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

FEVERFEW A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET R EFERENCES...

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FEVERFEW A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET

R EFERENCES

FEVERFEW 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., 1960Feverfew: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00466-6 1. Feverfew-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 feverfew. 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 FEVERFEW ................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Feverfew ........................................................................................ 5 The National Library of Medicine: PubMed .................................................................................. 6 CHAPTER 2. NUTRITION AND FEVERFEW ......................................................................................... 9 Overview........................................................................................................................................ 9 Finding Nutrition Studies on Feverfew......................................................................................... 9 Federal Resources on Nutrition ................................................................................................... 13 Additional Web Resources ........................................................................................................... 13 CHAPTER 3. ALTERNATIVE MEDICINE AND FEVERFEW ................................................................. 15 Overview...................................................................................................................................... 15 National Center for Complementary and Alternative Medicine.................................................. 15 Additional Web Resources ........................................................................................................... 24 General References ....................................................................................................................... 27 CHAPTER 4. PATENTS ON FEVERFEW .............................................................................................. 29 Overview...................................................................................................................................... 29 Patents on Feverfew ..................................................................................................................... 29 Patent Applications on Feverfew ................................................................................................. 34 Keeping Current .......................................................................................................................... 38 CHAPTER 5. PERIODICALS AND NEWS ON FEVERFEW .................................................................... 39 Overview...................................................................................................................................... 39 News Services and Press Releases................................................................................................ 39 Academic Periodicals covering Feverfew ..................................................................................... 41 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 45 Overview...................................................................................................................................... 45 NIH Guidelines............................................................................................................................ 45 NIH Databases............................................................................................................................. 47 Other Commercial Databases....................................................................................................... 49 APPENDIX B. PATIENT RESOURCES ................................................................................................. 51 Overview...................................................................................................................................... 51 Patient Guideline Sources............................................................................................................ 51 Finding Associations.................................................................................................................... 53 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 55 Overview...................................................................................................................................... 55 Preparation................................................................................................................................... 55 Finding a Local Medical Library.................................................................................................. 55 Medical Libraries in the U.S. and Canada ................................................................................... 55 ONLINE GLOSSARIES.................................................................................................................. 61 Online Dictionary Directories ..................................................................................................... 61 FEVERFEW DICTIONARY............................................................................................................ 63 INDEX ................................................................................................................................................ 85

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

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

Overview of Herbal Supplement Utilization with Particular Emphasis on Possible Interactions with Dental Drugs and Oral Manifestations Source: Journal of Dental Hygiene. 77(1): 37-46. Winter 2003. Contact: Available from American Dental Hygienists' Association. 444 North Michigan Avenue, Chicago, IL 60611. (312) 440-8900. Website: www.adha.org. Summary: Herbal medication in the United States is a popular form of therapy. This article provides an overview of the utilization of herbal supplements with particular emphasis on possible interactions with oral health drugs and oral manifestations. Herbal supplements are regulated by the Dietary Supplement Health and Education Act (DSHEA), which limits their regulation by the United States Food and Drug Administration (FDA). The majority of consumers of these products are white, middle-

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aged women who have some college education. Many of the consumers use pharmaceutical drugs concurrently, but most do not inform their health care providers about their use of herbal supplements. Various herbal supplements have been reported or are suspected to interact with certain oral health drugs, the most important being bromelain, cayenne, chamomile, feverfew, dong quai, eleuthro or Seberiean ginseng, garlic, ginkgo, and licorice interacting with aspirin; aloe latex, ephedra, ginseng, rhubarb, cascara sagrada, licorice, and senna interacting with corticosteroids; kava, St. John's wort, chamomile, and valerian interacting with central nervous system (CNS) depressant drugs; and herbs acting on the gastrointestinal system, altering the absorption of several orally administered drugs. Further, the use of some herbal supplements has been reported to be associated with oral manifestations, including aphthous ulcers, lip and tongue irritation, and swelling with feverfew; gingival bleeding with feverfew and ginkgo; tongue numbness with Echinacea; xerostomia (dry mouth) with St. John's wort; oral and lingual dyskinesia with kava; and salivation with yohimbe. The author concludes that dental hygienists should inform themselves about herbal supplements in order to offer appropriate oral health care to individuals who take these substances. 2 tables. 53 references. •

Herbal Supplements: Any Relevancy to Dental Practice? Source: New York State Dental Journal. NYSDJ. 68(10): 26-30. December 2002. Contact: Available from Dental Society of the State of New York. 7 Elk Street, Albany, NY 12207. (518) 465-0044. Summary: The increasing popularity of herbal supplements demands that dentists be more knowledgeable about the effects these supplements have on oral health and treatments. Based on the medical literature, at least some of the popular products appear to have the potential to elicit oral manifestations and adverse interactions with dental drugs. This article reviews these interactions and the relevancy of herbal supplements to dental practice. Specific herbal supplements discussed include Echinacea, ephedra (Ma huang), feverfew, garlic, ginkgo, ginseng, kava, St. John's wort, and valerian. The author notes that the effects seem to be associated primarily with antiplatelet, sedative, and hepatotoxic (toxic to the liver) properties of the herbs. An understanding of the effects of herbal supplements can allow dentists to provide improved dental care and educate patients who are using these products. 33 references.

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Complementary and Alternative Therapies for Rheumatic Disease Source: Hospital Practice. 36(4): 31-36. April 15, 2001. Summary: This journal article discusses some of the complementary and alternative therapies used for rheumatic disease. First, it briefly reviews patterns of complementary and alternative therapy use among rheumatology patients. Then, it highlights findings from clinical investigations of selected therapies, including glucosamine and chondroitin, dietary interventions, vitamin supplements, herbal preparations (willow bark, devil's claw, feverfew, and Chinese thunder god vine), and acupuncture. Finally, it discusses management concerns for physicians whose patients may be using complementary and alternative therapies. It includes a list of suggested questions to ask and information to give patients about nontraditional therapies. The article has 2 figures, 3 tables, and a suggested reading list.

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Review of 12 Commonly Used Medical Herbs Source: Archives of Family Medicine. 7(6): 523-536. November-December 1998.

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Summary: This journal article reviews the literature on 12 of the most commonly used and best-studied medicinal herbs in the United States: chamomile, echinacea, feverfew, garlic, ginger, ginkgo, ginseng, goldenseal, milk thistle, St. John's wort, saw palmetto, and valerian. For each herb, it lists the common and scientific names, common and investigational uses, and side effects; and then reviews existing data on the herb's history, safety, and efficacy. The article also summarizes general information about herbal therapies, including a brief history of the regulation of medicinal herbs, important similarities and differences between medications approved by the Food and Drug Administration and herbal therapies, and the nature of available data about medicinal herbs. Finally, it provides a list of introductory resources on the topic of medicinal herbs, guidelines for patients, and a selected list of potentially toxic herbs. The article has 6 tables and 112 references.

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

Project Title: REPRODUCIBLE FEVERFEW PREPARATIONS FOR MIGRAINE TRIALS Principal Investigator & Institution: Leung, Albert Y.; Phyto-Technologies, Inc. 107 Enterprise Dr Woodbine, Ia 51579 Timing: Fiscal Year 2003; Project Start 17-SEP-2001; Project End 31-JAN-2005 Summary: (Provided by applicant): A unique approach to the characterization and standardization of feverfew (Tanacetum parthenium) leaf materials and their preparations is proposed. Authenticated leaf materials from parthenolide-rich chemotypes associated with positive clinical outcomes, as well as material from parthenolide-free chemotypes, will be subjected to characterization, using physicochemical characteristics and phenotypic (morphological and microscopic) features. A set of combined relevant data derived from these studies will be established as criteria for the selection of leaf materials to be used for all subsequent studies. The preliminary physicochemical profiles of different materials and their preparations will be used to validate efficiency and reproducibility of extraction methods to be developed.

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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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The highly characterized and reproducible extracts prepared using these validated methods will be used as test materials for further intensive physicochemical studies, as well as for bioassay and gene expression studies for the correlation and prediction of anti-migraine activity of feverfew materials in Phase II. PROPOSED COMMERCIAL APPLICATION: To identify genotypic plant materials and appropriate quality control tests to facilitate consistent agricultural production of feverfew raw material. To provide a substantial (less arbitrary) basis for botanical and chemical standardization of feverfew leaf and extract preparations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

A simple method of isolating parthenolide from Tanacetum and other sensitizing plants. Author(s): Hausen BM. Source: Contact Dermatitis. 1991 February; 24(2): 153-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2040164

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Cranberry, feverfew, horse chestnut, and kava. Author(s): Cochrane Database Syst Rev. 2004;(1):CD002286 Source: The Western Journal of Medicine. 1999 September; 171(3): 195-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14973986

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Cytotoxic and antibacterial activities of sesquiterpene lactones isolated from Tanacetum praeteritum subsp. praeteritum. Author(s): Goren N, Woerdenbag HJ, Bozok-Johansson C. Source: Planta Medica. 1996 October; 62(5): 419-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8923806

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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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Effects of compounds extracted from Tanacetum microphyllum on arachidonic acid metabolism in cellular systems. Author(s): Silvan AM, Abad MJ, Bermejo P, Villar A. Source: Planta Medica. 1998 April; 64(3): 200-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9581513

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Evaluation of Tanacetum larvatum for an anti-inflammatory activity and for the protection against indomethacin-induced ulcerogenesis in rats. Author(s): Petrovic SD, Dobric S, Bokonjic D, Niketic M, Garcia-Pineres A, Merfort I. Source: Journal of Ethnopharmacology. 2003 July; 87(1): 109-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12787963

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Herbal remedies of the Maritime indians: sterols and triterpenes of Tanacetum vulgare L. (Tansy). Author(s): Chandler RF, Hooper SN, Hooper DL, Jamieson WD, Lewis E. Source: Lipids. 1982 February; 17(2): 102-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7087682

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

Finding Nutrition Studies on Feverfew The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “feverfew” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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

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

3,4-beta-Epoxy-8-deoxycumambrin B, a sesquiterpene lactone from Tanacetum parthenium. Source: Milbrodt, M. Schroder, F. Konig, W.A. Phytochemistry-Oxford. Oxford : Elsevier Science Ltd. February 1997. volume 44 (3) page 471-474. 0031-9422

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A biologically active lipophilic flavonol from Tanacetum parthenium. Author(s): Department of Botany, School of Plant Sciences, University of Reading, Whiteknights, Berkshire, U.K. Source: Williams, C A Hoult, J R Harborne, J B Greenham, J Eagles, J Phytochemistry. 1995 January; 38(1): 267-70 0031-9422

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A chloroform extract of the herb feverfew blocks voltage-dependent potassium currents recorded from single smooth muscle cells. Author(s): Division of Biomedical Sciences, King's College London, UK. Source: Barsby, R W Knight, D W McFadzean, I J-Pharm-Pharmacol. 1993 July; 45(7): 641-5 0022-3573

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A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. Author(s): Department of Medicine, University Hospital, Nottingham, UK. Source: Groenewegen, W A Heptinstall, S J-Pharm-Pharmacol. 1990 August; 42(8): 553-7 0022-3573

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Airborne Compositae dermatitis: monoterpenes and no parthenolide are released from flowering Tanacetum parthenium (feverfew) plants. Author(s): Department of Fruit, Vegetable and Food Science, Danish Institute of Agricultural Sciences, Aarslev. Source: Christensen, L P Jakobsen, H B Paulsen, E Hodal, L Andersen, K E ArchDermatol-Res. 1999 Jul-August; 291(7-8): 425-31 0340-3696

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An extract of feverfew inhibits interactions of human platelets with collagen substrates. Author(s): Institute of Pathological Biochemistry, Medical Academy of Erfurt, GDR. Source: Losche, W Mazurov, A V Heptinstall, S Groenewegen, W A Repin, V S Till, U Thromb-Res. 1987 December 1; 48(5): 511-8 0049-3848

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Antinociceptive and anti-inflammatory effects of Tanacetum parthenium L. extract in mice and rats. Author(s): Pharmacology Division, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India. Source: Jain, N K Kulkarni, S K J-Ethnopharmacol. 1999 December 15; 68(1-3): 251-9 0378-8741

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Chromosomal aberrations and sister chromatid exchanges in lymphocytes and urine mutagenicity of migraine patients: a comparison of chronic feverfew users and matched non-users. Author(s): Genetic and Reproductive Toxicology and Cell Biology Department, BIBRA, Carshalton Surrey SM5 4DS, UK. Source: Anderson, D Jenkinson, P C Dewdney, R S Blowers, S D Johnson, E S Kadam, N P Hum-Toxicol. 1988 March; 7(2): 145-52 0144-5952

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Comparative study of Tanacetum species growing in Bulgaria. Author(s): Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia. [email protected]

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Source: Todorova, M N Evstatieva, L N Z-Naturforsch-[C]. 2001 Jul-August; 56(7-8): 50612 0341-0382 •

Determination of parthenolide in selected feverfew products by liquid chromatography. Author(s): University of Mississippi, School of Pharmacy, National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, and Department of Pharmacognosy, University 38677, USA. Source: Abourashed, E A Khan, I A Abourashed, E A Khan, I A J-AOAC-Int. 2000 JulAugust; 83(4): 789-92 1060-3271

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Do monoterpenes released from feverfew (Tanacetum parthenium) plants cause airborne Compositae dermatitis? Author(s): Department of Dermatology, Odense University Hospital, Odense, Denmark. Source: Paulsen, E Christensen, L P Andersen, K E Contact-Dermatitis. 2002 July; 47(1): 14-8 0105-1873

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Effect of feverfew on phagocytosis and killing of Candida guilliermondii by neutrophils. Author(s): Department of Haematology, Nottingham City Hospital, U.K. Source: Williamson, L M Harvey, D M Sheppard, K J Fletcher, J Inflammation. 1988 February; 12(1): 11-6 0360-3997

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Effects of an extract of feverfew (Tanacetum parthenium) on arachidonic acid metabolism in human blood platelets. Author(s): Institute of Pathological Biochemistry, Medical Academy of Erfurt, GDR. Source: Loesche, W Groenewegen, W A Krause, S Spangenberg, P Heptinstall, S Biomed-Biochim-Acta. 1988; 47(10-11): S241-3 0232-766X

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Extracts of feverfew inhibit mitogen-induced human peripheral blood mononuclear cell proliferation and cytokine mediated responses: a cytotoxic effect. Source: O'Neill, L A Barrett, M L Lewis, G P Br-J-Clin-Pharmacol. 1987 January; 23(1): 81-3 0306-5251

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GC determination of parthenolide in feverfew products. Author(s): National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, USA. Source: Abourashed, E A Khan, I A Pharmazie. 2001 December; 56(12): 971-2 0031-7144

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Inhibition of interleukin-12 production in lipopolysaccharide-activated mouse macrophages by parthenolide, a predominant sesquiterpene lactone in Tanacetum parthenium: involvement of nuclear factor-kappaB. Author(s): College of Pharmacy, Chonnam National University, 500-757, Kwangju, South Korea. Source: Kang, B Y Chung, S W Kim, T S Immunol-Lett. 2001 July 2; 77(3): 159-63 01652478

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Investigation of possible genetoxic effects of feverfew in migraine patients. Author(s): City of London Migraine Clinic, UK. Source: Johnson, E S Kadam, N P Anderson, D Jenkinson, P C Dewdney, R S Blowers, S D Hum-Toxicol. 1987 November; 6(6): 533-4 0144-5952

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Low concentrations of the feverfew component parthenolide inhibit in vitro growth of tumor lines in a cytostatic fashion. Author(s): Department of Biology, University of Ottawa, Ontario, Canada. Source: Ross, J J Arnason, J T Birnboim, H C Planta-Med. 1999 March; 65(2): 126-9 00320943

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Multi-component metabolic classification of commercial feverfew preparations via high-field 1H-NMR spectroscopy and chemometrics. Author(s): Biological Chemistry, Biomedical Sciences Division, Imperial College of Science, Technology and Medicine, University of London, South Kensington, London, United Kingdom. [email protected] Source: Bailey, N J Sampson, J Hylands, P J Nicholson, J K Holmes, E Planta-Med. 2002 August; 68(8): 734-8 0032-0943

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Parthenocide: the demise of a facile theory of feverfew activity. Source: Awang, D.V.C. J-herbs-spices-med-plants. Binghamton, NY : The Haworth Herbal Press. 1998. volume 5 (4) page 95-98. 1049-6475

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Parthenolide content and bioactivity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.). Estimation of commercial and authenticated feverfew products. Author(s): Department of Medicine, University Hospital, Queen's Medical Centre, Nottingham, UK. Source: Heptinstall, S Awang, D V Dawson, B A Kindack, D Knight, D W May, J JPharm-Pharmacol. 1992 May; 44(5): 391-5 0022-3573

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Pharmacological activity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.): assessment by inhibition of human polymorphonuclear leukocyte chemiluminescence in-vitro. Author(s): Department of Life Science, University of Nottingham, University Park, UK. Source: Brown, A M Edwards, C M Davey, M R Power, J B Lowe, K C J-PharmPharmacol. 1997 May; 49(5): 558-61 0022-3573

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Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Author(s): Department of Medicine, University Hospital, Nottingham. Source: Murphy, J J Heptinstall, S Mitchell, J R Lancet. 1988 July 23; 2(8604): 189-92 01406736

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Rapid extraction and high-performance liquid chromatographic determination of parthenolide in feverfew (Tanacetum parthenium). Author(s): Department of Research and Development, Nature's Sunshine Products, Inc., 1655 North Main Street, Spanish Fork, Utah 84660, USA. [email protected] Source: Zhou, J Z Kou, X Stevenson, D J-Agric-Food-Chem. 1999 March; 47(3): 1018-22 0021-8561

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The activity of compounds extracted from feverfew on histamine release from rat mast cells. Source: Hayes, N A Foreman, J C J-Pharm-Pharmacol. 1987 June; 39(6): 466-70 0022-3573

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The anti-inflammatory natural product parthenolide from the medicinal herb Feverfew directly binds to and inhibits IkappaB kinase. Author(s): Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, CT 06520-8103, USA. Source: Kwok, B H Koh, B Ndubuisi, M I Elofsson, M Crews, C M Chem-Biol. 2001 August; 8(8): 759-66 1074-5521

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The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Author(s): Department of Complementary Medicine, School of Postgraduate Medicine and Health Science, University of Exeter, UK. [email protected] Source: Ernst, E Pittler, M H Public-Health-Nutr. 2000 December; 3(4A): 509-14 13689800

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The flavonoids of Tanacetum parthenium and T. vulgare and their anti-inflammatory properties. Author(s): Department of Botany, University of Reading, UK. Source: Williams, C A Harborne, J B Geiger, H Hoult, J R Phytochemistry. 1999 June; 51(3): 417-23 0031-9422

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Variations in parthenolide content and daily dose of feverfew products. Author(s): School of Pharmacy, Southwestern Oklahoma State University, 100 Campus Drive, Weatherford, OK 73096, USA. [email protected] Source: Nelson, M H Cobb, S E Shelton, J Am-J-Health-Syst-Pharm. 2002 August 15; 59(16): 1527-31 1079-2082

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

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CHAPTER 3. ALTERNATIVE MEDICINE AND FEVERFEW Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to feverfew. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to feverfew and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “feverfew” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to feverfew: •

5-Hydroxytryptamine-inhibiting property of Feverfew: role of parthenolide content. Author(s): Mittra S, Datta A, Singh SK, Singh A. Source: Acta Pharmacologica Sinica. 2000 December; 21(12): 1106-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11603284

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A chloroform extract of the herb feverfew blocks voltage-dependent potassium currents recorded from single smooth muscle cells. Author(s): Barsby RW, Knight DW, McFadzean I. Source: The Journal of Pharmacy and Pharmacology. 1993 July; 45(7): 641-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8105061

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A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. Author(s): Groenewegen WA, Heptinstall S.

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Source: The Journal of Pharmacy and Pharmacology. 1990 August; 42(8): 553-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1981582 •

A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Author(s): Makheja AN, Bailey JM. Source: Prostaglandins Leukot Med. 1982 June; 8(6): 653-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6810384

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Airborne Compositae dermatitis: monoterpenes and no parthenolide are released from flowering Tanacetum parthenium (feverfew) plants. Author(s): Christensen LP, Jakobsen HB, Paulsen E, Hodal L, Andersen KE. Source: Archives of Dermatological Research. 1999 July-August; 291(7-8): 425-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10482013

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Allergic reactivity of Parthenium hysterophorus (Santa Maria feverfew) pollen: an unrecognized allergen. Author(s): Wedner HJ, Zenger VE, Lewis WH. Source: Int Arch Allergy Appl Immunol. 1987; 84(2): 116-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3653998

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Amounts of feverfew in commercial preparations of the herb. Author(s): Groenewegen WA, Heptinstall S. Source: Lancet. 1986 January 4; 1(8471): 44-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2867286

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An extract of feverfew inhibits interactions of human platelets with collagen substrates. Author(s): Losche W, Mazurov AV, Heptinstall S, Groenewegen WA, Repin VS, Till U. Source: Thrombosis Research. 1987 December 1; 48(5): 511-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3441902

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Chromosomal aberrations and sister chromatid exchanges in lymphocytes and urine mutagenicity of migraine patients: a comparison of chronic feverfew users and matched non-users. Author(s): Anderson D, Jenkinson PC, Dewdney RS, Blowers SD, Johnson ES, Kadam NP. Source: Hum Toxicol. 1988 March; 7(2): 145-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2967795

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Chrysanthemum dermatitis in South Wales; diagnosis by patch testing with feverfew (Tanacetum parthenium) extract. Author(s): Schmidt RJ, Kingston T.

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Source: Contact Dermatitis. 1985 August; 13(2): 120-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4064647 •

Compounds extracted from feverfew that have anti-secretory activity contain an alpha-methylene butyrolactone unit. Author(s): Groenewegen WA, Knight DW, Heptinstall S. Source: The Journal of Pharmacy and Pharmacology. 1986 September; 38(9): 709-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2877077

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Contact allergy to parthenolide in Tanacetum parthenium (L.) Schulz-Bip. (feverfew, Asteraceae) and cross-reactions to related sesquiterpene lactone containing Compositae species. Author(s): Hausen BM, Osmundsen PE. Source: Acta Dermato-Venereologica. 1983; 63(4): 308-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6195862

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Cranberry, feverfew, horse chestnut, and kava. Author(s): Rotblatt MD. Source: The Western Journal of Medicine. 1999 September; 171(3): 195-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10560296

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Determination of parthenolide in selected feverfew products by liquid chromatography. Author(s): Abourashed EA, Khan IA, Abourashed EA, Khan IA. Source: J Aoac Int. 2000 July-August; 83(4): 789-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10995104

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Do monoterpenes released from feverfew (Tanacetum parthenium) plants cause airborne Compositae dermatitis? Author(s): Paulsen E, Christensen LP, Andersen KE. Source: Contact Dermatitis. 2002 July; 47(1): 14-8. Erratum In: Contact Dermatitis. 2003 March; 48(3): 179-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12225407

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Effect of feverfew on phagocytosis and killing of Candida guilliermondii by neutrophils. Author(s): Williamson LM, Harvey DM, Sheppard KJ, Fletcher J. Source: Inflammation. 1988 February; 12(1): 11-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3366482

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Effects of an extract of feverfew (Tanacetum parthenium) on arachidonic acid metabolism in human blood platelets. Author(s): Loesche W, Groenewegen WA, Krause S, Spangenberg P, Heptinstall S.

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Source: Biomed Biochim Acta. 1988; 47(10-11): S241-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3248111 •

Effects of an extract of feverfew on endothelial cell integrity and on cAMP in rabbit perfused aorta. Author(s): Voyno-Yasenetskaya TA, Loesche W, Groenewegen WA, Heptinstall S, Repin VS, Till U. Source: The Journal of Pharmacy and Pharmacology. 1988 July; 40(7): 501-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2904991

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Efficacy of feverfew as prophylactic treatment of migraine. Author(s): Wind J, Punt J. Source: British Medical Journal (Clinical Research Ed.). 1985 November 23; 291(6507): 1508. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3933730

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Efficacy of feverfew as prophylactic treatment of migraine. Author(s): Waller PC, Ramsay LE. Source: British Medical Journal (Clinical Research Ed.). 1985 October 19; 291(6502): 1128. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3931825

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Efficacy of feverfew as prophylactic treatment of migraine. Author(s): Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Source: British Medical Journal (Clinical Research Ed.). 1985 August 31; 291(6495): 56973. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3929876

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Extract of feverfew inhibits prostaglandin biosynthesis. Author(s): Collier HO, Butt NM, McDonald-Gibson WJ, Saeed SA. Source: Lancet. 1980 October 25; 2(8200): 922-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6107575

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Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Author(s): Heptinstall S, White A, Williamson L, Mitchell JR. Source: Lancet. 1985 May 11; 1(8437): 1071-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2860288

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Extracts of feverfew inhibit mitogen-induced human peripheral blood mononuclear cell proliferation and cytokine mediated responses: a cytotoxic effect. Author(s): O'Neill LA, Barrett ML, Lewis GP.

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Source: British Journal of Clinical Pharmacology. 1987 January; 23(1): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3493021 •

Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. Author(s): Heptinstall S, Groenewegen WA, Spangenberg P, Loesche W. Source: The Journal of Pharmacy and Pharmacology. 1987 June; 39(6): 459-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2886604

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Feverfew and vascular smooth muscle: extracts from fresh and dried plants show opposing pharmacological profiles, dependent upon sesquiterpene lactone content. Author(s): Barsby RW, Salan U, Knight DW, Hoult JR. Source: Planta Medica. 1993 February; 59(1): 20-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8441776

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Feverfew as a preventive treatment for migraine: a systematic review. Author(s): Vogler BK, Pittler MH, Ernst E. Source: Cephalalgia : an International Journal of Headache. 1998 December; 18(10): 7048. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9950629

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Feverfew extracts and parthenolide irreversibly inhibit vascular responses of the rabbit aorta. Author(s): Barsby RW, Salan U, Knight DW, Hoult JR. Source: The Journal of Pharmacy and Pharmacology. 1992 September; 44(9): 737-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1360525

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Feverfew extracts and the sesquiterpene lactone parthenolide inhibit intercellular adhesion molecule-1 expression in human synovial fibroblasts. Author(s): Piela-Smith TH, Liu X. Source: Cellular Immunology. 2001 May 1; 209(2): 89-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11446741

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Feverfew for preventing migraine. Author(s): Pittler MH, Ernst E. Source: Cochrane Database Syst Rev. 2004; (1): Cd002286. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14973986

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Feverfew for preventing migraine. Author(s): Pittler MH, Vogler BK, Ernst E.

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Source: Cochrane Database Syst Rev. 2000; (3): Cd002286. Review. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10908545 •

Feverfew in rheumatoid arthritis: a double blind, placebo controlled study. Author(s): Pattrick M, Heptinstall S, Doherty M. Source: Annals of the Rheumatic Diseases. 1989 July; 48(7): 547-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2673080

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Feverfew products. Author(s): Awang DV. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1997 September 1; 157(5): 510-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9294387

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Feverfew: chemistry and biological activity. Author(s): Knight DW. Source: Natural Product Reports. 1995 June; 12(3): 271-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7792073

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Feverfew--an ancient remedy for modern times? Author(s): Heptinstall S. Source: Journal of the Royal Society of Medicine. 1988 July; 81(7): 373-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3045310

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Feverfew--an antithrombotic drug? Author(s): Loesche W, Mazurov AV, Voyno-Yasenetskaya TA, Groenewegen WA, Heptinstall S, Repin VS. Source: Folia Haematol Int Mag Klin Morphol Blutforsch. 1988; 115(1-2): 181-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2459017

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GC determination of parthenolide in feverfew products. Author(s): Abourashed EA, Khan IA. Source: Pharmazie. 2001 December; 56(12): 971-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11802663

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Inhibition of 5-lipoxygenase and cyclo-oxygenase in leukocytes by feverfew. Involvement of sesquiterpene lactones and other components. Author(s): Sumner H, Salan U, Knight DW, Hoult JR. Source: Biochemical Pharmacology. 1992 June 9; 43(11): 2313-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1319159

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Inhibition of platelet behaviour by feverfew: a mechanism of action involving sulphydryl groups. Author(s): Heptinstall S, Groenewegen WA, Spangenberg P, Losche W. Source: Folia Haematol Int Mag Klin Morphol Blutforsch. 1988; 115(4): 447-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2465950

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Intra-specific variability of feverfew: correlations between parthenolide, morphological traits and seed origin. Author(s): Cutlan AR, Bonilla LE, Simon JE, Erwin JE. Source: Planta Medica. 2000 October; 66(7): 612-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11105564

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Investigation of possible genetoxic effects of feverfew in migraine patients. Author(s): Johnson ES, Kadam NP, Anderson D, Jenkinson PC, Dewdney RS, Blowers SD. Source: Hum Toxicol. 1987 November; 6(6): 533-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3692501

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Irreversible inhibition of vascular reactivity by feverfew. Author(s): Barsby R, Salan U, Knight DW, Hoult JR. Source: Lancet. 1991 October 19; 338(8773): 1015. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1681318

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Is feverfew a pharmacologic agent? Author(s): Wong HC. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1999 January 12; 160(1): 21-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9934331

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Low concentrations of the feverfew component parthenolide inhibit in vitro growth of tumor lines in a cytostatic fashion. Author(s): Ross JJ, Arnason JT, Birnboim HC. Source: Planta Medica. 1999 March; 65(2): 126-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10193202

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Melatonin in feverfew and other medicinal plants. Author(s): Murch SJ, Simmons CB, Saxena PK. Source: Lancet. 1997 November 29; 350(9091): 1598-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9393344

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Modulation of lipopolysaccharide-induced proinflammatory cytokine production in vitro and in vivo by the herbal constituents apigenin (chamomile), ginsenoside Rb(1)

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(ginseng) and parthenolide (feverfew). Author(s): Smolinski AT, Pestka JJ. Source: Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association. 2003 October; 41(10): 1381-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909272 •

Multi-component metabolic classification of commercial feverfew preparations via high-field 1H-NMR spectroscopy and chemometrics. Author(s): Bailey NJ, Sampson J, Hylands PJ, Nicholson JK, Holmes E. Source: Planta Medica. 2002 August; 68(8): 734-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12221598

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Parthenolide content and bioactivity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.). Estimation of commercial and authenticated feverfew products. Author(s): Heptinstall S, Awang DV, Dawson BA, Kindack D, Knight DW, May J. Source: The Journal of Pharmacy and Pharmacology. 1992 May; 44(5): 391-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1359053

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Pharmacological activity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.): assessment by inhibition of human polymorphonuclear leukocyte chemiluminescence in-vitro. Author(s): Brown AM, Edwards CM, Davey MR, Power JB, Lowe KC. Source: The Journal of Pharmacy and Pharmacology. 1997 May; 49(5): 558-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9178194

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Phase I dose escalation trial of feverfew with standardized doses of parthenolide in patients with cancer. Author(s): Curry EA 3rd, Murry DJ, Yoder C, Fife K, Armstrong V, Nakshatri H, O'Connell M, Sweeney CJ. Source: Investigational New Drugs. 2004 August; 22(3): 299-305. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15122077

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Platelet aggregation in patients using feverfew for migraine. Author(s): Biggs MJ, Johnson ES, Persaud NP, Ratcliffe DM. Source: Lancet. 1982 October 2; 2(8301): 776. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6125851

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Progress in the medicinal chemistry of the herb feverfew. Author(s): Groenewegen WA, Knight DW, Heptinstall S. Source: Prog Med Chem. 1992; 29: 217-38. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1475370

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Prostaglandin synthetase inhibitors in feverfew. Author(s): Pugh WJ, Sambo K. Source: The Journal of Pharmacy and Pharmacology. 1988 October; 40(10): 743-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2907548

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Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Author(s): Murphy JJ, Heptinstall S, Mitchell JR. Source: Lancet. 1988 July 23; 2(8604): 189-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2899663

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Rapid extraction and high-performance liquid chromatographic determination of parthenolide in feverfew (Tanacetum parthenium). Author(s): Zhou JZ, Kou X, Stevenson D. Source: Journal of Agricultural and Food Chemistry. 1999 March; 47(3): 1018-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10552409

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Standardised feverfew preparations. Author(s): Mervyn L. Source: Lancet. 1986 January 25; 1(8474): 209. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2868230

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The active principle in feverfew. Author(s): Makheja AN, Bailey JM. Source: Lancet. 1981 November 7; 2(8254): 1054. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6118512

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The activity of compounds extracted from feverfew on histamine release from rat mast cells. Author(s): Hayes NA, Foreman JC. Source: The Journal of Pharmacy and Pharmacology. 1987 June; 39(6): 466-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2441022

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The anti-inflammatory natural product parthenolide from the medicinal herb Feverfew directly binds to and inhibits IkappaB kinase. Author(s): Kwok BH, Koh B, Ndubuisi MI, Elofsson M, Crews CM. Source: Chemistry & Biology. 2001 August; 8(8): 759-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11514225

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The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Author(s): Ernst E, Pittler MH.

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Source: Public Health Nutrition. 2000 December; 3(4A): 509-14. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11276299 •

The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis--a double-blind, multicentre, randomized placebo-controlled doseresponse study. Author(s): Pfaffenrath V, Diener HC, Fischer M, Friede M, Henneicke-von Zepelin HH; Investigators. Source: Cephalalgia : an International Journal of Headache. 2002 September; 22(7): 52332. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230594

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The role of sesquiterpene lactones in contact hypersensitivity to some North and South American species of feverfew (Parthenium-Compositae). Author(s): Rodriguez E, Epstein WL, Mitchell JC. Source: Contact Dermatitis. 1977 June; 3(3): 155-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=891178

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Variations in parthenolide content and daily dose of feverfew products. Author(s): Nelson MH, Cobb SE, Shelton J. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2002 August 15; 59(16): 1527-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12185827

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Arthritis Source: Integrative Medicine Communications; www.drkoop.com Atherosclerosis and Heart Disease Prevention Source: Prima Communications, Inc.www.personalhealthzone.com Headache Source: Integrative Medicine Communications; www.drkoop.com Migraine Headache Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Migraine Headaches Source: Prima Communications, Inc.www.personalhealthzone.com Osteoarthritis Source: Prima Communications, Inc.www.personalhealthzone.com Parasites Source: Healthnotes, Inc.; www.healthnotes.com Rheumatoid Arthritis Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Prima Communications, Inc.www.personalhealthzone.com Sprains and Strains Source: Integrative Medicine Communications; www.drkoop.com

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Herbs and Supplements Achillea Alternative names: Yarrow; Achillea millefolium L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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Angelica sinensis Alternative names: Dong Quai Source: Integrative Medicine Communications; www.drkoop.com Arnica Alternative names: Arnica montana L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Borago Alternative names: Borage; Borago officinalis Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Chinese Angelica Alternative names: Dong Quai Source: Integrative Medicine Communications; www.drkoop.com Chrysanthemum parthenium Alternative names: Feverfew Source: Integrative Medicine Communications; www.drkoop.com Danggui Alternative names: Dong Quai Source: Integrative Medicine Communications; www.drkoop.com Dong Quai Alternative names: Angelica sinensis Source: Integrative Medicine Communications; www.drkoop.com Feverfew Alternative names: Tanacetum parthenium Source: Healthnotes, Inc.; www.healthnotes.com Feverfew Alternative names: Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com Feverfew Source: Prima Communications, Inc.www.personalhealthzone.com Feverfew Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Feverfew Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,780,00.html Glycyrrhiza Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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Heparin Alternative names: Hep-Lock Source: Prima Communications, Inc.www.personalhealthzone.com Herbal Decongestant Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,949,00.html Matricaria Alternative names: Chamomile; Matricaria chamomilla Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Nonsteroidal Anti-Inflammatory Drugs Source: Prima Communications, Inc.www.personalhealthzone.com Pentoxifylline Alternative names: Trental Source: Prima Communications, Inc.www.personalhealthzone.com Tanacetum Alternative names: Feverfew; Tanacetum parthenium (L.) Schultz-Bip. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Tanacetum Parthenium Alternative names: Feverfew Source: Integrative Medicine Communications; www.drkoop.com Tanacetum V Alternative names: Tansy; Tanacetum vulgare (L.) Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Tang Kuei Alternative names: Dong Quai Source: Integrative Medicine Communications; www.drkoop.com Warfarin Source: Healthnotes, Inc.; www.healthnotes.com Warfarin Alternative names: Coumadin Source: Prima Communications, Inc.www.personalhealthzone.com Zingiber Alternative names: Ginger; Zingiber officinale Roscoe Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page

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dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON FEVERFEW Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “feverfew” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on feverfew, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Feverfew By performing a patent search focusing on feverfew, 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

5Adapted

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

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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on feverfew: •

Dietary supplement for supporting cerebrovascular tone and treating migraine headaches Inventor(s): Hendrix; Curt (17401 Ventura Blvd., Encino, CA 91316) Assignee(s): none reported Patent Number: 6,068,999 Date filed: June 25, 1998 Abstract: The present invention relates to a dietary supplement for the support of normal cerebrovascular tone. Extracts of the feverfew plant in combination with magnesium and riboflavin, either singly or in combination provide the major therapeutic enhancement in the reduction of migraine headaches and the associated symptoms. Excerpt(s): The present invention provides a dietary supplement which supplies a combination of prophylactic and restorative components which assist the body in maintaining normal cerebrovascular tone and reduces the symptoms of migraine headaches. Migraine has been a well known medical problem for over 5,000 years and represents one of the most investigated types of head pain. Epidemiological research has shown that in the United States, 18% of women and 6% of men suffer from migraine headaches. This extrapolates to approximately 18 million females and 5.6 million males over the age of 12 with this disorder. The prevalence of migraine, according to the Center for Disease Control, has increased 60% from 1981 to 1989. While migraine can occur at any age, 30% of migraine sufferers report their first attack before the age of ten, and the condition is most common in adolescents and young adults. The economic impact of migraine is staggering, with annual cost of the disease estimated at 18 billion dollars. The basic cause of migraine is still unknown. Although genetics may play a role, with 50 to 70% of migraine sufferers reporting a familial occurrence, no consistent biochemical or physiological characteristic has yet to be identified in the relatives of those afflicted with the conditions There are several pathophysiological views on the origin of migraine. While not mutually exclusive, these views include the a.Evascular theory, b. central theory, c. neurogenic Inflammation theory and d. platelet theory. Web site: http://www.delphion.com/details?pn=US06068999__

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Herbal composition to relieve pain Inventor(s): Kelly; Gregory J. (Glastonbury, CT), Perry; Ann (Bayshore, NY) Assignee(s): Biotech Corporation (Glastonbury, CT) Patent Number: 6,312,736 Date filed: December 9, 1999 Abstract: An herbal composition is used to relieve pain and other symptoms associated with migraines and other types of headaches. The preferred herbal composition includes white willow bark extract, kava kava root extract, feverfew extract, ginger root extract, Guarana extract, and Vitamin B6. The herbal composition may be combined with liposomes to carry the composition. The result is an herbal composition that can be applied sublingually for rapid, effective pain relief.

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Excerpt(s): The present invention relates generally to herbal compositions, and more particularly, to herbal compositions for relieving pain associated with headaches, and combinations of such herbal compositions and liposomes to permit delivery of such compositions through a spray applied under the tongue. It is an object of the present invention to overcome one or more of the above-described drawbacks or disadvantages of the prior art. It is a further object of the present invention to combine white willow bark extract, kava kava extract, and at least one of feverfew and ginger root extract in a composition that provides relief from pain and other symptoms associated with headaches. The composition can be further combined with liposomes to permit delivery of the composition through a spray applied under the tongue. The present invention provides, in one aspect, a remedy for pain caused by headaches or migraine headaches. The invention comprises a combination of white willow bark extract, kava kava extract, and at least one of feverfew and ginger root extract. This combination provides the advantage of rapidly relieving pain and reducing symptoms caused by headaches. The herbal composition can be further combined with liposomes, which act as a carrier for the herbal composition and permit delivery through a spray applied under the tongue. Web site: http://www.delphion.com/details?pn=US06312736__ •

Manufacturing a product for treatment of the human body Inventor(s): Hancock; Kenneth A. (80 Holbrook Road, Alvaston, Derby, GB2) Assignee(s): none reported Patent Number: 4,704,279 Date filed: December 10, 1984 Abstract: A product for treatment of arthritis and migraine is formed from the Feverfew plant. The leaves and part of the stalk are harvested from the Chrysanthemum parthenium form of the plant immediately prior to flowering and then freeze dried, milled and converted into capsule or tablet form for human use. Excerpt(s): This invention relates to a method of manufacturing a product for treatment of the human body and the product produced by such manufacture. Certain herbs are known to have properties which can effectively treat certain human ailments, but it is important when converting a herb into a form suitable for healing use to ensure that the herb is cleansed but retains all its natural properties. Problems have been encountered in this respect resulting in unacceptable forms of the end product being made available for human use. It is also important to identify and use those parts of the herbs which contain all the natural properties so as to ensure that the product manufactured is wholly effective. According to the present invention there is provided a method of manufacturing a product for treatment of the human body, the method comprising the steps of harvesting the leaves together with an upper part of the stalk from the Chrysanthemum parthenium form of the Feverfew plant immediately prior to the flowering of the plant, freeze drying the harvested part of the plant, and converting the freeze dried harvested part of the plant, into a form suitable for treating the human body. Web site: http://www.delphion.com/details?pn=US04704279__

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Oil extract of Tanacetum parthenium for treating migraine Inventor(s): Hylands nee Jessup; Deborah M. (Wickham, GB2), Hylands; Peter J. (Wickham, GB2), Johnson; Edward S. (Maidenhead, GB2) Assignee(s): R. P. Scherer Corp. (Troy, MI) Patent Number: 4,758,433 Date filed: June 26, 1985 Abstract: A preparation for pharmaceutical use, especially in the treatment of migraine, arthritis and bronchial complaints contains a sesquiterpene lactone and is recovered from the plant Tanacetum parthenium by extraction using a pharmaceutically acceptable oil. Excerpt(s): This invention relates to sesquiterpene lactones and sesquiterpene lactonecontaining plant extracts and preparations for pharmaceutical use, and particularly to compositions which are useful in the treatment of migraine and various arthritic and bronchial conditions. The incidence of migraine is said to be in the region of 12% of the population. Its precise causes have not been determined but certain elements in its causation are well documented. Neurohumoral and local hormone (autacoid) factors such as noradrenaline, 5-hydroxytryptamine (serotonin), histamine and prostaglandins are implicated in migraine probably acting at the cerebro-vascular level. Web site: http://www.delphion.com/details?pn=US04758433__

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Pharmaceutically active composition extracted from tanacetum parthenium, process for its extraction, and pharmaceutical composition containing same Inventor(s): Beuscher; Norbert (Salzgitter, DE), Willigmann; Ingo (Goslar, DE) Assignee(s): Schaper & Bruemmer GmbH & Co., KG (Salzgitter, DE) Patent Number: 5,466,451 Date filed: January 29, 1993 Abstract: Extraction of pharmaceutically active compositions from a mixture of numerous ingredients, in particular from comminuted plants, such as Tanacetum parthenium, succeeds with a high yield and a surprisingly improved stability of the active substances when the extraction is carried out with a gas, preferably CO.sub.2, in the supercritical state. Excerpt(s): This invention relates to a pharmaceutically active composition from Tanacetum parthenium containing the sesquiterpene lactone parthenolide and parthenolide-like compounds as ingredients which predominate in terms of amount. The invention further relates to a process for extracting a pharmaceutically active composition from finely milled Tanacetum parthenium and to a medicament prepared with the resulting pharmaceutically active composition. For the preparation of an extract from the comminuted plant Tanacetum parthenium EP 0 098 041 A1 describes the extraction of sesquiterpene lactone with an oil from the plant. The sesquiterpene lactone is obtained from the plant in general using a non-polar organic solvent, and light petroleum, hexane or chloroform are suitable. It is possible in this connection after the extraction with a first non-polar solvent, to evaporate the first solvent and subsequently to chromatograph the extract with a second non-polar solvent as at least the first eluent. An article "The Active Principle In Feverfew" in The Lancet of Nov. 7, 1981, page 1054, discloses the preparation of an extract from the dried plant with light petroleum. A

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subsequent chromatography can be carried out with benzene as a polar eluent. Biochemical Systematics and Ecology, 1977, pages 207 to 218, describes the extraction of sesquiterpene lactones from Tanacetum parthenium with chloroform, that is to say with an a polar extraction agent. Web site: http://www.delphion.com/details?pn=US05466451__ •

Tanacetum parthenium extract and method of obtaining same Inventor(s): Bombardelli; Ezio (Milan, IT), Morazzoni; Paolo (Milan, IT) Assignee(s): Indena S.p.A. (Milan, IT) Patent Number: 6,224,875 Date filed: August 27, 1999 Abstract: Extracts of Tanacetum parthenium with a reduced content of.alpha.unsaturated.gamma.-lactones, particularly of parthenolide, obtainable by elution on basic resins are disclosed.The extracts of the invention have favourable pharmacological properties together with reduced risks of allergic reactions. Excerpt(s): The present invention relates to a Tanacetum parthenium extract substantially free of.alpha.-unsaturated.gamma.-lactones. The invention additionally relates to a process for the preparation of the extract and to pharmaceutical and cosmetic compositions containing a Tanacetum parthenium extract which is substantially free of parthenolide. Extracts of Tanacetum parthenium, a plant belonging to the family Asteracee/Composite, also known as Altamisa, Crisanthemum, Leucanthemum, Pyrethrum parthenium as well as under the common name "feverfew", have traditionally been used in the treatment of migraine, vertigo, arthritis, menstrual disorders, fever, toothache, stomach ache and insect bites. Extracts of Tanacetum parthenium contain various volatile oils having mono- and/or sesquiterpene components, flavonoids, tannins, and pyrethrin, as well as terpenoids of the family of sesquiterpene lactones known as germacranolides, guaianolides and eudesmanolides. These latter compounds are characterized by an.alpha.-unsaturated.gamma.-lactone structure and comprise in particular the compounds known as parthenolide, 3-.beta.hydroxy-parthenoide, costunolide, 3-.beta.-hydroxy-costunolide, artemorin, 8-.alpha.hydroxy-estafiatin and chrysanthemonin. The presence of these sesquiterpene lactones is considered necessary for the extracts to achieve pharmacological activity (J. Pharm. Pharmacol. 1992, 44:391-395). Particular attention has been focused on parthenolide, which is thought to be the fundamental active ingredient of these extracts, but which is also responsible for allergic reactions which can sometimes occur following treatment with the extracts of Tanacetum parthenium (See, for example, Arch. Dermatol. Forsch. 1975, 251 (3):235-44; Arch. Dermatol. Forsch. 1976, 255 (2):111-21; Contact Dermatitis, 1988, 38 (4):207-8; Am. J. Contact Dermatol. 1998-9 (1):49-50; Br. J. Dermatol. 1995, 132 (4):543-7). Extracts of Tanacetum parthenium containing parthenolide are disclosed in WO 94 06800; EP 0 553 658; WO 92 11857; GB 2,166,952; EP 98 041; WO 98 39018. Web site: http://www.delphion.com/details?pn=US06224875__

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Therapeutic nasal spray administered composition containing feverfew Inventor(s): Brucker; Donald (7777 Fay Ave., Suite 160, La Jolla, CA 92037), Lorenzen; Lee H. (15550-D Rockland Blvd., Irvine, CA 92718) Assignee(s): none reported Patent Number: 6,103,218 Date filed: April 23, 1997 Abstract: A composition and delivery system are disclosed that will allow feverfew to be administered to a person in form in which an active ingredient of feverfew, particularly parthenolide can be readily and quickly assimilated by the person's body, particularly the central nervous system, and the therapeutic effects of the feverfew be rapidly imparted to the person. Feverfew is administered in the form of aqueous nasal spray composition, to provide therapeutic moisturization of nasal mucous membranes, relief of migraine headaches and antispasmodic effect, such as to relieve menstrual cramping or aid digestion. The effect is enhanced when the composition also contains nanoclustered resonant water. Vitamins, vitamin derivatives, surfactants, wetting agents, preservatives and emulsifiers may also be present. Excerpt(s): The invention herein relates to therapeutic medications. More particularly it relates to therapeutic nasal sprays. Feverfew (Tanacetum parthenium) is an herb in the Compositae family which has long been known to have therapeutic properties; see Bremness, (ed.), HERBS (1990), pp. 91, 185-186 and Castleman, THE HEALING HERBS (1991), pp. 173-176. At various times feverfew has been considered to have therapeutic properties for reducing high blood pressure, acting as a digestive tract antispasmodic, relieving menstrual cramps and, most importantly, relieving migraine headaches. It has been administered as the raw feverfew leaf, either fresh or frozen, which is taken by chewing or by swallowing pills or capsules in which the feverfew is incorporated. It has also been administered as a tea with a concentration of 0.5-1 teaspoonfuls of feverfew per cup of boiling water, and which is drunk after the tea has steeped for 5-10 minutes. Such delivery systems have had significant problems. Raw feverfew leaves are bitter and therefore unpleasant to chew and the tea is unpleasant to drink. It has also been documented that raw feverfew leaves can cause oral ulcers or other irritation to the buccal membranes or mucous lining of the mouth. Therefore, when leaves are to be chewed, it has been recommended that they be chewed in combination with a larger quantity of an innocuous foodstuff, commonly slices of bread. The general use of feverfew in the form of capsules or pills has been an attempt to avoid the buccal irritation and ulcers and the bitter taste of the herb. Web site: http://www.delphion.com/details?pn=US06103218__

Patent Applications on Feverfew As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to feverfew:

6

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

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Composition containing feverfew extract and use thereof Inventor(s): Eisinger, Magdalena; (Demarest, NJ), Martin, Katharine M.; (Ringoes, NJ), Saliou, Claude; (Bernardsville, NJ), Zhang, Li; (Lawrenceville, NJ) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030077343 Date filed: September 9, 2002 Abstract: The present invention features a method for constricting blood vessels, inhibiting angiogenesis, and/or reducing non-inflammatory redness in the skin by the topical administration of a composition comprising a Feverfew extract. Excerpt(s): This application claims priority from U.S. Ser. No. 10/099,159, filed on Mar. 14, 2002 and U.S. Ser. No. filed Mar. 16, 2001, which are both herein incorporated by reference. The present invention relates to compositions comprising Feverfew extract and the cosmetic use thereof. Tanacetum parthenium, a plant commonly known as feverfew, has been recognized since the Middle Ages as having significant medicinal properties when taken orally as a general febrifuge, hence its common name. Many have isolated extracts of this plant, and those extracts have been used to orally treat migraines, arthritis, and bronchial complaints. See, e.g., U.S. Pat. No. 4,758,433 and PCT Patent Application No. WO 94/06800. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Compositions and methods of treatment to alleviate or prevent migrainous headaches and their associated symptoms Inventor(s): Higgins, James W.; (Rothschild, WI), Mitchell, Russell W.; (Schofield, WI), Roberts, Stephen C.; (Minnetonka, MN) Correspondence: Kagan Binder, Pllc; Suite 200, Maple Island Building; 221 Main Street North; Stillwater; MN; 55082; US Patent Application Number: 20040086582 Date filed: June 6, 2003 Abstract: Methods of treating migrainous headaches and their associated symptoms are provided by administering a composition comprising parthenolide or feverfew sublingually to a patient in need thereof. Treatments are surprisingly effective with low total administered amounts of parthenolide or feverfew. Compositions and unit dose systems are also described. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 10/288,610, filed Nov. 5, 2002, entitled "COMPOSITIONS AND METHODS OF TREATMENT TO ALLEVIATE OR PREVENT MIGRAINOUS HEADACHES AND THEIR ASSOCIATED SYMPTOMS", which application is incorporated herein by reference in its entirety. The present invention relates to treatment of migrainous headaches and their associated symptoms. The present invention also relates to compositions, unit dose applicators, treatment regimens and compositions comprising parthenolide and/or feverfew. The American Migraine Study reports that 32 million Americans, 11.8% of the population, suffer with at least one migraine headache annually, and that 23 million people in the US suffer with "severe migraine" (Stewart W F JAMA 1992; 267:64-9, Lipton, RB Headache. 2001; 41:638-645). Women account for

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two-thirds to three-fourths of all migraine patients, as gender specific prevalence in the US is 17.6% for females and 6% for males using the IHS (International Headache Society) criteria for migraine diagnosis (Lipton R B, Neurology 1993; 43(Suppl 3):6-10). Twentyfive percent of women with migraine experience four or more severe attacks per month, 35% experience one to three severe attacks per month, and 40% experience one or less than one severe attack per month. Similar frequency patterns of migraine were observed in men (Stewart W F, JAMA 1992; 267:64-9). The overall average number of migraine attacks per year for men is 34 and 37.4 for women. In addition, "chronic recurrent headache" affects approximately 45 million Americans, the underlying pathophysiology for this condition is not yet fully understood (Meuller, L Journal of the American Osteopathic Association, 2000 September;100(9 Suppl):S14-21). Many researchers believe that these clinically significant headaches are primarily migraine-like (migrainous). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Dietary supplement comprising parthenolide Inventor(s): Higgins, James W.; (Rothschild, WI), Mitchell, Russell W.; (Schofield, WI), Roberts, Stephen C.; (Minnetonka, MN) Correspondence: Kagan Binder, Pllc; Suite 200, Maple Island Building; 221 Main Street North; Stillwater; MN; 55082; US Patent Application Number: 20040086579 Date filed: June 6, 2003 Abstract: An improved method for administering parthenolide and/or feverfew extract as a dietary supplement is provided, wherein an oral dosage composition comprising a dietary supplemental amount of parthenolide in a predetermined dosage amount of at least about 0.05 mg of parthenolide is orally administered to a patient. At least a portion of the administered oral dosage composition is retained by the patient in the oral cavity for a time sufficient to allow absorption of parthenolide by oral mucosal tissues. Compositions particularly suitable for oral mucosal administration of a parthenolide dietary supplement are also provided. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 10/288,610, filed Nov. 5, 2002, entitled "COMPOSITIONS AND METHODS OF TREATMENT TO ALLEVIATE OR PREVENT MIGRAINOUS HEADACHES AND THEIR ASSOCIATED SYMPTOMS", which application is incorporated herein by reference in its entirety. This invention relates to the field of natural dietary supplements. It is directed particularly towards the supplementation of diets, and most particularly towards supplementation of the diet with parthenolide. Dietary supplements are materials provided to animals, typically multi-vitamin and mineral supplements, for treating specific medical conditions and as general nutritional supplements to promote and maintain good health of animals, particularly mammals. In particular, compositions and methods for optimizing the general health of both men and women by supplementing the daily diet with specific and multi-vitamin compositions. Dietary supplements are typically administered for ready consumption by the user, either as a combination with food or in a delivery vehicle suitable for swallowing by the user. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 37

•

Method for the topical treatment and prevention of inflammatory disorders and related conditions using extracts of feverfew (Tanacetum parthenium) Inventor(s): Callaghan, Theresa; (Delft, NL), Gendimenico, Gerard; (Neshanic Station, NJ), Martin, Katharine; (Ringoes, NJ), Oddos, Thierry; (Meudon, FR) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030003170 Date filed: May 6, 2002 Abstract: This invention relates to a method of treating and preventing inflammatory disorders and related conditions using an extract of feverfew. Particularly, the invention includes a method of treating and preventing inflammatory disorders and related conditions which comprises applying a topical composition comprising an effective amount of an extract of feverfew to a patient and a method of treating and preventing inflammatory disorders and related conditions of the skin by applying a topical composition containing an effective amount of an extract of feverfew to a patient. In addition, the invention includes a method of treating and preventing inflammatory disorders and related conditions by applying a topical composition containing an effective amount of an extract of feverfew to a patient where said extract is substantially free of.alpha.-unsaturated.gamma.-lactone. Excerpt(s): This invention relates to the topical treatment and prevention of inflammatory disorders and related conditions using extracts of feverfew (Tanacetum parthenium). Tanacetum parthenium, a plant commonly known as Feverfew, has been recognized since the Middle Ages as having significant medicinal properties when taken orally--used as a general febrifuge, hence its common name. Many have isolated extracts of the plant and those extracts have been used to orally treat migraines, arthritis, and bronchial complaints. (See Johnson et al, U.S. Pat. No. 4,758,433, discussing the treatment of a variety of diseases by oral, inhalation, injection or suppository administration of the extract and see WO 94 06800, discussing a extract of feverfew which contains parthenolide). Extracts of feverfew contain many components. Although not all components have been isolated and characterized, the known components of an extract of feverfew contain a significant number of biologically active components. To date, the chemical constituents of whole feverfew extract are as follows: apigenin-7glucoside, apigenin-7-glucuronide, 1-.beta.-hydroxyarbusculin, 6-hydroxykaempferol3,7-4'-trimethylether (Tanetin), 6-hydroxykaempferol-3,7-dimethyl ether, 8-.beta.reynosin, 10-epicanin, ascorbic acid, beta-carotene, calcium, chromium, chrysanthemolide, chrysanthemomin, chrysarten-A, chrsyarten-c, chrysoeriol-7glucuronide, cobalt, cosmosiin, epoxyartemorin, luteolin-7-glucoside, luteolin-7glucuronide, mangnoliolide, parthenolide, quercetagentin-3,7,3'-trimethylether, quercetagetin-3'7-dimethylether, reynosin, tanaparthin, tanaparthin-1.alpha.,4.alpha.epoxide, tanaparthin-1.beta.,4.beta.-epoxid- e,.beta.-costunolide, 3-.beta.-hydroxyparthenolide, and 3,7,3'-trimethoxyquercetagetin. The specific role that each of these component compounds plays in the biological activity of feverfew is to date unknown. However, some information is known about the allergic reactions to the extract. It is believed that many of these allergic reactions are caused by the.alpha.unsaturated.gamma.-lactones such as parthenolide. (See, Arch. Dermatol. Forsch. 1975, 251 (3):235-44; Arch. Dermatol. Forsch 1976, 255 (2):111-21; Contact Dermatitis, 1988, 38 (4):207-8; Am. J. Contact Dermatol. 1998-9 (1):49-50; Br. J. Dermatol, 1995, 132 (4): 54347).

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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 feverfew, 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 “feverfew” (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 feverfew. You can also use this procedure to view pending patent applications concerning feverfew. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

39

CHAPTER 5. PERIODICALS AND NEWS ON FEVERFEW Overview In this chapter, we suggest a number of news sources and present various periodicals that cover feverfew.

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

Role of feverfew in migraine still uncertain Source: Reuters Health eLine Date: February 19, 1999

•

Efficacy of feverfew for migraine prophylaxis still unclear Source: Reuters Medical News Date: February 18, 1999

40

•

Feverfew

Active ingredient of migraine prophylactic feverfew still unknown Source: Reuters Medical News Date: May 13, 1998 The NIH

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

Periodicals and News

41

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

43

APPENDICES

45

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 Institute7: •

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/

7

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

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Feverfew

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

47

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 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:9 •

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

8

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). 9 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 Gateway10 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.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “feverfew” (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 204 3 154 1 3 365

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 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.14 Simply search by “feverfew” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

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

11

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

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

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

Physician Resources

49

Coffee Break: Tutorials for Biologists15 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.16 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.17 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/.

15 Adapted 16

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. 17 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.

51

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 feverfew 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 feverfew. 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 feverfew. 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 “feverfew”:

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Feverfew

Anesthesia http://www.nlm.nih.gov/medlineplus/anesthesia.html Dietary Supplements http://www.nlm.nih.gov/medlineplus/dietarysupplements.html Herbal Medicine http://www.nlm.nih.gov/medlineplus/herbalmedicine.html Osteogenesis Imperfecta http://www.nlm.nih.gov/medlineplus/osteogenesisimperfecta.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to feverfew. 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

Patient Resources

53

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

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “feverfew” (or a synonym) into the search box, and click “Submit Query.”

55

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.18

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

18

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

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Feverfew

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)19: •

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/

19

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

Finding Medical Libraries

57

•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

Finding Medical Libraries

59

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

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

•

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).

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

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FEVERFEW DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] 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] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alloys: A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions. [NIH] Aloe: A genus of the family Liliaceae containing anthraquinone glycosides such as aloinemodin or aloe-emodin (emodin). [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] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] 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] Analogous: Resembling or similar in some respects, as in function or appearance, but not in

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origin or development;. [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] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [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] Antispasmodic: An agent that relieves spasm. [EU] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aqueous: Having to do with water. [NIH] Arachidonate 12-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 12-hydroperoxyarachidonate (12-HPETE) which is itself rapidly converted by a peroxidase to 12-hydroxy-5,8,10,14-eicosatetraenoate (12-HETE). The 12-hydroperoxides are preferentially formed in platelets. EC 1.13.11.31. [NIH] Arachidonate 15-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 15-hydroperoxyarachidonate (15-HPETE) which is rapidly converted to 15-hydroxy5,8,11,13-eicosatetraenoate (15-HETE). The 15-hydroperoxides are preferentially formed in neutrophils and lymphocytes. EC 1.13.11.33. [NIH] Arachidonate Lipoxygenases: Enzymes catalyzing the oxidation of arachidonic acid to hydroperoxyarachidonates (HPETES). These products are then rapidly converted by a peroxidase to hydroxyeicosatetraenoic acids (HETES). The positional specificity of the enzyme reaction varies from tissue to tissue. The final lipoxygenase pathway leads to the leukotrienes. EC 1.13.11.- . [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH]

Dictionary 65

Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] 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] Basophil: A type of white blood cell. Basophils are granulocytes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] 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] Bioassay: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH]

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Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [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] Bromelain: An enzyme found in pineapples that breaks down other proteins, such as collagen and muscle fiber, and has anti-inflammatory properties. It is used as a meat tenderizer in the food industry. [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] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] 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] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [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] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Cascara: Component of the dried bark of a buckthorn (Rhamnus purshiana) that contains the anthraquinone emodin. It is used as a laxative. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [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] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and

Dictionary 67

meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] 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 the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chamomile: Common name for several daisy-like species native to Europe and Western Asia, now naturalized in the United States and Australia. The dried flower-heads of two species, Anthemis nobilis (Chamaemelum nobile) and Matricaria recutita, have specific use as herbs. They are administered as tea, extracts, tinctures, or ointments. Chamomile contains choline, coumarins, cyanogenic glycosides, flavonoids, salicylate derivatives, tannins, and volatile oils. [NIH] Chloroform: A commonly used laboratory solvent. It was previously used as an anesthetic, but was banned from use in the U.S. due to its suspected carcinogenecity. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] 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] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] 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] Cobalt: A trace element that is a component of vitamin B12. It has the atomic symbol Co, atomic number 27, and atomic weight 58.93. It is used in nuclear weapons, alloys, and pigments. Deficiency in animals leads to anemia; its excess in humans can lead to erythrocytosis. [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] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the

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high content of polar groups which are responsible for its swelling properties. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] 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] 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] 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 Media: Substances used in radiography that allow visualization of certain tissues. [NIH]

Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments,

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etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coumarins: Synthetic or naturally occurring substances related to coumarin, the deltalactone of coumarinic acid. Coumarin itself occurs in the tonka bean. The various coumarins have a wide range of proposed actions and uses including as anticoagulants, pharmaceutical aids, indicators and reagents, photoreactive substances, and antineoplastic agents. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytostatic: An agent that suppresses cell growth and multiplication. [EU] Cytotoxic: Cell-killing. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Hygienists: Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [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] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of

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the environment, or lightheadedness. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Echinacea: A genus of perennial herbs used topically and internally. It contains echinacoside, glycosides, inulin, isobutyl amides, resin, and sesquiterpenes. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emodin: Purgative anthraquinone found in several plants, especially Rhamnus frangula. It was formerly used as a laxative, but is now used mainly as tool in toxicity studies. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [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] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU]

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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] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Flatus: Gas passed through the rectum. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Freeze Drying: Method of tissue preparation in which the tissue specimen is frozen and then dehydrated at low temperature in a high vacuum. This method is also used for dehydrating pharmaceutical and food products. [NIH] Gamma-interferon: Interferon produced by T-lymphocytes in response to various mitogens and antigens. Gamma interferon appears to have potent antineoplastic, immunoregulatory and antiviral activity. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastric: Having to do with the stomach. [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] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [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] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Ginger: Deciduous plant rich in volatile oil (oils, volatile). It is used as a flavoring agent and has many other uses both internally and topically. [NIH] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Granule: A small pill made from sucrose. [EU]

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Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatotoxic: Toxic to liver cells. [EU] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] 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] Histamine Release: The secretion of histamine from mast cell and basophil granules by exocytosis. This can be initiated by a number of factors, all of which involve binding of IgE, cross-linked by antigen, to the mast cell or basophil's Fc receptors. Once released, histamine binds to a number of different target cell receptors and exerts a wide variety of effects. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [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] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] 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] Illusion: A false interpretation of a genuine percept. [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]

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

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Intercellular Adhesion Molecule-1: A cell-surface ligand with a role in leukocyte adhesion and inflammation. Its production is induced by gamma-interferon and it is required for neutrophil migration into inflamed tissue. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-12: A heterodimeric cytokine that stimulates the production of interferon gamma from T-cells and natural killer cells, and also induces differentiation of Th1 helper cells. It is an initiator of cell-mediated immunity. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles,

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etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Kava: Dried rhizome and roots of Piper methysticum, a shrub native to Oceania and known for its anti-anxiety and sedative properties. Heavy usage results in some adverse effects. It contains alkaloids, lactones, kawain, methysticin, mucilage, starch, and yangonin. Kava is also the name of the pungent beverage prepared from the plant's roots. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lenses: Pieces of glass or other transparent materials used for magnification or increased visual acuity. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] 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] Lubricants: Oily or slippery substances. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH]

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Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

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] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] 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] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milk Thistle: The plant Silybum marianum in the family Asteraceae containing the bioflavonoid complex silymarin. For centuries this has been used traditionally to treat liver disease. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] 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] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Mutagenic: Inducing genetic mutation. [EU] Mutagenicity: Ability to damage DNA, the genetic material; the power to cause mutations.

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[NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] 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] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutralization: An act or process of neutralizing. [EU] Neutrophil: A type of white blood cell. [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] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] 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] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [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]

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Perennial: Lasting through the year of for several years. [EU] Peripheral blood: Blood circulating throughout the body. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] Physicochemical: Pertaining to physics and chemistry. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [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] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polyethylene Glycols: Alpha-Hydro-omega-hydroxypoly(oxy-1,2-ethanediyls). Additional polymers of ethylene oxide and water and their ethers. They vary in consistency from liquid to solid, depending on the molecular weight, indicated by a number following the name. Used as surfactants in industry, including foods, cosmetics and pharmaceutics; in biomedicine, as dispersing agents, solvents, ointment and suppository bases, vehicles, tablet excipients. Some specific groups are lauromagrogols, nonoxynols, octoxynols and poloxamers. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful

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substance to worsen a disease already contracted. [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] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostaglandins D: Physiologically active prostaglandins found in many tissues and organs. They show pressor activity, are mediators of inflammation, and have potential antithrombotic effects. [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] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] 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

Dictionary 79

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] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] 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] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivation: 1. The secretion of saliva. 2. Ptyalism (= excessive flow of saliva). [EU] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU]

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Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Senna: Preparations of Cassia senna L. and C. angustifolia of the Leguminosae. They contain sennosides, which are anthraquinone type cathartics and are used in many different preparations as laxatives. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] 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] Silymarin: A mixture of flavonoids extracted from seeds of the milk thistle, Silybum marianum. It consists primarily of three isomers: silicristin, silidianin, and silybin, its major component. Silymarin displays antioxidant and membrane stabilizing activity. It protects various tissues and organs against chemical injury, and shows potential as an antihepatoxic agent. [NIH] Sister Chromatid Exchange: An exchange of segments between the sister chromatids of a chromosome, either between the sister chromatids of a meiotic tetrad or between the sister chromatids of a duplicated somatic chromosome. Its frequency is increased by ultraviolet and ionizing radiation and other mutagenic agents and is particularly high in Bloom syndrome. [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]

Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [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] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Sperm: The fecundating fluid of the male. [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] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on

Dictionary 81

muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] 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]

Supplementation: Adding nutrients to the diet. [NIH] Suppository: A medicated mass adapted for introduction into the rectal, vaginal, or urethral orifice of the body, suppository bases are solid at room temperature but melt or dissolve at body temperature. Commonly used bases are cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, polyethylene glycols of various molecular weights, and fatty acid esters of polyethylene glycol. [EU] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Synovial: Of pertaining to, or secreting synovia. [EU] Systemic: Affecting the entire body. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Toothache: Pain in the adjacent areas of the teeth. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic

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microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [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] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitamin D: The vitamin that mediates intestinal calcium absorption, bone calcium metabolism, and probably muscle activity. It usually acts as a hormone precursor, requiring 2 stages of metabolism before reaching actual hormonal form. It is isolated from fish liver oils and used in the treatment and prevention of rickets. [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] Wetting Agents: A surfactant that renders a surface wettable by water or enhances the spreading of water over the surface; used in foods and cosmetics; important in contrast media; also with contact lenses, dentures, and some prostheses. Synonyms: humectants; hydrating agents. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

Dictionary 83

85

INDEX A Adverse Effect, 63, 74, 80 Affinity, 63, 74 Algorithms, 63, 65 Alkaline, 63, 66 Allergen, 16, 63 Alloys, 63, 67 Aloe, 4, 63 Alternative medicine, 40, 63 Amine, 63, 72 Amino acid, 63, 69, 72, 75, 77, 78, 80, 81, 82 Analogous, 63, 77, 82 Anemia, 64, 67 Anesthesia, 52, 64 Angiogenesis, 35, 64 Antibacterial, 6, 64 Antigen, 63, 64, 68, 72, 73, 75 Anti-inflammatory, 7, 10, 12, 13, 23, 64, 65, 66, 73, 79 Anti-Inflammatory Agents, 64, 65 Antioxidant, 64, 65, 80 Antispasmodic, 34, 64 Antithrombotic, 20, 64, 78 Anxiety, 64, 74 Aorta, 18, 19, 64 Aqueous, 34, 64, 69 Arachidonate 12-Lipoxygenase, 64, 74 Arachidonate 15-Lipoxygenase, 64, 74 Arachidonate Lipoxygenases, 64, 74 Arachidonic Acid, 7, 11, 17, 64, 78 Arteries, 64, 65, 66, 69, 75, 81 Arterioles, 65, 66 Ascorbic Acid, 37, 65, 72 Aspirin, 4, 65 B Bacteria, 64, 65, 75 Basophil, 65, 72 Benign, 65, 72 Benzene, 33, 65 Bile, 65, 74 Bioassay, 6, 65 Biochemical, 20, 30, 33, 65, 80 Biosynthesis, 18, 64, 65 Biotechnology, 6, 40, 47, 65 Bladder, 65, 82 Blood Coagulation, 65, 66 Blood Platelets, 11, 17, 18, 65, 80 Blood pressure, 34, 65, 72, 75

Blood vessel, 35, 64, 65, 66, 67, 70, 80, 82 Bone Marrow, 65, 66, 75, 80 Bromelain, 4, 66 Bronchi, 66 Bronchial, 32, 35, 37, 66, 72 Buccal, 34, 66 C Calcium, 37, 66, 68, 82 Capsules, 34, 66, 71 Carcinogenic, 65, 66, 73 Carcinogens, 66, 67 Cardiovascular, 66, 80 Carotene, 37, 66 Cascara, 4, 66 Cell, 10, 11, 18, 65, 66, 67, 68, 69, 70, 72, 73, 74, 75, 76, 77, 78 Cell Division, 65, 66, 77 Cell proliferation, 11, 18, 66 Cellulose, 66, 77 Central Nervous System, 4, 34, 65, 66, 72, 80 Central Nervous System Infections, 66, 72 Cerebrovascular, 30, 67 Cerebrum, 67 Chamomile, 4, 5, 21, 27, 67 Chloroform, 10, 15, 32, 67 Choline, 67 Chromatin, 67, 70, 74 Chromium, 37, 67 Chromosome, 67, 72, 80 Chronic, 10, 16, 36, 67, 73 Clinical trial, 5, 47, 67, 68, 70, 78 Cloning, 65, 67 Cobalt, 37, 67 Coenzyme, 65, 67 Collagen, 10, 16, 63, 66, 67, 71, 78 Complement, 68 Complementary and alternative medicine, 15, 28, 68 Complementary medicine, 15, 68 Computational Biology, 47, 68 Connective Tissue, 65, 66, 67, 68, 71, 79 Contraindications, ii, 68 Contrast Media, 68, 82 Controlled study, 20, 68 Coronary, 68, 69, 75 Coronary Thrombosis, 69, 75 Coumarins, 67, 69

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Cranial, 69, 72 Craniocerebral Trauma, 69, 72 Curative, 69, 79, 81 Cytokine, 11, 18, 21, 69, 73 Cytoplasm, 69, 70, 74, 75 Cytostatic, 11, 21, 69 Cytotoxic, 6, 11, 18, 69 D Decarboxylation, 69, 72 Degenerative, 69, 79 Dental Care, 4, 69 Dental Hygienists, 3, 4, 69 Dentists, 4, 69 Dentures, 69, 82 Dermatitis, 6, 10, 11, 16, 17, 24, 33, 37, 69 Diagnostic procedure, 29, 40, 69 Digestion, 34, 65, 69, 74, 81 Digestive tract, 34, 69, 80 Dimethyl, 37, 69 Diploid, 69, 77 Direct, iii, 69, 79 Dizziness, 69, 82 Double-blind, 12, 23, 24, 70 Drug Interactions, 70 Duodenum, 65, 70, 81 Dyes, 70 Dyskinesia, 4, 70 E Echinacea, 4, 5, 70 Efficacy, 5, 12, 18, 23, 24, 39, 70 Elastin, 67, 70 Electrolyte, 70, 77 Embryo, 70, 77 Emodin, 63, 66, 70 Endothelial cell, 18, 70 Environmental Health, 46, 48, 70 Enzymatic, 63, 66, 68, 70, 72 Enzyme, 64, 66, 67, 70, 73, 74, 76, 82 Eosinophils, 70, 74 Escalation, 22, 70 Esophagus, 69, 70, 81 Ether, 37, 70 Extracellular, 68, 70, 71 Extracellular Matrix, 68, 70, 71 Extraction, 5, 12, 23, 32, 70 F Family Planning, 47, 71 Fat, 64, 66, 71, 74, 79, 81 Fibroblasts, 19, 71 Flatus, 71 Forearm, 65, 71 Freeze Drying, 31, 71

G Gamma-interferon, 71, 73 Gas, 32, 71 Gasoline, 65, 71 Gastric, 71, 72 Gastrin, 71, 72 Gastrointestinal, 4, 71, 80, 81 Gastrointestinal tract, 71, 80 Gelatin, 71, 81 Gene, 6, 65, 71, 74 Gene Expression, 6, 71 Genetics, 30, 71 Ginger, 5, 27, 30, 31, 71 Ginseng, 4, 5, 22, 71 Gland, 71, 79 Glucose, 65, 66, 67, 71 Governing Board, 71, 78 Granule, 18, 71 H Haploid, 72, 77 Headache, 19, 24, 25, 35, 72 Headache Disorders, 72 Heme, 72, 76 Hemorrhage, 69, 72 Hemostasis, 72, 80 Hepatotoxic, 4, 72 Heredity, 71, 72 Histamine, 12, 23, 32, 72 Histamine Release, 12, 23, 72 Histidine, 72 Hormonal, 72, 82 Hormone, 32, 65, 71, 72, 75, 79, 82 Hydroxylysine, 67, 72 Hydroxyproline, 63, 67, 72 Hypersensitivity, 24, 63, 72, 79 Hypertension, 72 I Illusion, 72, 82 In vitro, 11, 21, 72 In vivo, 21, 72, 81 Indomethacin, 7, 73 Infarction, 69, 73, 75 Infection, 73, 74, 79 Inflammation, 11, 17, 30, 64, 65, 69, 73, 77, 78, 79 Inhalation, 37, 73 Initiator, 73 Intercellular Adhesion Molecule-1, 19, 73 Interferon, 71, 73 Interleukin-1, 11, 73 Interleukin-12, 11, 73 Interleukin-2, 73

87

Intestinal, 66, 73, 82 Intestines, 71, 73 Intracellular, 73, 75, 77, 78 Inulin, 70, 73 Ionizing, 73, 80 K Kava, 4, 6, 17, 30, 31, 74 Kb, 46, 74 L Large Intestine, 69, 73, 74, 79, 80 Laxative, 66, 70, 74 Lenses, 74, 82 Leukocytes, 20, 66, 70, 73, 74, 75 Lip, 4, 74 Lipid, 67, 74 Lipophilic, 10, 74 Lipopolysaccharide, 11, 21, 74 Liposomes, 30, 31, 74 Lipoxygenase, 20, 64, 74 Liver, 4, 64, 65, 72, 74, 75, 79, 82 Localized, 73, 74, 77 Locomotion, 74, 77 Lubricants, 74, 77 Lymph, 70, 74 Lymphocytes, 10, 16, 64, 71, 73, 74, 76 Lymphoid, 74 M Macrophage, 73, 75 Meat, 66, 75 Mediator, 73, 75, 80 Medicament, 32, 75 MEDLINE, 47, 75 Membrane, 68, 70, 74, 75, 79, 80 Membrane Proteins, 74, 75 Meninges, 66, 67, 69, 75 Metabolite, 69, 75 Methionine, 69, 75 MI, 23, 32, 61, 75 Microorganism, 75, 82 Migration, 73, 75 Milk Thistle, 5, 75, 80 Molecular, 12, 47, 49, 65, 68, 74, 75, 77, 79, 81 Monitor, 75, 76 Monocytes, 73, 74, 75 Mononuclear, 11, 18, 75 Morphological, 5, 21, 70, 75 Motility, 73, 75, 80 Mutagenic, 75, 80 Mutagenicity, 10, 16, 75 Myocardium, 75, 76

N Natural killer cells, 73, 76 Necrosis, 73, 75, 76 Nerve, 64, 75, 76, 79 Nervous System, 66, 67, 75, 76, 81 Neurotic, 76, 82 Neurotransmitter, 63, 72, 76, 81 Neutralization, 19, 76 Neutrophil, 73, 76 Nuclear, 11, 67, 76 Nucleus, 67, 69, 70, 74, 75, 76 O Ointments, 67, 76 Oral Health, 3, 4, 76 Oral Manifestations, 3, 4, 76 Ovary, 76, 77 Oxygenase, 20, 76 P Palliative, 76, 81 Patch, 16, 76 Pathologic, 69, 72, 76 Pathophysiology, 36, 76 Perennial, 70, 77 Peripheral blood, 11, 18, 77 Petroleum, 32, 71, 77 Phagocytosis, 11, 17, 77 Pharmacologic, 21, 64, 77, 82 Phosphorus, 66, 77 Physicochemical, 5, 77 Physiologic, 65, 73, 77, 78 Pigments, 66, 67, 77 Plants, 6, 10, 11, 12, 16, 17, 19, 21, 32, 67, 70, 71, 73, 77 Platelets, 10, 16, 64, 77, 81 Pneumonia, 68, 77 Pollen, 16, 77 Polyethylene, 77, 81 Polyethylene Glycols, 77, 81 Polypeptide, 63, 67, 77 Potassium, 10, 15, 77 Potentiates, 73, 77 Practice Guidelines, 48, 78 Precursor, 64, 67, 70, 78, 82 Prevalence, 30, 36, 78 Proline, 67, 72, 78 Prophylaxis, 24, 39, 69, 78, 79 Prostaglandins, 16, 32, 64, 73, 78 Prostaglandins A, 32, 73, 78 Prostaglandins D, 78 Protein S, 65, 78 Proteins, 63, 64, 66, 67, 68, 73, 75, 78 Public Policy, 47, 78

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Pulmonary, 65, 78, 81 Pulmonary Artery, 65, 78 R Radiation, 73, 78, 80, 82 Radioactive, 76, 78 Randomized, 24, 70, 78 Receptor, 64, 78, 80 Receptors, Serotonin, 78, 80 Rectal, 79, 81 Rectum, 69, 71, 74, 79 Red blood cells, 76, 79 Refer, 1, 66, 68, 69, 74, 79 Regimen, 70, 79 Retina, 79 Retinoids, 79, 82 Rheumatism, 79 Rheumatoid, 20, 25, 79 Rheumatoid arthritis, 20, 79 Rheumatology, 4, 79 Riboflavin, 30, 79 Rickets, 79, 82 S Salicylate, 67, 79 Saliva, 79 Salivary, 79, 82 Salivation, 4, 79 Screening, 67, 79 Secretion, 18, 72, 79, 80 Secretory, 17, 80 Sedative, 4, 74, 80, 82 Senna, 4, 80 Serotonin, 32, 76, 78, 80, 82 Side effect, 5, 63, 80, 81 Silymarin, 75, 80 Sister Chromatid Exchange, 10, 16, 80 Small intestine, 70, 72, 73, 80 Smooth muscle, 10, 15, 19, 72, 80, 81 Solid tumor, 64, 80 Solvent, 32, 65, 67, 80 Somatic, 80 Spasm, 64, 80 Specialist, 53, 80 Species, 10, 17, 24, 67, 75, 80, 81 Sperm, 67, 77, 80 Spinal cord, 66, 75, 76, 80 Stimulant, 72, 80 Stomach, 33, 69, 70, 71, 72, 73, 80, 81

Stress, 79, 81 Subarachnoid, 72, 81 Subspecies, 80, 81 Substance P, 75, 79, 81 Supplementation, 36, 81 Suppository, 37, 77, 81 Surfactant, 81, 82 Synovial, 19, 81 Systemic, 64, 65, 73, 81 T Therapeutics, 81 Thrombocytes, 77, 81 Thromboxanes, 64, 81 Tissue, 64, 65, 66, 68, 71, 73, 74, 75, 76, 79, 80, 81 Tone, 30, 81 Tonus, 81 Toothache, 33, 81 Topical, 35, 37, 81 Toxic, iv, 4, 5, 65, 72, 81, 82 Toxicity, 70, 81 Toxicology, 10, 22, 48, 82 Trace element, 67, 82 Transfection, 65, 82 Tryptophan, 67, 80, 82 U Urethra, 82 Urine, 10, 16, 65, 79, 82 V Vaginal, 81, 82 Valerian, 4, 5, 82 Vascular, 19, 21, 32, 72, 73, 82 Vasodilator, 72, 82 Vein, 76, 82 Venules, 66, 82 Vertigo, 33, 82 Veterinary Medicine, 47, 82 Vitamin A, 36, 82 Vitamin D, 34, 79, 82 Vitro, 10, 12, 15, 22, 82 Vivo, 82 W Wetting Agents, 34, 82 X Xerostomia, 4, 82 X-ray, 76, 82

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