Diploid, 123, 143 Direct, iii, 4, 68, 74, 79, 123, 146 Discrete, 123, 156 Disinfectant, 123, 125 Disorientation, 74, 123 Disposition, 20, 123 Distal, 123, 145 Diuresis, 4, 123, 152 Dopamine, 113, 120, 122, 123 Dose-dependent, 123, 156 Doxylamine, 18, 59, 123 Drug Interactions, 8, 80, 81, 124 Drug Tolerance, 124, 153 Duodenum, 115, 124, 133, 150 Dyskinesia, 113, 119, 124 Dyslipidemia, 70, 94, 124 Dysplasia, 91, 124 Dystrophy, 5, 26, 37, 55, 90, 124 E Edema, 124, 138, 139, 140, 154 Elective, 45, 124 Electrocoagulation, 120, 124 Electrolyte, 4, 56, 67, 71, 124, 129, 144, 149, 154 Elementary Particles, 124, 136, 145 Embolus, 124, 132 Embryo, 124, 132

160 Rhabdomyolysis

Emollient, 124, 128 Endemic, 124, 150 Endocarditis, 74, 117, 124 Endocardium, 124 Endogenous, 123, 124, 145 Endometriosis, 122, 125 Endothelium, 125, 140 Endothelium-derived, 125, 140 Endotoxic, 125, 135 Endotoxin, 55, 125 End-stage renal, 41, 119, 125, 144 Enhancer, 7, 125 Environmental Exposure, 125, 140 Environmental Health, 86, 88, 125 Enzymatic, 110, 117, 125, 130 Enzyme, 4, 7, 66, 70 Epidemic, 125, 150 Epithelial, 125, 130, 137 Epithelial Cells, 125, 130, 137 Epithelium, 125, 156 Erythrocytes, 111, 116, 125, 129, 146 Erythromycin, 114, 119, 125 Essential Tremor, 90, 125 Ethanol, 15, 24, 119, 125 Evacuation, 125, 134, 146 Excitatory, 114, 126 Excrete, 126, 134, 147 Exercise Test, 6, 54, 126 Exercise Tolerance, 6, 126 Exhaustion, 4, 111, 126 Exogenous, 124, 126, 145, 154 Extracellular, 120, 126, 149, 152 Extracorporeal, 126, 129 Eye Movements, 126, 146 F Family Planning, 87, 126 Fat, 9, 49, 59, 115, 116, 121, 124, 126, 134, 135, 141, 154 Fatigue, 105, 126, 128 Fatty acids, 110, 123, 126 Fibrosis, 91, 126, 148 Fluconazole, 47, 126 Flushing, 70, 106, 126 Free Radical Scavengers, 68, 126 Free Radicals, 68, 112, 126, 138 Fungi, 67, 112, 114, 126, 137, 155 G Gallbladder, 109, 115, 127 Ganglia, 109, 114, 127, 139, 142 Ganglion, 127, 156 Gas, 111, 117, 127, 130, 136, 140, 147 Gas exchange, 127, 147

Gastric, 33, 41, 114, 118, 127, 130 Gastric Bypass, 33, 41, 127 Gastrin, 127, 130 Gastrointestinal, 116, 125, 127, 148, 151 Gastrointestinal tract, 125, 127, 148 Gelsolin, 46, 127 Gemfibrozil, 8, 9, 14, 15, 35, 47, 54, 56, 57, 66, 76, 80, 127 Gene, 7, 10, 26, 91, 92, 115, 127, 140 Gene Expression, 7, 91, 127 General practitioner, 73, 127 Genotype, 127, 143 Gland, 127, 135, 139, 141, 145, 148, 150, 152 Glomerular, 67, 71, 127, 147 Glomeruli, 5, 127 Glomerulus, 127, 139 Glucose, 90, 116, 118, 119, 122, 128, 129, 132 Glucose Intolerance, 122, 128 Glutathione Peroxidase, 128, 148 Glycerol, 55, 128, 143 Glycols, 128, 131 Glycoprotein, 8, 74, 128, 142 Governing Board, 128, 144 Gram-negative, 109, 125, 128 Growth, 7, 67, 90 Growth factors, 7, 128 Guanylate Cyclase, 128, 140 H Haematoma, 128 Haemorrhage, 48, 128 Haploid, 128, 143 Heart attack, 118, 128 Heart failure, 15, 128, 140 Heart Transplantation, 15, 128 Heat Exhaustion, 4, 128 Heat Stroke, 128, 131 Hematologic malignancies, 12, 129 Hematuria, 36, 129 Heme, 7, 69, 122, 129, 138, 141 Hemlock, 51, 129 Hemodialysis, 3, 5, 123, 129, 134, 154 Hemofiltration, 16, 129, 154 Hemoglobin, 69, 107, 111, 125, 129 Hemoglobin A, 69, 129 Hemoglobinuria, 90, 129 Hemolysis, 42, 69, 129 Hemolytic, 26, 58, 129, 150 Hemoperfusion, 19, 129 Hemorrhage, 47, 124, 129, 138, 146, 150 Hemostasis, 129, 148

161

Hepatic, 110, 130, 149 Hepatitis, 11, 20, 45, 74, 130 Hepatitis A, 45, 130 Hepatocyte, 67, 68, 71, 130 Hepatocyte Growth Factor, 67, 68, 71, 130 Hepatotoxicity, 69, 70, 130 Hepatovirus, 130 Hereditary, 130, 147 Heredity, 109, 127, 130 Heterotrophic, 126, 130 Histamine, 112, 113, 123, 130 Homeostasis, 7, 130 Hormonal, 114, 130 Hormone, 28, 117, 127, 130, 132, 149, 152 Hybrid, 7, 130 Hydration, 4, 5, 130 Hydrogen, 7, 67, 68, 109, 115, 117, 122, 128, 130, 131, 135, 137, 141, 143, 145 Hydrogen Peroxide, 7, 68, 128, 130, 135 Hydrolysis, 119, 130, 135 Hydrophobic, 130, 135 Hydroxides, 130, 131 Hydroxyl Radical, 68, 131 Hydroxylation, 117, 131 Hypercalcemia, 26, 27, 131 Hypercholesterolemia, 124, 131 Hyperglycemia, 39, 56, 131 Hyperkalaemia, 35, 56, 58, 131 Hyperlipidemia, 57, 69, 70, 124, 131 Hyperpyrexia, 51, 131 Hypersensitivity, 36, 123, 131 Hypertension, 58, 118, 131, 154 Hyperthermia, 19, 27, 34, 55, 57, 131 Hypertriglyceridemia, 70, 124, 131 Hypnotic, 123, 131 Hypoglycemia, 6, 11, 131 Hypotension, 113, 121, 131 Hypothyroidism, 24, 28, 67, 131 I Id, 60, 90, 94, 95, 96, 102, 104, 131 Ileus, 46, 131 Immune response, 112, 114, 131, 132, 151, 155 Immune system, 114, 115, 131, 155 Immunity, 131, 132, 137 Immunization, 131, 145 Immunodeficiency, 42, 90, 132 Immunogenic, 132, 135 Immunoglobulin, 46, 112, 132 Immunologic, 5, 131, 132, 156 In vitro, 7, 132 In vivo, 7, 8, 68, 132

Incision, 132, 142, 145 Indicative, 132, 142, 155 Induction, 7, 112, 132, 149 Infarction, 32, 132, 147 Infection, 18, 22, 30, 42, 43, 46, 49, 50, 51, 74, 115, 117, 121, 132, 135, 140, 150, 153, 156 Infiltration, 132, 156 Inflammation, 109, 110, 112, 126, 130, 132, 136, 138, 139, 141, 144, 155 Infusion, 36, 132, 138 Ingestion, 45, 55, 58, 132, 144, 152 Inhalation, 132, 144 Inlay, 132, 147 Inorganic, 119, 130, 132 Insulin, 58, 123, 132, 134, 154 Insulin-dependent diabetes mellitus, 58, 132 Intensive Care, 12, 24, 27, 31, 36, 40, 46, 58, 133 Intercostal, 14, 133 Interferon, 11, 133 Interferon-alpha, 133 Internal Medicine, 31, 32, 33, 39, 47, 56, 133, 139 Interstitial, 67, 71, 133, 139, 147 Intestinal, 32, 117, 121, 133, 136, 137 Intestines, 109, 127, 131, 133 Intoxication, 15, 47, 51, 54, 59, 133 Intracellular, 7, 74, 132, 133, 140, 144, 146, 148 Intravascular, 4, 10, 18, 27, 30, 69, 133 Intravenous, 5, 46, 74, 107, 132, 133 Involuntary, 114, 125, 133, 138, 146, 153 Ions, 109, 115, 119, 124, 127, 130, 133 Irinotecan, 45, 133 Ischemia, 4, 7, 14, 68, 69, 71, 114, 133, 138, 147 Isoenzyme, 50, 121, 133 Isoniazid, 30, 55, 58, 133 Isotretinoin, 11, 30, 56, 133 Itraconazole, 31, 46, 57, 133 J Jejunum, 127, 133 K Kb, 57, 86, 133 Keto, 134, 153 Ketoacidosis, 17, 134 Ketone Bodies, 123, 134 Ketosis, 123, 134 Kidney Disease, 25, 41, 47, 73, 86, 91, 95, 134

162 Rhabdomyolysis

Kidney Failure, 125, 134 Kinetics, 19, 134 L Lactate Dehydrogenase, 50, 134 Laxative, 134, 137 Leptospirosis, 30, 36, 134 Lethargy, 131, 134 Leukemia, 19, 90, 129, 134 Leukocytes, 116, 122, 133, 134 Leukopenia, 134, 156 Library Services, 102, 134 Life cycle, 126, 134 Ligament, 134, 145 Ligation, 68, 71, 134 Linkages, 129, 134, 150, 156 Lipid, 3, 7, 23, 28, 37, 69, 70, 113, 127, 128, 132, 134, 135, 141, 154 Lipid A, 7, 134 Lipid Peroxidation, 28, 135, 141 Lipolysis, 70, 135 Lipophilic, 8, 135 Lipopolysaccharides, 134, 135 Lipoprotein, 70, 124, 128, 135 Lithotomy, 41, 48, 135 Lithotomy position, 41, 48, 135 Liver, 8, 36, 109, 110, 111, 115, 116, 118, 119, 127, 130, 135, 154 Localized, 111, 128, 132, 135, 140, 143, 148, 154 Locomotion, 135, 143 Loop, 127, 135 Lovastatin, 32, 33, 57, 61, 66, 135, 149 Low-density lipoprotein, 124, 135 Lumbar, 33, 34, 44, 135 Lumbosacral Plexus, 37, 135 Lumen, 113, 135 Lymph, 125, 135, 139 Lymph node, 135, 139 Lymphatic, 125, 132, 135, 140, 150 Lymphoid, 112, 135, 136 Lymphoma, 19, 30, 34, 90, 129, 136 M Maculopapular, 136, 148 Magnetic Resonance Imaging, 136 Magnetic Resonance Spectroscopy, 8, 58, 136 Maintenance therapy, 17, 136 Malabsorption, 90, 136, 149 Malabsorption syndrome, 136, 149 Malaise, 5, 106, 136 Malignant, 10, 16, 20, 22, 23, 25, 30, 34, 35, 40, 47, 55, 57, 90, 112, 136

Malignant Hyperthermia, 10, 16, 20, 22, 23, 35, 40, 47, 55, 136 Malnutrition, 110, 114, 136, 138 Mammogram, 117, 136, 137 Mediate, 7, 123, 136 Mediator, 136, 148 Medicament, 66, 67, 110, 136 MEDLINE, 87, 89, 91, 136 Melanocytes, 136 Melanoma, 90, 136 Membrane, 4, 118, 123, 125, 128, 129, 136, 143 Meninges, 118, 136, 150 Meningitis, 126, 133, 136 Mental, iv, 6, 86, 88, 92, 96, 118, 119, 120, 123, 126, 131, 137, 144, 145, 154, 155 Mental Disorders, 137, 144, 145 Mental Health, iv, 6, 86, 88, 96, 137, 145 Metabolite, 68, 116, 135, 137, 144 Methylcellulose, 70, 137 MI, 26, 46, 108, 137 Microbe, 137, 153 Microbiology, 43, 114, 137 Microcalcifications, 117, 137 Microorganism, 120, 137, 155 Microscopy, 5, 137 Mobility, 7, 137 Modification, 110, 137, 156 Molecular, 6, 7, 87, 89, 111, 115, 120, 128, 137, 143, 146, 151, 153, 154 Molecule, 4, 67, 112, 115, 120, 125, 130, 137, 141, 146 Monensin, 23, 55, 58, 137 Monitor, 47, 121, 137, 140 Monotherapy, 14, 24, 137 Morphine, 58, 137, 139, 141 Motility, 127, 137, 148 Motion Sickness, 137, 139 Motor Activity, 121, 138, 146 Multidrug resistance, 138, 143 Muscle Fibers, 4, 5, 138, 139, 154 Muscle relaxant, 138, 151 Muscle Relaxation, 138, 151 Muscular Atrophy, 90, 138 Muscular Diseases, 138, 140, 141, 146 Muscular Dystrophies, 124, 138 Myalgia, 34, 74, 106, 138 Myocardial infarction, 22, 121, 137, 138 Myocardial Reperfusion, 138, 147 Myocardial Reperfusion Injury, 138, 147 Myocarditis, 56, 138 Myocardium, 137, 138

163

Myoglobin, 4, 5, 19, 40, 48, 68, 71, 74, 107, 138 Myopathy, 8, 32, 37, 55, 58, 66, 67, 69, 70, 138 Myosin, 139, 154 Myositis, 29, 94, 139 Myotonic Dystrophy, 90, 139 N Naloxone, 139 Naltrexone, 17, 139 Narcotic, 37, 137, 139 Nausea, 74, 112, 134, 139, 154, 155 Need, 3, 58, 71, 73, 97, 109, 119, 139, 153 Neoplasia, 90, 139 Neoplastic, 136, 139 Nephrectomy, 25, 43, 139 Nephritis, 67, 71, 139 Nephrology, 9, 10, 11, 19, 20, 22, 24, 27, 28, 29, 35, 36, 40, 46, 57, 58, 73, 139 Nephropathy, 74, 134, 139 Nephrosis, 139 Nephrotic, 70, 74, 139 Nephrotic Syndrome, 74, 139 Nephrotoxic, 68, 69, 71, 139 Nerve, 111, 114, 119, 127, 136, 139, 142, 148, 150, 155, 156 Nervous System, 74, 90, 118, 129, 136, 139, 140, 142, 151 Neuroleptic, 25, 57, 112, 139 Neuromuscular, 10, 16, 50, 55, 94, 109, 140, 141, 144, 146, 154 Neuromuscular Diseases, 140, 141, 146 Neuronal, 119, 140 Neurons, 120, 126, 127, 138, 140 Neuropathy, 37, 140 Niacin, 66, 140, 154 Nitric Oxide, 7, 140 Nitrogen, 7, 68, 71, 110, 140, 154 Nuclear, 13, 17, 22, 25, 26, 28, 30, 39, 48, 50, 51, 55, 58, 114, 117, 127, 140, 154 Nuclei, 136, 140, 145 Nucleic acid, 140, 156 O Oedema, 58, 140 Oncogene, 90, 130, 140 Opacity, 122, 140 Opiate, 39, 137, 139, 140 Opium, 137, 140, 141 Overdose, 3, 15, 18, 37, 38, 50, 58, 59, 141 Overweight, 6, 60, 141 Oxidation, 9, 11, 49, 59, 109, 112, 122, 123, 128, 135, 141

Oxidative Stress, 48, 141 Oxygen Consumption, 126, 141, 147 Oxygenase, 7, 141 P Palliative, 141, 152 Pancreas, 109, 132, 141 Pancreatic, 90, 118, 126, 141 Pancreatic cancer, 90, 141 Pancreatitis, 39, 54, 56, 141 Paralysis, 27, 116, 141, 146, 149 Paraplegia, 50, 141 Parathyroid, 26, 117, 141, 152 Parathyroid Glands, 141 Parathyroid hormone, 26, 117, 141 Parkinsonism, 113, 124, 142 Paroxysmal, 90, 142 Pathogenesis, 7, 30, 40, 67, 74, 142 Pathologic, 4, 5, 109, 113, 116, 121, 131, 142, 147, 150 Pathophysiology, 5, 45, 142 Patient Education, 6, 100, 102, 108, 142 Pelvic, 125, 142, 145 Pelvis, 135, 142 Peptide, 110, 119, 142, 145, 152 Peptide Chain Elongation, 119, 142 Perfusion, 126, 142, 153 Perineal, 48, 142 Perineal prostatectomy, 48, 142 Perineum, 142 Perioperative, 19, 40, 142 Peripheral blood, 30, 133, 142 Peripheral Nervous System, 140, 141, 142, 146, 151 Peripheral Nervous System Diseases, 140, 141, 142, 146 Peritoneal, 123, 140, 142 Peritoneal Cavity, 140, 142 Peroxide, 68, 142 Petechiae, 128, 142 P-Glycoprotein, 8, 142 PH, 31, 37, 58, 143 Pharmacokinetic, 8, 143 Pharmacologic, 111, 143, 153 Phenmetrazine, 37, 143 Phenotypes, 70, 143 Phosphoglycerate Kinase, 10, 22, 143 Phospholipids, 126, 135, 143 Phosphorus, 117, 141, 143 Phosphorylated, 120, 143 Photocoagulation, 120, 143 Physiologic, 110, 143, 146, 147, 154 Physiology, 36, 59, 68, 71, 139, 143

164 Rhabdomyolysis

Plants, 67, 110, 117, 120, 128, 129, 143, 153 Plasma, 4, 56, 57, 68, 71, 110, 112, 116, 118, 119, 128, 129, 134, 143, 148, 153 Plasmapheresis, 46, 143 Plasminogen, 143, 150 Platelet Aggregation, 140, 144 Platelets, 140, 144, 152 Platinum, 119, 135, 144 Pleural, 140, 144 Pleural cavity, 140, 144 Pneumonia, 29, 31, 121, 144 Poisoning, 23, 39, 51, 54, 56, 58, 76, 133, 139, 144, 148 Polycystic, 91, 144 Polydipsia, 13, 51, 144 Polymyxin, 19, 144 Polysaccharide, 55, 58, 110, 112, 118, 144 Posterior, 111, 114, 141, 144 Postoperative, 16, 34, 35, 41, 144 Potassium, 41, 107, 131, 144 Practice Guidelines, 88, 94, 144 Pravastatin, 8, 30, 61, 66, 144 Primary Prevention, 95, 144 Progression, 70, 111, 145 Progressive, 4, 119, 124, 128, 138, 139, 145, 147 Promoter, 7, 145 Propofol, 36, 42, 145 Prostate, 90, 142, 145 Prostatectomy, 145 Protease, 120, 145, 147 Protein Binding, 7, 145, 153 Protein C, 110, 113, 135, 145, 154 Protein S, 91, 115, 119, 125, 145 Proteins, 7, 110, 112, 113, 118, 121, 122, 125, 137, 140, 142, 143, 145, 146, 148, 153 Proteinuria, 139, 145 Protocol, 44, 145 Protons, 130, 136, 145, 146 Proximal, 7, 123, 127, 145 Pruritus, 123, 145, 154 Psychiatry, 13, 51, 145, 150 Psychic, 137, 145, 146, 148 Psychogenic, 51, 145 Psychomotor, 140, 146 Public Policy, 87, 146 Pulmonary, 4, 17, 116, 120, 126, 129, 134, 146, 155 Pulmonary Edema, 17, 134, 146 Punishment, 48, 146 Purgative, 35, 134, 146 Purpura, 128, 146

Pyridoxal, 146, 153 Q Quadriplegia, 27, 146 Quaternary, 146, 151 R Radiation, 124, 125, 126, 131, 146, 155 Radioactive, 130, 140, 146, 151, 154 Randomized, 6, 146 Receptor, 7, 14, 70, 112, 123, 130, 146, 148 Receptors, Serotonin, 146, 148 Rectum, 113, 120, 127, 145, 146 Red blood cells, 125, 129, 141, 146 Red Nucleus, 114, 146 Reductase, 8, 30, 35, 66, 69, 70, 80, 135, 144, 146, 149 Refer, 1, 126, 135, 139, 146, 153 Reflex, 26, 55, 126, 146 Rehydration, 67, 146 Relaxant, 147, 151 Remission, 136, 147 Renal Artery, 68, 71, 147 Renal failure, 3, 4, 5, 7, 12, 24, 31, 32, 40, 47, 48, 51, 54, 55, 56, 57, 58, 67, 68, 71, 74, 147 Renal tubular, 27, 58, 147 Renal tubular acidosis, 27, 147 Reperfusion, 4, 7, 138, 147 Reperfusion Injury, 4, 147 Resection, 145, 147, 149 Resorption, 117, 147 Respiration, 117, 137, 147 Respiratory failure, 8, 27, 147 Restoration, 4, 138, 146, 147 Retinoblastoma, 90, 147 Rigidity, 136, 142, 143, 147 Risk factor, 76, 94, 147 Ritonavir, 19, 147 Rod, 109, 114, 147 Ryanodine, 7, 147 S Salicylate, 15, 148 Salivary, 141, 148 Scleroderma, 15, 148 Sclerosis, 90, 91, 94, 113, 148 Screening, 5, 7, 94, 95, 119, 148 Scrotum, 142, 148 Scrub Typhus, 10, 148 Secretion, 28, 109, 130, 131, 132, 148 Sedative, 123, 129, 148 Seizures, 4, 13, 45, 55, 74, 106, 142, 148 Selenium, 67, 148 Semen, 145, 148

165

Semisynthetic, 117, 119, 148 Sepsis, 12, 19, 24, 148 Septic, 4, 148 Septicemia, 12, 148 Serotonin, 45, 113, 119, 146, 148, 154 Serum, 18, 22, 46, 47, 66, 68, 69, 70, 71, 107, 110, 121, 127, 135, 148 Sex Determination, 91, 148 Shock, 4, 39, 56, 68, 71, 107, 148, 153 Short Bowel Syndrome, 10, 149 Side effect, 6, 79, 109, 113, 115, 119, 149, 153 Signs and Symptoms, 5, 147, 149, 154 Simvastatin, 9, 12, 23, 26, 31, 41, 43, 45, 47, 49, 57, 61, 149 Skeletal, 3, 4, 5, 7, 18, 34, 54, 55, 68, 74, 121, 138, 147, 149, 151, 154 Skeleton, 109, 149 Small intestine, 119, 124, 130, 133, 149 Smooth muscle, 111, 130, 137, 138, 149, 151 Sodium, 5, 23, 55, 80, 137, 149 Sodium Bicarbonate, 5, 80, 149 Solvent, 125, 128, 149 Spastic, 11, 149 Spasticity, 114, 149 Specialist, 97, 123, 149 Species, 7, 118, 130, 137, 149, 151, 153, 155 Specificity, 110, 149, 153 Spinal cord, 114, 116, 118, 119, 127, 135, 136, 139, 140, 141, 142, 146, 149, 150 Spinal Cord Diseases, 141, 146, 150 Spleen, 111, 135, 150 Sporadic, 10, 147, 150 Stem cell transplantation, 30, 150 Stem Cells, 150 Sterile, 141, 150 Steroid, 115, 122, 149, 150 Stimulant, 96, 122, 130, 150 Stimulus, 120, 146, 150, 152 Stomach, 109, 114, 127, 130, 133, 134, 139, 142, 149, 150 Stool, 120, 150 Streptococci, 150 Streptokinase, 22, 150 Stress, 48, 126, 139, 141, 150 Stroke, 86, 118, 150 Stupor, 74, 134, 139, 150 Subacute, 132, 150 Subarachnoid, 47, 48, 150 Subclinical, 35, 132, 148, 150 Subcutaneous, 17, 124, 140, 151

Subspecies, 149, 151 Substance P, 125, 137, 148, 151 Succinylcholine, 14, 151 Superoxide, 68, 151 Supine, 49, 151 Supine Position, 49, 151 Supplementation, 6, 18, 151 Suppression, 26, 151, 156 Supraspinal, 114, 151 Sympathomimetic, 122, 123, 143, 151 Symphysis, 119, 145, 151 Symptomatic, 108, 141, 151 Synergistic, 151, 153 Systemic, 4, 5, 26, 69, 80, 111, 113, 116, 117, 132, 140, 148, 149, 151 Systolic, 131, 151 T Tachycardia, 45, 114, 151 Tachypnea, 114, 151 Tardive, 113, 119, 151 Technetium, 20, 28, 151 Telangiectasia, 91, 151 Teratogenic, 133, 151 Terminator, 152, 156 Testosterone, 111, 146, 152 Tetany, 141, 152 Thalamic, 114, 152 Thalamic Diseases, 114, 152 Theophylline, 59, 111, 152 Therapeutics, 81, 152 Thigh, 13, 23, 152 Thorax, 135, 152 Threshold, 131, 152 Thrombolytic, 144, 150, 152 Thrombolytic Therapy, 150, 152 Thrombosis, 50, 145, 150, 152 Thrombus, 121, 132, 138, 144, 152 Thyroid, 131, 141, 152 Thyroid Gland, 141, 152 Thyrotropin, 131, 152 Tic, 73, 153 Tissue, 4, 8, 74 Tissue Distribution, 8, 153 Tolerance, 6, 128, 153 Tonicity, 129, 153 Topical, 58, 125, 130, 133, 149, 153 Topoisomerase inhibitors, 133, 153 Torsion, 132, 153 Toxic, iv, 4, 5, 68, 122, 125, 129, 131, 139, 140, 148, 153, 156 Toxicity, 4, 8, 23, 48, 55, 59, 124, 153 Toxicologic, 5, 153

166 Rhabdomyolysis

Toxicology, 23, 26, 27, 37, 38, 39, 58, 88, 153 Toxin, 125, 153 Toxoplasmosis, 114, 153 Trace element, 119, 153 Transaminase, 18, 153 Transfection, 115, 153 Translocation, 119, 125, 153 Transplantation, 14, 15, 19, 22, 24, 29, 31, 35, 43, 46, 57, 119, 131, 153 Trauma, 3, 4, 42, 44, 49, 56, 68, 115, 141, 152, 153 Tremor, 90, 142, 154 Tricyclic, 119, 154 Triglyceride, 6, 8, 9, 49, 59, 70, 120, 131, 154 Tropomyosin, 154 Troponin, 18, 154 Tryptophan, 148, 154 Tuberculostatic, 133, 154 Tuberous Sclerosis, 91, 154 Type 2 diabetes, 95, 154 U Ulcer, 38, 154 Ultrafiltration, 129, 154 Unconscious, 131, 154 Univalent, 131, 141, 154 Uraemia, 141, 154 Uranium, 151, 154 Urea, 68, 71, 114, 116, 154 Uremia, 67, 71, 134, 147, 154 Ureters, 147, 155 Urethra, 145, 155

Urinary, 50, 145, 154, 155 Urine, 4, 5, 56, 58, 68, 74, 105, 107, 112, 115, 121, 122, 123, 129, 134, 145, 155 V Vaccine, 29, 145, 155 Varicella, 18, 50, 51, 155 Vascular, 32, 34, 40, 125, 132, 140, 150, 152, 155 Vasculitis, 67, 71, 74, 141, 155 Vasodilators, 140, 155 Vein, 50, 133, 140, 155 Venlafaxine, 45, 155 Venous, 16, 140, 145, 155 Ventricle, 151, 155 Ventricles, 56 Ventricular, 45, 138, 155 Verapamil, 26, 155 Veterinary Medicine, 54, 56, 87, 155 Viral, 155, 156 Virulence, 153, 155 Virus, 42, 46, 125, 133, 155, 156 Vitro, 7, 155 Vivo, 7, 8, 68, 155 W Weight Lifting, 10, 155 X Xenograft, 111, 155 X-ray, 113, 121, 136, 140, 155 Y Yeasts, 126, 155 Z Zidovudine, 29, 156 Zoster, 50, 51, 156

167

168 Rhabdomyolysis

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