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

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

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FREQUENT URINATION 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., 1960Frequent Urination: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84427-5 1. Frequent Urination-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 frequent urination. 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 FREQUENT URINATION ............................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Frequent Urination ....................................................................... 5 The National Library of Medicine: PubMed .................................................................................. 6 CHAPTER 2. NUTRITION AND FREQUENT URINATION..................................................................... 9 Overview........................................................................................................................................ 9 Finding Nutrition Studies on Frequent Urination........................................................................ 9 Federal Resources on Nutrition ................................................................................................... 10 Additional Web Resources ........................................................................................................... 10 CHAPTER 3. PATENTS ON FREQUENT URINATION ......................................................................... 13 Overview...................................................................................................................................... 13 Patents on Frequent Urination .................................................................................................... 13 Patent Applications on Frequent Urination ................................................................................ 15 Keeping Current .......................................................................................................................... 16 CHAPTER 4. BOOKS ON FREQUENT URINATION ............................................................................. 17 Overview...................................................................................................................................... 17 Book Summaries: Federal Agencies.............................................................................................. 17 Chapters on Frequent Urination.................................................................................................. 18 CHAPTER 5. MULTIMEDIA ON FREQUENT URINATION .................................................................. 21 Overview...................................................................................................................................... 21 Video Recordings ......................................................................................................................... 21 CHAPTER 6. PERIODICALS AND NEWS ON FREQUENT URINATION ............................................... 25 Overview...................................................................................................................................... 25 News Services and Press Releases................................................................................................ 25 Newsletters on Frequent Urination ............................................................................................. 27 Newsletter Articles ...................................................................................................................... 27 Academic Periodicals covering Frequent Urination .................................................................... 29 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 31 Overview...................................................................................................................................... 31 U.S. Pharmacopeia....................................................................................................................... 31 Commercial Databases ................................................................................................................. 32 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 35 Overview...................................................................................................................................... 35 NIH Guidelines............................................................................................................................ 35 NIH Databases............................................................................................................................. 37 Other Commercial Databases....................................................................................................... 39 APPENDIX B. PATIENT RESOURCES ................................................................................................. 41 Overview...................................................................................................................................... 41 Patient Guideline Sources............................................................................................................ 41 Finding Associations.................................................................................................................... 48 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 51 Overview...................................................................................................................................... 51 Preparation................................................................................................................................... 51 Finding a Local Medical Library.................................................................................................. 51 Medical Libraries in the U.S. and Canada ................................................................................... 51 ONLINE GLOSSARIES.................................................................................................................. 57 Online Dictionary Directories ..................................................................................................... 57

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FREQUENT URINATION DICTIONARY ................................................................................. 59 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 frequent urination 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 frequent urination, 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 frequent urination, 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 frequent urination. 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 frequent urination, 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 frequent urination. 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 FREQUENT URINATION Overview In this chapter, we will show you how to locate peer-reviewed references and studies on frequent urination.

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

Overactive Bladder Source: Healthline. 18(11): 3-4. November 1999. Contact: Available from Healthline Publishing, Inc. 830 Menlo Avenue, Suite 100, Menlo Park, CA 94025. (650) 325-6457. Website: www.healthline.com. Summary: Overactive bladder is a common and chronic disorder that affects approximately 17 million Americans. This newsletter article defines overactive bladder and encourages readers to seek health care for this problem. Overactive bladder refers to a group of symptoms that include urgency, frequent urination, and urge incontinence. The author explains that many patients feel humiliation and hesitate to obtain treatment for their overactive bladder problems. Patients may be too embarrassed to discuss their

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symptoms or may think that overactive bladder is a normal part of aging. Many patients even make lifestyle restrictions or changes in order to accommodate their bladder problems. The author reassures readers that overactive bladder is usually a benign disorder. The author also discusses the use of drug therapy for overactive bladder, including a new formulation of oxybutynin (called Ditropan XL) which combines a proven treatment for overactive bladder with a state of the art drug delivery system. The medication can now be released over time by this pill into the bloodstream, helping to reduce side effects and the need for multiple doses throughout the day. In addition to medication, behavior modification (such as biofeedback, scheduled voiding, and diet), implantable sacral stimulation devices, and physical therapy can help reduce the symptoms of overactive bladder. One sidebar reiterates the importance of talking with a health care provider about the problem of overactive bladder. •

Ketoacidosis: The Snake in the Grass Source: Diabetes Forecast. 54(7): 70-74. July 2001. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article discusses the symptoms, cause, and treatment of diabetic ketoacidosis (DKA). This condition is caused by dehydration and lack of insulin. When the body does not get enough insulin, the body starts breaking down fat for energy. Ketones are a by product of this process. They are normally removed from the body by the kidneys via urine, but in DKA, ketone formation occurs so quickly that the kidneys cannot keep up. Thus, ketones end up in the blood, causing the blood to become acidic. At the same time, blood glucose continues to rise because the body does not have enough insulin, and the kidneys work to get the sugar out of the body by increasing the output of urine. This leaves a person dehydrated. Dehydration is a stress on the body, so it responds by releasing stress hormones. These hormones counteract insulin. In addition, the liver starts releasing glycogen, which is then converted into more sugar. Preventing DKA involves knowing when one is most at risk. The greatest danger occurs when the body is being stressed by illness or injury. Thus, adhering to one's insulin regimen, monitoring blood glucose, and checking for ketones is important during an illness or after an injury. Symptoms of DKA include lack of appetite, abdominal pains, vomiting or nausea, blurry vision, dry or flushed skin, difficulty breathing, feelings of weakness, sleepiness, a fruity odor on the breath, intense thirst, dry mouth, and frequent urination. Treatment may include taking extra insulin, drinking plenty of water, and getting emergency medical treatment if necessary. The article also includes information on ketoacidosis in children.

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Dentoalveolar Abscess in a Pediatric Patient with Ketoacidosis Caused by Occult Diabetes Mellitus: A Case Report Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 88(2): 164-166. August 1999. Contact: Available from Mosby, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-3318. (800) 453-4351 or (314) 453-4351. Summary: This article presents a case report of a child who was referred for management of a routine odontogenic infection and found on physical examination and clinical work-up to be in frank diabetic ketoacidosis secondary to previously undiagnosed type 1 diabetes. The patient, a 3 year old Vietnamese girl, was brought to the emergency department of a university hospital for evaluation of a facial swelling on

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her left cheek. Purulence was noted around an upper tooth, and the patient's parents gave a medical history of their daughter that included progressive lethargy and recent weight loss, frequent urination, poor appetite, and excessive thirst. Laboratory tests were performed because the girl's presentation and history suggested underlying systemic disease and dehydration. On the basis of the clinical history, physical examination, and laboratory findings, the patient was diagnosed with new onset type 1 diabetes complicated by diabetic ketoacidosis, dehydration, and a canine space dentoalveolar infection from the maxillary left first molar. The patient was immediately admitted into the pediatric intensive care unit for treatment. After 5 days, the patient was discharged from the hospital with an insulin regimen. Arrangements were made for a visiting nurse to visit her twice daily for continued diabetic education. This case illustrates the importance of a comprehensive approach to patient evaluation and diagnosis in a case that might otherwise have been interpreted as a simple odontogenic infection. Oral health professionals need to be aware of the signs and symptoms of common systemic diseases that may initially manifest themselves in connection with a dental oral complaint. 1 figure. 4 references. (AA-M). •

UTI in Women: How Best to Treat Acute and Recurrent Infections Source: Consultant. 39(5): 1457-1460, 1463-1464. May 1999. Contact: Available from Cliggott Publishing Company. 55 Holly Hill Lane, Box 4010, Greenwich, CT 06831-0010. Summary: This article reviews recent changes in the recommended strategies for diagnosing and managing acute and recurrent urinary tract infections (UTIs) in women. Microscopically proven pyuria (the presence of white blood cells in the urine) usually can help the physician confirm the diagnosis of acute, uncomplicated UTI in patients who present with dysuria (painful urination) and urinary frequency and urgency; urine cultures are rarely necessary. Empiric, short course antibiotic therapy successfully cures most such infections. In contrast, culture and antimicrobial sensitivity testing are needed to direct management of recurrent or complicated UTIs. Physicians should also be aware of an inciting event that may trigger recurrences. Depending on the pattern of reinfection, recurrent UTIs can be managed by self medication during symptomatic episodes; for example, precoital or postcoital antibiotic prophylaxis; prophylaxis during menstruation; or long term, low dose, every other night prophylaxis. An estrogen cream may ease the dysuria and frequent urination common in elderly women. The author reiterates the need to reserve urologic evaluation, including intravenous pyelography, for suspected anatomic or functional abnormalities of the urinary tract. One chart provides the suggested patient care algorithm for managing recurrent, uncomplicated lower UTIs in women. 1 figure. 4 tables. 10 references. (AA-M).

Federally Funded Research on Frequent Urination The U.S. Government supports a variety of research studies relating to frequent urination. 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

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

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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 frequent urination. 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 frequent urination. The following is typical of the type of information found when searching the CRISP database for frequent urination: •

Project Title: UROTHELIAL DIFFERENTIATION IN INTERSTITIAL CYSTITIS Principal Investigator & Institution: Liebert, Monica; Director; Urology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Interstitial cystitis is a poorly understood syndrome that includes pelvic pain, frequent urination and urinary urgency. There is increasing evidence that mature differentiated urothelial antigens and barrier functions are lost in patients with interstitial cystitis and in a spontaneous cat model of interstitial cystitis. We have developed a unique panel of biomarkers for different stages of urothelial differentiation. In these exploratory studies, we propose to perform the first systematic evaluation of urothelial differentiation in interstitial cystitis through the following Specific Aims: Aim 1: to evaluate the expression of biomarkers in urothelial cells taken from tissues. Normal urothelial cells will be harvested from urothelial tissues (bladder or ureter) and evaluated by flow cytometry, immunostaining, RT-PCR and Northern and Western blotting for expression of a panel of biomarkers. These studies will confirm the utility of the biomarker panel in defining specific stages of urothelial differentiation in situ. Aim 2: to study biomarker expression in urine samples. Urine samples will be collected from interstitial cystitis patients and normal volunteers. Evaluation of urothelial differentiation biomarker content will be performed. Soluble forms of the biomarkers in the urine will be evaluated by qualitative and quantitative immunoassay. Cells recovered from the urine sample will also be tested by immunostaining, immunoassay, and RT-PCR. Results of the biomarker assays will be compared to patient characteristics. These exploratory studies will develop a new series of biomarkers that may be informative for the diagnosis, patient stratification and effective use of treatment modalities for interstitial cystitis. 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 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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

Frequent urination, leg cramps, leg weakness, erection difficulties: HIV myelopathy amino acid study. Author(s): James JS. Source: Aids Treat News. 2000 June 2; (344): 3-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12170973

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Splenic lymphangioma and presentation with frequent urination: a case report. Author(s): Niramis R, Tanvichien L, Hemsrichart V. Source: J Med Assoc Thai. 2003 August; 86 Suppl 3: S644-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700161

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CHAPTER 2. NUTRITION AND FREQUENT URINATION Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and frequent urination.

Finding Nutrition Studies on Frequent Urination 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 “frequent urination” (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 “frequent urination” (or a synonym): •

Beta(3)-adrenoceptor agonists for the treatment of frequent urination and urinary incontinence: 2-[4-(2-[[(1S,2R)-2-hydroxy-2-(4-hydroxyphenyl)-1methylethyl]amino]ethyl)phenoxy]-2-methylpropionic acid. Author(s): Central Research Laboratory, Kissei Pharmaceutical Company Ltd., 4365-1, Hotaka, Nagano, 399-8304, Japan. [email protected] Source: Tanaka, N Tamai, T Mukaiyama, H Hirabayashi, A Muranaka, H Ishikawa, T Akahane, S Akahane, M Bioorg-Med-Chem. 2001 December; 9(12): 3265-71 0968-0896

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/

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. PATENTS ON FREQUENT URINATION 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 “frequent urination” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on frequent urination, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Frequent Urination By performing a patent search focusing on frequent urination, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 5Adapted

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

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

Danazol for treatment of urinary incontinence Inventor(s): Harrington, Jr.; William J. (Miami, FL) Assignee(s): Sterling Winthrop Inc. (new York, Ny) Patent Number: 5,340,805 Date filed: December 10, 1992 Abstract: The method of use of danazol for reducing or eliminating urinary incontinence and any associated frequent urination in a person suffering therefrom and pharmaceutical compositions therefor are disclosed. Excerpt(s): The invention relates to danazol or a pharmaceutical composition thereof for treatment of urinary incontinence and any associated frequent urination. Anterior pituitary supressant [sic]. Anabolic steroid derivative of ethisterone, q.nu., with mild androgenic side effects (an impeded androgen). Clinical studies in endometriosis. Use in idiopathic thrombocytopenic purpura. in hemophilia. THERAP CAT: Antigonadotropin. Physician's Desk Reference.RTM. (Forty-sixth Edition, 1992, pp. 2046-2047) describes danazol under the brand name DANOCRINE.RTM., which is a pharmaceutical composition of danazol in capsule form containing as active ingredient 50 milligrams, 100 milligrams or 200 milligrams of danazol per capsule and as inactive ingredients benzyl alcohol, gelatin, lactose, magnesium stearate, parabens, sodium propionate, starch and talc, with indication for use in endometriosis, fibrocystic breast disease and hereditary angioedema. Web site: http://www.delphion.com/details?pn=US05340805__

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Remedies for frequent urination and urinary incontinence Inventor(s): Sasaki; Yasuo (Kameoka, JP) Assignee(s): Nippon Shinyaku Co., Ltd. (kyoto, Jp) Patent Number: 6,090,856 Date filed: January 3, 2000 Abstract: The object of this invention is to provide a novel medicinal use for tramadol the safety, among other properties, of which has already been established. This invention is directed to a therapeutic or prophylactic composition for urinary frequency and a therapeutic or prophylactic composition for urinary incontinence, both comprising tramadol or a salt thereof. The preferable salt of tramadol includes tramadol hydrochloride. Excerpt(s): This invention relates to a therapeutic or prophylactic composition for urinary frequency or a therapeutic or prophylactic composition for urinary incontinence, which comprises tramadol or a salt thereof as an active ingredient. Tramadol is an opioid non-narcotic analgesic drug having the chemical name of trans-(.+-.)-2[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol and has heretofore been used broadly in the form of hydrochloride for the management of intense to moderate pain. Urinary incontinence is a disease generally considered to occur when the intravesical pressure involuntarily exceeds the urethral closure pressure and is

Patents 15

suspected to involve, as an etiologic factor, an increase in intravesical pressure (which chiefly causes urge urinary incontinence or urinary frequency) or a decrease in urethral closure pressure (which chiefly causes stress urinary incontinence). Web site: http://www.delphion.com/details?pn=US06090856__

Patent Applications on Frequent Urination 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 frequent urination: •

Heterocyclic Beta-3 adrenergic receptor agonists Inventor(s): Ashwell, Mark A.; (Plainsboro, NJ), Solvibile, William R.; (East Windsor, NJ) Correspondence: Steven R. Eck; American Home Products Corporation; Patent Law Department - 2B; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20020022638 Date filed: July 12, 2001 Abstract: This invention provides compounds of Formula I having the structure 1wherein, 2U, V, and W are as defined hereinbefore,or a pharmaceutically acceptable salt thereof, which are useful in treating or inhibiting metabolic disorders related to insulin resistance or hyperglycemia (typically associated with obesity or glucose intolerance), atherosclerosis, gastrointestinal disorders, neurogenetic inflammation, glaucoma, ocular hypertension and frequent urination; and are particularly useful in the treatment or inhibition of type II diabetes. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/218,700, filed Jul. 17, 2000. This invention relates to heterocyclic.beta.sub.3 adrenergic receptor agonists useful for the treatment of metabolic disorders related to insulin resistance or hyperglycemia (typically associated with obesity or glucose intolerance), atherosclerosis, gastrointestinal disorders, neurogenetic inflammation, glaucoma, ocular hypertension, and and frequent urination, and are particularly useful in the treatment or inhibition of type II diabetes. The subdivision of.beta. adrenergic receptors (.beta.-AR) into.beta.sub.1- and.beta.sub.2-AR has led to the development of.beta.sub.1- and.beta.sub.2-antagonists and/or agonists which have been useful for the treatment of cardiovascular disease and asthma. The recent discovery of "atypical" receptors, later called.beta.sub.3-AR, has led to the development of.beta.sub.3-AR agnoists which may be potentially useful as antiobesity and antidiabetic agents. For recent reviews on.beta.sub.3-AR agnoists, see: 1. A. D. Strosberg, Annu. Rev. Pharmacol. Toxicol. 1997, 37, 421; 2. A. E. Weber, Ann. Rep. Med. Chem. 1998, 33, 193; 3. C. P. Kordik and A. B. Reitz, J. Med. Chem. 1999, 42, 181; 4. C. Weyer, J. F. Gautier and E. Danforth, Diabetes and Metabolism, 1999, 25, 11. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

6

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

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Keeping Current In order to stay informed about patents and patent applications dealing with frequent urination, 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 “frequent urination” (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 frequent urination. You can also use this procedure to view pending patent applications concerning frequent urination. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 4. BOOKS ON FREQUENT URINATION Overview This chapter provides bibliographic book references relating to frequent urination. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on frequent urination include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Kidney and Urinary Tract Diseases and Disorders Sourcebook Source: Detroit, MI: Omnigraphics, Inc. 1997. 602 p. Contact: Available from Omnigraphics, Inc. Penobscot Building, Detroit, MI 48226. (800) 234-1340 or (313) 961-1340. Fax (313) 961-1383. PRICE: $75.00. ISBN: 0780800796. Summary: This sourcebook provides nontechnical information to address the concerns of those who live with kidney and urinary tract diseases and disorders. The book provides research, diagnostic, and treatment information; demographic and statistical data; and lists of resources. The book's 43 chapters are presented in 10 sections. General Information on Kidney and Urinary Tract Disease Resources provides general information on and contacts for organizations that support patients with kidney disease. In addition, a glossary provides definitions of terms associated with kidney disease. Introduction to the Kidneys explains normal kidney function and the complications that

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result from a nonfunctioning organ. Also included in this section is information about kidney disease among African Americans, a population in which the incidence of various kidney diseases is disproportionately high. Kidney Disorders in Children discusses the diagnosis, treatment, and followup care for those with Wilms' Tumor (a form of kidney cancer that most often appears in children) and childhood nephrotic syndrome. Understanding Adult Kidney Disorders describes the symptoms, diagnosis, and treatment options available to those with common and rare kidney problems. Cancer and the Kidney contains recent information about the diagnosis and treatment of kidney cancer, including an online service for kidney cancer patients. End-stage Renal Disease (ESRD), Dialysis, and Amyloidosis presents material on the differences between the various treatments of ESRD, the nutritional needs of ESRD patients, and related health concerns such as the risk of AIDS and amyloidosis in dialysis patients. General Information on Urinary Tract Disorders gives basic facts about urologic diseases and disorders, including when to be concerned about blood in the urine, and explains the information that is gained from a urinalysis. Children and Urinary Tract Disorders addresses common problems including bedwetting, frequent urination, and urinary reflux in children. Understanding Adult Urinary Tract Disorders supplies information about incontinence, interstitial cystitis, and urinary tract infections. The resources in this section are designed to help the reader and concerned loved ones to gain basic information about the causes and treatment of these problems and can provide a basis of discussion with a health professional. Finally, Cancer of the Urinary Tract delineates diagnosis, treatment, and coping strategies for those faced with cancer of the bladder and urethra. Throughout the guidebook, readers are provided with suggestions for additional resources, including supporting organizations. A detailed subject index concludes the volume. (AA-M).

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

What Type of Diabetes Do You Have? Source: in Rubin, A.L. Diabetes for Dummies. Foster City, CA: IDG Books Worldwide, Inc. 1999. p. 25-42. Contact: Available from IDG Books Worldwide, Inc. 919 E. Hillsdale Blvd., Suite 400, Foster City, CA 94404-2112. (800) 762-2974 or (416) 293-8464. Website: www.idgbooks.com. PRICE: $19.99 plus shipping and handling. ISBN: 076455154X. Summary: This chapter provides people who have diabetes with information on the functions of the pancreas and the symptoms, causes, and prevention of type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease. In some genetically predisposed people, an environmental trigger may be needed to cause type 1 diabetes, whereas in others, the disease is an entirely autoimmune destruction of the beta cells. Symptoms of

Books

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type 1 diabetes include frequent urination, increased thirst, weight loss, increased hunger, and weakness. Although primary methods for preventing type 1 diabetes are still being investigated, some of the more promising secondary prevention approaches include steroid drugs, cytotoxic drugs, nicotinamide, and insulin. Type 2 diabetes is a disease of gradual onset in which the body resists the normal, healthy functioning of insulin. Symptoms may be mild at first, so they may be ignored. Symptoms include fatigue; frequent urination and thirst; blurred vision; slow healing of skin, gum, and urinary tract infections; genital itching; numbness in the feet or legs; heart disease; and obesity. Although genetic inheritance causes type 2 diabetes, environmental factors trigger it. Major environmental factors include high body mass index, physical inactivity, central distribution of fat, and low intake of dietary fiber. Type 1 and type 2 diabetes differ with regard to age of onset, body weight, level of glucose, and severity of onset. Pregnant women may develop gestational diabetes. In addition, other types of diabetes include diabetes due to loss or disease of pancreatic tissue, diabetes due to other diseases, diabetes due to hormone treatments for other diseases, and diabetes due to medications. 1 figure. •

What Is Diabetes? Source: in Siminerio, L.M. and Betschart, J. American Diabetes Association Guide to Raising a Child with Diabetes. 2nd ed. Alexandria, VA: American Diabetes Association. 2000. p. 1-9. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $16.95 plus shipping and handling. ISBN: 1580400272. Summary: This chapter, part of a book on raising a child with diabetes, provides an overview of diabetes. The chapter focuses on the causes of type 1 diabetes, identifies the signs and symptoms of diabetes, and discusses the management of blood glucose levels. Diabetes occurs when the body either does not make any or enough insulin or it cannot use the insulin it makes properly. As a result, glucose remains in the blood and cells starve. The most common types of diabetes are type 1 and type 2 diabetes. Although the causes of type 1 diabetes are not well understood, it is known that pancreatic beta cells are destroyed through an autoimmune process. This process may be triggered by a virus. In addition, genetic predisposition may increase the risk for type 1 diabetes. Signs and symptoms of diabetes include frequent urination, excessive thirst, weight loss, increased appetite, tiredness and weakness, and vision problems. Hypoglycemia is a common side effect of treatment in children with diabetes and needs to be treated with a sweet food. Another problem that children who have type 1 diabetes may experience is diabetic ketoacidosis. Parents, a child, and his or her health care provider should determine what the child's target blood glucose range should be to help prevent the complications of diabetes.

•

Who, What, Where, Why, and How of Type II Diabetes Source: in Magee, E. Tell Me What to Eat If I Have Diabetes. Franklin Lakes, NJ: Career Press, Inc. 1999. p. 7-13. Contact: Available from Career Press, Inc. 3 Tice Road, P.O. Box 687, Franklin Lakes, NJ 07417. (800) 227-3371. Website: www.careerpress.com or www.newpagebooks.com. PRICE: $10.99 plus shipping and handling.

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Summary: This introductory chapter is from a book that offers eating and nutrition guidelines for people who have been diagnosed with diabetes mellitus. The author focuses on type 2 diabetes, noting that diabetes can manifest differently in different patients and sometimes even changing throughout its course within one person. The author encourages readers to learn as much as they can about their disease and to utilize nutrition as an adjunct therapy and a vital component of their diabetes care. Type 2 diabetes is a metabolic disorder resulting from the body's inability to make or properly use insulin. Most people (90 to 95 percent) with diabetes have type 2. The warning signs of type 2 diabetes include frequent infections, blurred vision, cuts and bruises that are slow to heal, tingling or numbness in the hands or feet, unusual thirst, frequent urination, extreme hunger, unusual weight loss, extreme fatigue, and irritability. The author outlines the three keys to diabetes management success: monitoring blood glucose levels, exercising regularly, and following a personalized eating plan. The author emphasizes the importance of following a personalized eating plan that helps keep blood glucose (sugar) levels normal, and helps protect against heart disease and weight gain without making the patient feel deprived. The chapter concludes with a brief section of sources for additional information, including the American Association of Certified Diabetes Educators (800-832-6874), the American Dietetic Association's National Center for Nutrition and Dietetics (800-366-1655), and the American Diabetes Association (800-342-2383).

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CHAPTER 5. MULTIMEDIA ON FREQUENT URINATION Overview In this chapter, we show you how to keep current on multimedia sources of information on frequent urination. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

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

Prostate: Why Does It Enlarge? What Should I Do About It? Source: Hanover, MD: American Prostate Society. 1994. (videocassette). Contact: Available from American Prostate Society. 1340-F Charwood Road, Hanover, MD 21076-3169. (410) 859-3735. E-mail: [email protected]. Web site: http://www.ameripros.org. PRICE: Contact producer directly for current price. Summary: This patient education videotape provides viewers with an overview of benign prostatic hyperplasia (BPH) or enlargement. Narrated by Doug Roberts, the program first defines BPH, describes the role of the prostate gland, and describes how an enlarged prostate can affect urination. The program then covers the symptoms of BPH, which include a weak or interrupted urine stream, the sensation of incomplete bladder emptying, urine leakage, difficulty starting urination, frequent urination, especially at night, and an uncontrollable urge to urinate. The program then outlines three options for men with BPH: watchful waiting (close monitoring), medications, and

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surgery. The section on surgery focuses on transurethral resection of the prostate (TURP), showing how the procedure is done, and describing the possible side effects. These side effects include sexual dysfunction (retrograde ejaculation occurs in up to 50 percent of patients), sexual impotence (5 percent), and urinary incontinence (1 percent). The section on drug therapy describes Hytrin (terazosin hydrochloride), which works as a muscle relaxant on the 40 percent of the prostate that is made of smooth muscle, and Proscar, which shrinks the prostate. The side effects of both medications are discussed. The last section of the video describes the risk factors for BPH and the roles of the PSA (prostate specific antigen) test and the rectal examination in screening and diagnosis of prostate problems. The video concludes with a brief message from Claude Gerard, the founder of the American Prostate Society, who encourages viewers to consult a health care provider with any urinary problems and to take the time to have screening tests done for prostatic diseases. The program features graphics, real-time footage of a TURP procedure, interviews with patients, and footage of a variety of men in active physical settings, including sports and recreation activities. •

Diabetes: Multiple Ways to Gain Control Source: Calhoun, KY: NIMCO. 1994. (videocassette). Contact: Available from NIMCO. P.O. Box 9, 117 Highway 815, Calhoun, KY 423270009. (800) 962-6662 or (502) 273-5050. Fax (502) 273-5844. PRICE: $39.95. Order number: NIM-SM-CD2-V. Summary: This video which focuses on new developments in the treatment of diabetes, explains what diabetes is and reviews common symptoms and risk factors. Symptoms include excessive thirst, hunger, fatigue, blurred vision, frequent urination, and tingling in the hands and feet. Risk factors include being overweight and over 40 years old, having a family history of diabetes, and experiencing stress. The video then explains the team concept of care, which involves the patient interacting with a physician, dietitian, diabetes educator, pharmacist, and podiatrist. In addition, the video stresses meal planning, physical activity, medications, education, and self monitoring as ways to gain control of the disease.

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Bladder Leakage (Urinary Incontinence): Don't Suffer in Silence! Source: Royal Palm Beach, FL: Hepworth International, Inc. 1996. (videocassette). Contact: Available from SRS Medical Systems, Inc. 14950 NE 95th Street, Redmond, WA 98052. (800) 345-5642 or (425) 882-1101. PRICE: $19.95 each. Item number 4632B. Summary: This videotape program educates the public about treatments for bladder leakage. The program features experts in the field of urinary incontinence (UI) explaining the various treatment options. Topics covered include the types and causes of bladder leakage, prevention strategies (particularly before and after surgery, including childbirth), a structured program of pelvic muscle exercises (Kegels), foods and beverages that cause frequent urination, how to control the urge to urinate, treatment options including surgery and drug therapy, and where to find additional help and information. The program emphasizes that education and knowledge are the first steps toward successful treatment. The video comes with a self-test that helps viewers determine if they are a candidate for medical treatment for bladder leakage (UI). This viewer insert also lists beverages and foods to avoid if UI is a problem. (AAM).

Multimedia 23

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New Definition of Diabetes Source: Los Angeles, CA: National Health Video, Inc. 1998. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Blvd., Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail: [email protected]. PRICE: $89.00 plus shipping and handling. Order number 283. Summary: This videotape provides people who have diabetes with information on the new definition of the disease. The videotape begins by explaining the revised fasting plasma glucose (FPG) criteria and their diagnostic implications and discussing the impaired fasting glucose (IFG) category. Diabetes is diagnosed as a FPG level of 126 or above. The criteria for diagnosis were lowered to allow for earlier identification of diabetes so that complications can be prevented. IFG is defined as a blood glucose level of 110 to 125. People with such a value do not yet have diabetes, but they are at risk of developing it. The video continues by identifying factors that indicate the need for diabetes testing, including excessive thirst, frequent urination, weight loss, a family member who has diabetes, age over 45, and obesity. This is followed by an explanation of type 1 and type 2 diabetes. In addition, the videotape presents the food guide pyramid tailored for persons who have diabetes and provides suggestions on food preparation and exercise.

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CHAPTER 6. PERIODICALS AND NEWS ON FREQUENT URINATION Overview In this chapter, we suggest a number of news sources and present various periodicals that cover frequent urination.

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

Kidney transplant can lead to frequent urination Source: Reuters Health eLine Date: October 09, 2001

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “frequent urination” (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 “frequent urination” (or synonyms). If you know the name of a company that is relevant to frequent urination, 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 “frequent urination” (or synonyms).

Periodicals and News

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Newsletters on Frequent Urination Find newsletters on frequent urination using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “frequent urination.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “frequent urination” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Kidney Disease Source: Sarcoidosis Networking. 8(3): 2. May-June 2000. Contact: Available from Sarcoid Network Association. Sarcoidosis Networking, 13925 80th Street East, Puyallup, WA 98372-3614. Email: [email protected]. Summary: Sarcoidosis is a chronic, progressive systemic granulomatous (causing lesions) disease of unknown cause (etiology), involving almost any organ or tissue, including the skin, lungs, lymph nodes, liver, spleen, eyes, and small bones of the hands or feet. This brief article, from a newsletter for patients with sarcoidosis, reviews kidney disease, its types, diagnosis, and management. The article begins with a summary of the anatomy and function of the kidneys, which filter the blood (removing waste and excess body fluids), and maintain the balance of some essential nutrients helping to regulate blood pressure, red blood cells, and elements such as potassium and calcium. Without functioning kidneys, one cannot live without dialysis, the mechanical filtration of the blood. Kidneys fail for a variety of reasons, including trauma to the kidney, toxins, heart failure, obstruction (kidney stones), overuse of some medications, and diseases that invade the kidney, such as sarcoidosis. Diabetes and high blood pressure are the most common causes for loss of kidney function. Warning signs of kidney disease are high blood pressure (hypertension), blood or protein in the urine, creatinine level greater than 1.2 in women or 1.4 in men, more frequent urination (especially at night), difficult or painful urination, and puffy eyes or swelling of the hands or feet (especially in children). Loss of kidney function can produce symptoms including fatigue, weakness, nausea, vomiting, diarrhea or constipation, headaches, loss of appetite, increased edema (fluid retention), and fever or chills. Kidney failure is characterized as acute kidney failure, chronic kidney insufficiency, and chronic kidney failure. The need to put a person on dialysis depends upon the levels of creatinine and urea nitrogen in the blood and the evaluation of body parameters such as fluid status, and symptoms of toxicity. The author encourages readers to practice preventive measures which include drinking 8 to 10 glasses of water per day, preventing or treating diabetes and high blood pressure, avoiding tobacco, eating a well balanced diet, practicing good hygiene, treating wounds and infections, limiting exposure to heavy metals and toxic chemicals, and avoiding unnecessary over the counter drug use.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you

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prefer. For the format option, select “Newsletter Article.” Type “frequent urination” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on frequent urination: •

Nocturia: When Nature Calls at Night Source: Harvard Health Letter. 24(10): 6. August 1999. Contact: Available from Harvard Medical School Health Publications Group. Harvard Health Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail: [email protected]. Summary: This health newsletter article describes nocturia, the condition of frequent urination at night. Nocturia is often more of a bother than a major burden, but readers are cautioned that it can be a sign of early kidney, bladder, or prostate disease. Nocturia can also be a byproduct of heart failure and other conditions that cause edema (retention of fluid). Physicians usually treat nocturia by addressing the conditions that cause it. More men in their 40s and 50s are bothered by nocturia than women the same age, but the numbers start to even out with age. For men, nocturia is often associated with prostate problems. In this situation, the bladder can't completely empty because benign prostatic hyperplasia (BPH), the noncancerous enlargement of the prostate gland, compresses the urethra and slows or impedes the flow of urine. For women, childbirth and lower estrogen levels cause the muscles of the pelvic floor to weaken. Weaker pelvic floor muscles can mean less control and more interruptions at night to urinate. The article concludes by encouraging readers to seek treatment for nocturia, particularly that which interferes with adequate sleep, as there are a variety of approaches to the problem. 1 figure.

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Principles of Bladder Retraining Source: Quality Care. 15(3): 5. Summer 1997. Contact: Available from National Association for Continence. P.O. Box 8310, Spartanburg, SC 29305-8310. (800) 252-3337 or (864) 579-7900. Fax (864) 579-7902. Summary: This newsletter article reviews the principles of bladder retraining. Bladder training is a simple and effective treatment in the management of urge, stress, and mixed incontinence, as well as of urgency-frequency symptoms without incontinence. It consists of a program of scheduled toileting separated by gradually increasing intervals, in combination with strategies to control bladder urgency. The goals of treatment are to correct faulty patterns of frequent urination, improve the ability to control bladder urgency, prolong voiding (toileting) intervals, reduce incontinence episodes, and restore one's confidence in the ability to control bladder function. The author then outlines the specifics of bladder training for readers who wish to try the method. The initial toileting schedule is set up depending on habitual voiding patterns. Patients are then encouraged to void on schedule whether or not the need is felt. Every effort should be made not to void in between scheduled toiletings. A daily record of toiletings and incontinence episodes should be kept. Patients should stay on a specific schedule for a minimum of 1 week. If this schedule is kept without too many interruptions due to urgency, and the number of incontinence episodes is reduced, then the schedule should be increased by 30 minutes. Patients should aim for a goal of voiding every 2 to 3 hours. The author also lists distraction strategies to use while undertaking bladder retraining.

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

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

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

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to frequent urination: Lypressin •

Systemic - U.S. Brands: Diapid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202334.html

Vasopressin •

Systemic - U.S. Brands: Pitressin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202591.html

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

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

35

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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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.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 “frequent urination” (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 280 5 963 0 144 1392

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 “frequent urination” (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.

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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.

41

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 frequent urination can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased 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 frequent urination. 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 frequent urination. 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 “frequent urination”:

42

•

Frequent Urination

Other guides Bladder Diseases http://www.nlm.nih.gov/medlineplus/bladderdiseases.html Prostate Cancer http://www.nlm.nih.gov/medlineplus/prostatecancer.html Prostate Diseases http://www.nlm.nih.gov/medlineplus/prostatediseases.html Toilet Training and Bedwetting http://www.nlm.nih.gov/medlineplus/toilettrainingandbedwetting.html Urinary Tract Infections http://www.nlm.nih.gov/medlineplus/urinarytractinfections.html

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

Prostate Health: Basic Facts for Better Health. What Every Man Should Know Source: Baltimore, MD: American Foundation for Urologic Disease. 200x. 32 p. Contact: Available from American Foundation for Urologic Disease (AFUD). 1128 North Charles Street, Baltimore, MD 21201. (800) 242-2383. Website: www.afud.org. PRICE: $13.00 for pack of 50; plus shipping and handling. Summary: Designed for men over the age of 40, this health education brochure explains how the prostate works, the problems that can happen with the prostate, the tests that are used to diagnose prostate diseases, and treatment options. Some of the prostate problems discussed are enlarged prostate (benign prostatic hyperplasia, BPH), prostatitis (inflammation of the prostate), and prostate cancer. The brochure focuses on the importance of the digital rectal examination (DRE) to identify prostate problems of all sorts and to identify them early enough for successful treatment options to be initiated. Some symptoms that may indicate a prostate problem include a weak urinary stream, difficulty starting urination, interruption of the stream (stopping and starting), pain or burning on urination, urgency (difficulty postponing urination), frequent urination, awakening often at night to urinate, and blood in the urine. Diagnostic methods include a thorough medical history, the physical examination (including the

Patient Resources

43

DRE), and the prostate specific antigen (PSA) test. For BPH, if men are not bothered by their symptoms, they may just be put on a program of watchful waiting, which entails regular followup but no actual treatment. Other treatments are drug therapy, thermal (heat based) therapy, surgery, and alternative treatments (such as herbal remedies). The brochure describes the four types of surgery that may be used for BPH: transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), open prostatectomy (removal of the prostate), and laser surgery. Prostatitis (acute, chronic, or noninfectious) is treated based on type; treatment can include antimicrobials, muscle relaxants, and lifestyle changes. When prostate cancer is diagnosed early, the chances for curative treatment are greatly increased. After classification, the cancer is treated by surgery, radiation therapy, hormonal therapy, or a combination. The brochure concludes with a glossary of terms used in the text. 3 figures. 1 table. •

Polycystic Kidney Disease: The Most Common Life-Threatening Genetic Disease Source: Kansas City, MO: PKD (Polycystic Kidney Disease) Foundation. 200x. [7 p.]. Contact: Available from PKD (Polycystic Kidney Disease) Foundation. 9221 Ward Parkway, Suite 400 Kansas City, MO 64114.(800) PKD-CURE. Fax (816) 931-8655. Email:[email protected]. Website: www.pkdcure.org. PRICE: Single copy free. Summary: Polycystic kidney disease (PKD) is a disease that comes in two hereditary forms: autosomal dominant (ADPKD), the most common of all life threatening genetic diseases, or autosomal recessive (ARPKD), a relatively rare disease that often causes significant mortality in the first month of life. This brochure describes PKD and the work of the PKD Foundation, formerly called the Polycystic Kidney Research Foundation, an organization devoted to improving clinical treatment and discovering a cure for PKD. With the presence of PKD, cysts develop in both kidneys. There may be just a few cysts or many, and the cysts may range in size from a pinhead to the size of a grapefruit. Cysts are sacs of fluid that cause the kidney to enlarge and can hinder its filtering ability. Cysts also squeeze on blood vessels, forcing the pressure to rise. Beyond high blood pressure, symptoms of PKD include fatigue, frequent urination, blood in the urine, headaches, kidney stones, or urinary tract infections. ADPKD is not limited to the kidneys; common complications can include abnormalities in the vascular and cardiac systems. There are three main clinical tests used to diagnose PKD: ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI). Current research demonstrates that a person with ADPKD may play a major role in controlling the disease with regular health care maintenance, a good diet, and regular exercise. The booklet describes many of the PKD Foundation's activities in research funding and advances, public awareness, and education. The booklet concludes with an invitation for readers to join the PKD Foundation and send a donation to support the work of this organization. 2 figures.

•

Diabetes: How Do I Know If I Have It? Source: American Family Physician. 62(9): 2137-2138. November 1, 2000. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. Summary: This article uses a question and answer format to provide people with information on the symptoms and diagnosis of diabetes. This disease, which occurs when the body does not make enough insulin or the body does not use insulin properly, can result in many complications if left untreated. Early symptoms may include extreme thirst, frequent urination, unexplained weight loss, blurry vision, unusual tiredness or

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drowsiness, tingling or numbness in the hands or feet, and frequent or recurring skin, gum, and bladder infections. Risk factors include age, body weight, inactivity, family history, and ethnic heritage. Testing for diabetes is usually done with a fasting blood test. Although a test result higher than 125 milligrams per deciliter suggests diabetes, two tests with this result on two different days are needed for a diagnosis of diabetes. Early diagnosis is important to prevent the complications of diabetes. The American Diabetes Association can provide people with more information about diabetes. •

Diabetes: Get the Facts Source: Santa Cruz, CA: ETR Associates. 2000. 15 p. Contact: Available from ETR Associates. 4 Carbonero Way, Scotts Valley, CA 950664200. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: Single copy free; $16.00 for 50 copies, discounts for larger orders. Order number: R349. Summary: This booklet provides people who have type 2 diabetes with information on the symptoms, diagnosis, and management of this disease. People who have type 2 diabetes do not make enough insulin or their body does not use the insulin it makes as well as it should. Symptoms include frequent urination and feeling tired, weak, very thirsty, hungry, and irritable. The most common test used in the diagnosis of type 2 diabetes is the fasting plasma glucose test. Many people can manage their diabetes by losing weight, eating healthy foods every day, and being physically active. However, some people may need to take oral drugs or insulin to manage their diabetes. The booklet provides guidelines for taking medications, checking blood sugar, coping with sick days, and managing low and high blood sugar. In addition, the booklet outlines the tests that people who have diabetes should undergo at every checkup, two to four times per year, and once per year.

•

Diabetes: In Your Family, and Your Future? Source: Albany, NY: New York State Health Department. 1995. 4 p. Contact: Available from New York State Health Department. Box 2000, Albany, NY 12220. PRICE: Single copy free. Summary: This brochure advises readers to consider whether they have a family history of type 2 diabetes. People who have immediate family members with diabetes are at higher risk for developing it themselves. Others at higher risk include African Americans, Hispanics, Native Americans, people 45 and older, overweight people, those who do not exercise, and women who have delivered babies who weighed more than nine pounds at birth. Although it is possible to have type 2 diabetes for years without knowing it, common symptoms include thirst and frequent urination, increased appetite, unexplained weight loss, and fatigue. The brochure notes that people with a family history of diabetes should have annual medical checkups that include a blood test for glucose. Improved diet and exercise habits can help to prevent diabetes. (AA-M).

•

Enlarged Prostate: BPH and Male Urinary Problems Source: Baltimore, MD: American Foundation for Urologic Disease. 1998. 12 p. Contact: Available from American Foundation for Urologic Disease (AFUD). 1128 North Charles Street, Baltimore, MD 21201. (800) 242-2383. Website: www.afud.org. PRICE: $13.00 for pack of 50; plus shipping and handling.

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Summary: This brochure describes a particular prostate disease: noncancerous enlargement of the prostate or benign prostatic hyperplasia (BPH). Topics include the anatomy and physiology of the prostate, a definition of BPH, the symptoms of BPH, how it is diagnosed, how it differs from prostate cancer, when to see a specialist, when BPH requires treatment, surgical treatment, nonsurgical treatments, and lifestyle issues. A brief quiz at the beginning of the brochure emphasizes the information that all men should know. The prostate is a gland of the male reproductive system; the gland is made up largely of muscular and glandular tissues and its main function is to produce fluid for semen, which transports sperm. The symptoms of BPH can include a weak urinary stream, difficulty starting urination, interruption of the stream (stopping and starting), pain or burning on urination, urgency (difficulty postponing urination), frequent urination, and awakening frequently at night to urinate. Diagnostic methods include a thorough medical history and the physical examination, including the digital rectal examination. For BPH, if men are not bothered by their symptoms, they may just be put on a program of watchful waiting, which entails regular followup but no actual treatment. Other treatments are drug therapy, thermal (heat based) therapy, surgery, and alternative treatments (such as herbal remedies). The brochure describes the four types of surgery that may be used for BPH: transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), open prostatectomy (removal of the prostate), and laser surgery. The brochure reiterates the differences between BPH and prostate cancer and cautions readers that they must stay vigilant for the signs of prostate cancer, which is best treated when detected early. The brochure concludes with a glossary of terms used in the text and the answers to the pretest. 5 figures. •

Diabetes: Should I Worry? Source: Santa Cruz, CA: ETR Associates. 1997. 2 p. Contact: Available from ETR Associates. 4 Carbonero Way, Scotts Valley, CA 950664200. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: Single copy free; $16.00 for 50 copies, discounts for larger orders. Order number: R300. Summary: This brochure provides introductory information about diabetes. Diabetes symptoms may include frequent urination; tiredness and weakness; an ill feeling; unusual thirst; weight loss; blurred vision; slow healing of cuts, sores, or infections; hunger most of the time; and dry, itchy skin. Topics include insulin, risk factors, the three types of diabetes, prevention, and monitoring. The author notes that the risk for developing diabetes increases if a person has an immediate family member with diabetes; is 20 percent or more over ideal weight; is over 40; is Native American, African American, Asian American, or Hispanic; or has had gestational diabetes. In order to reduce the risk for developing diabetes, a person should maintain body weight in the normal range; lose weight if he or she is 20 percent over ideal weight; exercise to control weight and more effectively use insulin; and get regular health checkups. Health care professionals should help people with diabetes monitor ideal weight, diet, exercise, blood glucose levels, medication, and regular health care. Contact information for four diabetes organizations concludes the brochure. (AA-M).

•

Diabetes: What Is It? Source: Lexington, KY: Lexington-Fayette County Health Department. 1995. 4 p. Contact: Available from Lexington-Fayette County Health Department. Division of Nutrition and Health Education, 650 Newtown Pike, Lexington, KY 40508. (606) 2882333. Fax (606) 288-2359. PRICE: $15.00 per 50 copies plus shipping.

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Summary: This general introduction to diabetes is one in a series of 22 diabetes education materials that combine practical tips and humorous drawings with current diabetes information. The series is written at a sixth grade reading level and is designed to teach and motivate patients to take care of themselves. The fact sheet provides a description of how insulin helps the body use glucose for energy and what happens when the insulin is missing or when the body doesn't use the available insulin. The fact sheet illustrates the symptoms of diabetes, including excessive thirst and hunger, tiredness, frequent urination, blurred vision, weight loss, and sores that won't heal. The fact sheet continues by defining Type 1 and Type 2 diabetes and describing how each is treated. The fact sheet concludes with a brief section on impaired glucose tolerance (IGT). •

You Can Do Something About Incontinence: A Physical Therapist's Perspective Source: Alexandria, VA: American Physical Therapy Association (APTA). 1998. 8 p. Contact: Available from American Physical Therapy Association (APTA). 111 North Fairfax Street, Alexandria, VA 22314-1488. (800) 999-APTA or (800) 999-2782. E-mail: [email protected]. Website: www.apta.org. PRICE: $18.75 per package of 25 for nonmembers; $12.50 per package of 25 for members. Order number PR-198. Summary: This illustrated brochure helps people who have urinary incontinence understand incontinence and the different kinds of physical therapy options available to manage the condition or regain complete continence. Urinary incontinence is the involuntary loss of urine. Besides leakage, symptoms include an urgent need to urinate, frequent urination, and nocturia (urinating at night). Many factors contribute to urinary incontinence, including childbirth, obesity, improper lifting of heavy objects, chronic constipation, or post-menopause. Urinary incontinence can be stress incontinence, the sudden involuntary loss of urine when exercising or moving in a certain way, or urge incontinence, defined as urine leakage that occurs as soon as a person senses the need to urinate. Treatments for urinary incontinence include patient education, bladder retraining and timed schedules for urinating, exercises or vaginal weights to strengthen the pelvic floor muscles, medication, dietary modifications, and surgery. One section of the brochure describes Kegel exercises (exercises to strengthen the pelvic floor muscles to help improve bladder control) in detail. A physical therapist may also use biofeedback or electrical stimulation of the pelvic floor muscles to strengthen those muscles. In addition, various lifestyle modifications may help reduce bladder irritation. The brochure is illustrated with simple line drawings and concludes with a brief description of the work of the American Physical Therapy Association (APTA). 7 figures.

•

Six Warning Signs of Kidney and Urinary Tract Disease Source: New York, NY: National Kidney Foundation, Inc. 199x. 1 p. Contact: Available from National Kidney Foundation, Inc. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free; bulk copies available. Summary: This leaflet uses simple images to explain six warning signs of kidney and urinary tract disease. Signs covered include burning or difficulty during urination; more frequent urination; passage of bloody-appearing urine; puffiness around eyes, or swelling of hands and feet; pain in the small of the back just below the ribs; and high blood pressure. The leaflet is printed in bright purple and pink, and includes graphics illustrating each of the six warning signs.

Patient Resources

•

47

Prostatitis: Patient Education Source: Tarrytown, NY: Bayer Corporation. 1999. 11 p. Contact: Available from Bayer Corporation. Diagnostics Division, 511 Benedict Avenue, Tarrytown, NY 10591-5097. (800) 445-5901. PRICE: Single copy free. Summary: This patient education brochure reviews prostatitis, inflammation or infection of the prostate gland. The brochure defines the condition, describes risk factors and causes, outlines the diagnostic approaches that may be used, reviews treatment options, and offers suggestions for prevention. In most men, the prostate gland begins a gradual process of enlargement at about 40 years of age; benign prostatic hyperplasia (BPH) does not always cause problems, although it can result in problems with urination. Prostatitis is a different condition, usually caused by infections by bacteria or other organisms. Prostatitis can be a secondary problem related to the urinary retention (urine remaining in the bladder or urethra after urination) caused by BPH; a chemical in the urine (urate) can irritate the tissues of the prostate gland and cause inflammation. There are three major types of prostatitis: bacterial, nonbacterial, and prostatodynia (pain in the area of the prostate gland). Symptoms of bacterial prostatitis are often severe and therefore quickly diagnosed; they include fever, chills, pain in the lower back, aching muscles, fatigue, and frequent or painful urination. Nonbacterial prostatitis (occurring in about 10 percent of cases) is harder to diagnose and often presents with occasional vague discomfort in the testicles, urethra, lower abdomen, and back, discharge from the urethra, blood or urine in the ejaculate, low sperm count, sexual difficulties, and frequent urination. Diagnosis includes the digital rectal exam (DRE) to reveal the size, shape, and texture of the prostate; prostate massage; sequential urine test; needle biopsy; prostate specific antigen (PSA) test; and imaging tests, such as ultrasound, x rays, magnetic resonance imaging (MRI), and computed tomography (CT scan). Treatment often includes antibiotics and other drugs to combat urinary problems; thermotherapy (heating the prostate gland) may also be used. Alternative or adjunctive therapies include topical heat and cold therapy, zinc supplemenation, and antianxiety medications. The brochure concludes with a brief glossary of terms and a short list of resources for readers wishing to obtain additional information. A tear-off section lists the topics covered in the booklet; readers are encouraged to check off the items corresponding to issues they would like to discuss with their health care provider, to use the checklist as a reminder tool.

•

Urinary Tract Infections Source: Emeryville, CA: Parlay International. 1997. [4 p.]. Contact: Available from Parlay International. Box 8817, Emeryville, CA 94662-0817. (800) 457-2752. Website: www.parlay.com. PRICE: $20.00 per package of 50. Order number: 7026. Summary: Urinary tract infection is a common problem affecting men, women, and children; women are more prone to developing the infection due to the structure of their urinary system. This brochure provides basic information about urinary tract infections (UTIs), emphasizing the importance of recognizing the symptoms and obtaining prompt medical assistance. The brochure outlines the female urinary tract (a simple drawing is included) and the function of each organ in the urinary tract. The bladder and urethra make up the lower urinary tract and are the most common site for infection. Bladder infection, commonly known as cystitis, is usually mild. By seeking medical attention promptly, a variety of antibiotic treatments can be administered to help prevent further discomfort and effect a rapid cure. The majority of cases of UTIs exhibit three common

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symptoms: discomfort or burning during urination, feeling the need to urinate more than usual, and frequent urination (often in small amounts). Other symptoms may include lower back and side pain and lower abdominal soreness or slight fever, which are also possible signs of a kidney infection. The brochure briefly describes the use of urinalysis to pinpoint diagnosis and therefore optimize therapy. Various antibiotic treatments are available, depending on the individual's condition. Repeat UTI is not uncommon. Some people achieve relief with prescribed preventive antibiotic therapy. The brochure reiterates the importance of recognizing the symptoms and getting medical care, not attempting to self-treat. 1 figure. 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 frequent urination. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Patient Resources

49

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

51

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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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

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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/

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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 53 •

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/

•

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

•

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

•

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

•

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

•

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries 55 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

57

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

59

FREQUENT URINATION DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] 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] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonists: Drugs that trigger an action from a cell or another drug. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [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

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herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Androgenic: Producing masculine characteristics. [EU] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the capillaries, and characterized by development of giant wheals. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidiabetic: An agent that prevents or alleviates diabetes. [EU] Antidiabetic Agent: A substance that helps a person with diabetes control the level of glucose (sugar) in the blood so that the body works as it should. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU]

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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] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [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] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Benzyl Alcohol: A colorless liquid with a sharp burning taste and slight odor. It is used as a local anesthetic and to reduce pain associated with lidocaine injection. Also, it is used in the manufacture of other benzyl compounds, as a pharmaceutic aid, and in perfumery and flavoring. [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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived 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]

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Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] 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]

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Cell Division: The fission of a cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Checkup: A general physical examination. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] 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] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] 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] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [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]

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Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Continence: The ability to hold in a bowel movement or urine. [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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cystitis: Inflammation of the urinary bladder. [EU] Cytotoxic: Cell-killing. [NIH] Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Dehydration: The condition that results from excessive loss of body water. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Ketoacidosis: Complication of diabetes resulting from severe insulin deficiency coupled with an absolute or relative increase in glucagon concentration. The metabolic acidosis is caused by the breakdown of adipose stores and resulting increased levels of free fatty acids. Glucagon accelerates the oxidation of the free fatty acids producing excess ketone bodies (ketosis). [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the

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alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digital rectal examination: DRE. An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Dysuria: Painful or difficult urination. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [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] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach.

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[NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethisterone: 17 alpha-Hydroxypregn-4-en-20-yn-3-one. A synthetic steroid hormone with progestational effects. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excrete: To get rid of waste from the body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Facial: Of or pertaining to the face. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH]

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Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [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] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to 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]

Genital: Pertaining to the genitalia. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and

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used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] 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] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to

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an increase in the number of cells. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical

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patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intravenous: IV. Into a vein. [NIH] Intravenous pyelography: IVP. X-ray study of the kidneys, ureters, and bladder. The x-rays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. [NIH] Intravesical: Within the bladder. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [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] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually

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associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney Pelvis: The flattened, funnel-shaped expansion connecting the ureter to the kidney calices. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [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] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH]

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Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Medical Assistance: Financing of medical care provided to public assistance recipients. [NIH] 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] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other

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procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] 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] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] 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,

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epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nocturia: Excessive urination at night. [EU] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ocular Hypertension: A condition in which the intraocular pressure is elevated above normal and which may lead to glaucoma. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Overactive bladder: A condition in which the patient experiences two or all three of the following conditions: [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH]

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Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

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

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Podiatrist: A doctor who treats and takes care of people's feet. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation

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of, or exposure to a deleterious agent. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino

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acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [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] 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]

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Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reinfection: A second infection by the same pathogenic agent, or a second infection of an organ such as the kidney by a different pathogenic agent. [EU] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [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] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Self Administration: Administration of a drug or chemical by the individual under the direction of a physician. It includes administration clinically or experimentally, by human or animal. [NIH]

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Self Medication: The self administration of medication not prescribed by a physician or in a manner not directed by a physician. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] 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]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Sperm: The fecundating fluid of the male. [NIH] Sperm Count: A count of sperm in the ejaculum, expressed as number per milliliter. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress incontinence: An involuntary loss of urine that occurs at the same time that internal

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abdominal pressure is increased, such as with laughing, sneezing, coughing, or physical activity. [NIH] Stress urinary: Leakage of urine caused by actions--such as coughing, laughing, sneezing, running, or lifting--that place pressure on the bladder from inside the body. Stress urinary incontinence can result from either a fallen bladder or weak sphincter muscles. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Talc: A native magnesium silicate. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH]

Dictionary 81

Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Transurethral resection of the prostate: Surgical procedure to remove tissue from the prostate using an instrument inserted through the urethra. Also called TURP. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH]

82

Frequent Urination

Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urge urinary incontinence: Urinary leakage when the bladder contracts unexpectedly by itself. [NIH] Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital Diseases: Diseases of the urogenital tract. [NIH] Urologic Diseases: Diseases of the urinary tract in both male and female. It does not include the male genitalia for which urogenital diseases is used for general discussions of diseases of both the urinary tract and the genitalia. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] 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] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or

Dictionary 83

viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Void: To urinate, empty the bladder. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Watchful waiting: Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called observation. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

85

INDEX A Abdomen, 47, 59, 62, 65, 71, 75, 79, 80 Abdominal, 4, 48, 59, 74, 80 Abdominal Pain, 4, 59 Acidosis, 59, 64, 70 Adjuvant, 59, 67 Adrenal Glands, 59, 60 Adrenergic, 15, 59, 65 Adverse Effect, 59, 79 Affinity, 59, 79 Age of Onset, 19, 59, 81 Agonists, 10, 15, 59 Algorithms, 59, 61 Alimentary, 59, 65, 70 Alkaline, 59, 60, 62 Alpha Particles, 59, 77 Alternative medicine, 26, 59 Amino acid, 7, 60, 67, 75, 76, 81 Ammonia, 60, 81 Amyloidosis, 18, 60 Analgesic, 14, 60, 73, 81 Androgenic, 14, 60, 64 Angioedema, 14, 60 Antibiotic, 5, 47, 60 Antibiotic Prophylaxis, 5, 60 Antibody, 59, 60, 69, 73, 77 Antidiabetic, 15, 60 Antidiabetic Agent, 15, 60 Antigen, 22, 43, 47, 59, 60, 67, 69 Antimicrobial, 5, 60 Anuria, 60, 70 Anus, 60, 62, 70, 77 Arterial, 60, 68, 76, 80 Arteries, 60, 61, 62, 64, 72 Arterioles, 61, 62 Assay, 61, 69 Atypical, 15, 61 Autoimmune disease, 18, 61 B Bacteria, 47, 60, 61, 66, 72, 82 Bacteriuria, 61, 82 Base, 61, 64, 70, 71 Benign, 4, 21, 28, 42, 45, 47, 61, 64, 77 Benign prostatic hyperplasia, 21, 28, 42, 45, 47, 61 Benzyl Alcohol, 14, 61 Bile, 61, 67, 71, 79 Biochemical, 61, 66, 71

Biomarkers, 6, 61 Biopsy, 61 Biotechnology, 6, 26, 37, 61 Bladder, 3, 6, 18, 21, 22, 28, 42, 44, 46, 47, 61, 64, 69, 70, 73, 76, 78, 80, 82, 83 Blood Coagulation, 62 Blood Glucose, 4, 19, 20, 23, 45, 62, 69 Blood pressure, 27, 43, 46, 62, 68, 72, 79 Blood vessel, 43, 62, 63, 70, 71, 79, 80, 82 Body Fluids, 27, 61, 62, 79, 81 Body Mass Index, 19, 62, 74 Bowel, 62, 64, 79 Bowel Movement, 62, 64, 79 Brachytherapy, 62, 70, 77 Branch, 55, 62, 71, 79, 80 Breakdown, 62, 64, 65, 67 C Calcium, 27, 62 Capsules, 62, 67 Carbohydrate, 62, 67, 76 Carcinogenic, 62, 79 Cardiac, 43, 62, 65, 71, 73, 79 Cardiovascular, 15, 62 Cardiovascular disease, 15, 62 Case report, 4, 7, 62 Cell, 59, 61, 62, 63, 64, 66, 67, 70, 73, 75, 77, 78, 80, 83 Cell Division, 61, 63, 75 Cell Size, 63, 66 Cerebrovascular, 62, 63 Cervix, 63, 78 Checkup, 44, 63 Cholesterol, 61, 63, 64, 79 Chronic, 3, 27, 43, 46, 63, 69, 70, 71, 80 Clinical trial, 6, 37, 63 Cloning, 61, 63 Coagulation, 62, 63, 71 Collagen, 60, 63, 67 Computational Biology, 37, 63 Computed tomography, 43, 47, 63 Computerized tomography, 63 Connective Tissue, 63, 64, 66, 67, 71 Consciousness, 60, 64 Constipation, 27, 46, 64 Continence, 28, 46, 64 Contraindications, ii, 64 Coronary, 62, 64, 72 Coronary heart disease, 62, 64

86

Frequent Urination

Coronary Thrombosis, 64, 72 Creatinine, 27, 64, 71 Curare, 64, 73 Curative, 43, 64, 80 Cystitis, 6, 18, 47, 64 Cytotoxic, 19, 64, 77 D Danazol, 14, 64 Deamination, 64, 81 Dehydration, 4, 5, 64 Density, 62, 64, 66 Dermis, 60, 64 Diabetes Mellitus, 4, 20, 64, 67 Diabetic Ketoacidosis, 4, 19, 64 Diagnostic procedure, 13, 26, 64 Diarrhea, 27, 64 Diastolic, 64, 68 Dietary Fiber, 19, 64 Dietitian, 22, 65 Digestion, 59, 61, 62, 64, 65, 71, 79 Digital rectal examination, 42, 45, 65 Dilatation, 60, 65 Direct, iii, 5, 31, 65, 78, 80 Drug Interactions, 32, 65 Dysuria, 5, 65 E Edema, 27, 28, 60, 65, 73 Ejaculation, 22, 65, 79 Electrolyte, 65, 71, 76, 79 Endometrial, 65 Endometriosis, 14, 64, 65 Endometrium, 65 Environmental Health, 36, 38, 65 Enzymatic, 60, 62, 65 Enzyme, 65, 72 Epidermis, 64, 65, 77 Epigastric, 65, 74 Epinephrine, 59, 65, 74 Erectile, 65, 75 Erection, 7, 65 Erythrocytes, 65, 77 Esophagus, 65, 78, 79 Estrogen, 5, 28, 66 Ethisterone, 14, 66 Evacuation, 64, 66 Excitation, 66, 73 Excrete, 60, 66, 70 Exocrine, 66, 74 Exogenous, 66, 81 External-beam radiation, 66, 77 Extracellular, 63, 66, 79

F Facial, 4, 66, 75 Fallopian tube, 66, 78 Family Planning, 37, 66 Fat, 4, 19, 64, 66, 70, 71, 74 Fatigue, 19, 20, 22, 27, 43, 44, 47, 66, 68 Fatty acids, 64, 66 Feces, 64, 66, 79 Fibrosis, 66, 78 Filtration, 27, 66, 70 Fine-needle aspiration, 66, 73 Flow Cytometry, 6, 66 Fluorescence, 66, 67 Fluorescent Dyes, 66, 67 Forearm, 62, 67 G Gallbladder, 59, 67 Gamma Rays, 67, 77 Gas, 60, 67, 74, 80 Gastrin, 67, 68 Gastrointestinal, 15, 65, 67, 81 Gelatin, 14, 67, 80 Gene, 61, 67 Genital, 19, 67, 82 Gestational, 19, 45, 67 Giant Cells, 67, 78 Gland, 45, 47, 67, 71, 74, 75, 76, 78 Glucose, 4, 15, 19, 20, 23, 44, 46, 60, 62, 64, 67, 68, 69, 78 Glucose Intolerance, 15, 64, 67 Glucose tolerance, 46, 67 Glucose Tolerance Test, 67 Glycine, 60, 67, 74 Glycogen, 4, 68 Gonadal, 68, 79 Governing Board, 68, 76 Grade, 46, 68 Granulocytes, 68, 83 Growth, 60, 68, 75 H Habitual, 28, 68 Health Education, 42, 45, 68 Heart attack, 62, 68 Heart failure, 27, 28, 68 Hemodialysis, 68, 70, 71 Hemophilia, 14, 68 Hemorrhage, 68, 77, 80 Hepatic, 67, 68 Hereditary, 14, 43, 68 Hormonal, 43, 68 Hormonal therapy, 43, 68 Hormone, 19, 65, 66, 67, 68, 69, 76

Index 87

Hormone therapy, 68 Hydroxyproline, 60, 63, 68 Hyperglycemia, 15, 68 Hypertension, 27, 62, 68 Hypertrophy, 61, 68 I Id, 10, 48, 54, 56, 69 Idiopathic, 14, 69, 78 Immune response, 59, 60, 61, 69, 83 Immune system, 69, 72, 83 Immunoassay, 6, 69 Immunologic, 69, 77 Implant radiation, 69, 70, 77 Impotence, 22, 65, 69 In situ, 6, 69 Incision, 43, 45, 69, 70, 76 Incontinence, 3, 10, 14, 18, 22, 28, 46, 69, 80 Indicative, 69, 82 Infarction, 64, 69, 72 Infection, 4, 47, 69, 71, 72, 78, 80, 83 Inflammation, 15, 42, 47, 64, 66, 69, 75, 76 Ingestion, 67, 69, 75 Insulin, 4, 5, 15, 19, 20, 43, 44, 45, 46, 64, 67, 69, 70, 81 Insulin-dependent diabetes mellitus, 69 Intensive Care, 5, 69 Internal radiation, 70, 77 Interstitial, 6, 18, 62, 70 Intestinal, 67, 70 Intestines, 59, 66, 67, 70 Intracellular, 69, 70, 76 Intraocular, 70, 74 Intraocular pressure, 70, 74 Intravenous, 5, 70 Intravenous pyelography, 5, 70 Intravesical, 14, 70 Invasive, 70, 72 Involuntary, 46, 70, 73, 79 K Kb, 36, 70 Ketoacidosis, 4, 5, 70 Ketone Bodies, 64, 70 Ketosis, 64, 70 Kidney Disease, 17, 27, 36, 43, 70 Kidney Failure, 27, 70, 71 Kidney Failure, Acute, 70 Kidney Failure, Chronic, 27, 70, 71 Kidney Pelvis, 71, 82 Kidney stone, 27, 43, 71 Kidney Transplantation, 71 L Large Intestine, 70, 71, 77, 79

Laser Surgery, 43, 45, 71 Latent, 71, 76 Lethargy, 5, 71 Library Services, 54, 71 Lidocaine, 61, 71 Ligament, 66, 71, 76 Lipid, 69, 71 Liver, 4, 27, 59, 60, 61, 66, 67, 68, 71, 78, 81 Localized, 60, 69, 71, 75 Lymph, 27, 71, 78 Lymph node, 27, 71, 78 Lymphatic, 69, 71, 79 Lymphatic system, 71, 79 Lymphocyte, 60, 72 M Magnetic Resonance Imaging, 43, 47, 72 Manifest, 5, 20, 72 Maxillary, 5, 72 Medical Assistance, 47, 72 MEDLINE, 37, 72 Membrane, 65, 72, 75 Menopause, 46, 72 Menstruation, 5, 72 Mental, iv, 5, 36, 38, 66, 72, 77, 82 Mercury, 66, 72 Metabolic disorder, 15, 20, 72 MI, 17, 57, 72 Microbe, 72, 81 Microbiology, 61, 72 Milliliter, 72, 79 Modification, 4, 60, 72 Molecular, 37, 39, 61, 63, 72 Molecule, 60, 61, 66, 72, 74, 77 Monitor, 45, 64, 72 Monoclonal, 73, 77 Morphine, 73 Motion Sickness, 73 Motor nerve, 73 Muscle relaxant, 22, 43, 73 Muscle tension, 73 Myocardium, 72, 73 N Narcosis, 73 Narcotic, 14, 73, 81 Nausea, 4, 27, 70, 73, 82 Need, 3, 4, 5, 17, 18, 21, 23, 27, 28, 44, 46, 48, 49, 68, 73, 81 Needle biopsy, 47, 66, 73 Nephropathy, 70, 73 Nephrosis, 73 Nephrotic, 18, 73 Nephrotic Syndrome, 18, 73

88

Frequent Urination

Nerve, 59, 73, 75 Neurogenic, 73, 82 Neurons, 73, 80 Neurotransmitter, 60, 68, 73, 74 Neutrons, 59, 74, 77 Nitrogen, 27, 71, 74 Nocturia, 28, 46, 74 Norepinephrine, 59, 73, 74 Nuclei, 59, 72, 74, 77 Nucleic acid, 74 O Ocular, 15, 74 Ocular Hypertension, 15, 74 Oliguria, 70, 71, 74 Orgasm, 65, 74 Ovaries, 74, 78 Overactive bladder, 3, 74 Overweight, 10, 22, 44, 74 Oxidation, 64, 74 P Palliative, 74, 80 Pancreas, 18, 59, 61, 69, 74, 81 Pancreatic, 19, 74 Parotid, 75, 78 Patient Education, 21, 42, 46, 47, 52, 54, 57, 75 Pelvic, 6, 22, 28, 46, 65, 75, 76 Pelvis, 59, 74, 75, 82 Penis, 65, 75, 78 Peptide, 60, 75, 76 Pharmaceutical Preparations, 67, 75 Pharmacist, 22, 75 Pharmacologic, 75, 81, 82 Phospholipids, 66, 75 Phosphorus, 62, 75 Physical Examination, 4, 42, 45, 63, 75 Physical Therapy, 4, 46, 75 Physiologic, 72, 75, 77 Physiology, 45, 75 Plants, 67, 74, 75, 78, 81 Plasma, 23, 44, 67, 70, 75, 79 Pneumonia, 64, 75 Podiatrist, 22, 75 Poisoning, 72, 73, 75 Polysaccharide, 60, 76 Posterior, 74, 76 Potassium, 27, 76 Practice Guidelines, 38, 76 Predisposition, 19, 76 Progesterone, 76, 79 Progressive, 5, 27, 68, 71, 76 Prone, 47, 76

Prophylaxis, 5, 76 Prostate, 21, 28, 42, 44, 45, 47, 61, 76, 78, 81 Prostate gland, 21, 28, 47, 76 Prostatectomy, 43, 45, 76 Prostatic Hyperplasia, 76 Prostatitis, 42, 47, 76 Protein C, 76, 81 Protein S, 61, 76 Proteins, 60, 63, 68, 72, 74, 75, 76, 81, 82 Proteinuria, 73, 77 Protons, 59, 77 Psychogenic, 77, 82 Public Assistance, 72, 77 Public Policy, 37, 77 Pulmonary, 62, 70, 77 Pulmonary Artery, 62, 77 Pulmonary Edema, 70, 77 Pulse, 72, 77 Purpura, 14, 77 R Radiation, 43, 66, 67, 70, 77, 83 Radiation therapy, 43, 66, 70, 77 Radioactive, 69, 70, 77 Radiolabeled, 77 Radiotherapy, 62, 77 Receptor, 15, 60, 77 Rectal, 22, 47, 77 Rectum, 60, 62, 65, 67, 69, 71, 76, 77, 80 Red blood cells, 27, 65, 77, 78 Refer, 1, 74, 78 Reflux, 18, 78 Regimen, 4, 5, 78 Reinfection, 5, 78 Relaxant, 78 Renal pelvis, 71, 78 Reproductive system, 45, 76, 78 Resection, 78, 81 Respiration, 64, 72, 78 Restoration, 75, 78 Retrograde, 22, 78 Retropubic, 76, 78 Risk factor, 22, 44, 45, 47, 78 S Saponins, 78, 79 Sarcoidosis, 27, 78 Screening, 22, 63, 78, 82 Scrotum, 78, 80 Secretion, 69, 78, 79 Sediment, 78, 82 Self Administration, 78, 79 Self Medication, 5, 79 Semen, 45, 65, 76, 79

Index 89

Serologic, 69, 79 Shock, 79, 81 Side effect, 4, 14, 19, 22, 31, 59, 79, 81 Signs and Symptoms, 5, 19, 79 Small intestine, 68, 70, 79 Smooth muscle, 22, 73, 79 Sneezing, 79, 80 Sodium, 14, 79 Specialist, 45, 49, 79 Sperm, 45, 47, 79, 80 Sperm Count, 47, 79 Sphincter, 79, 80 Spleen, 27, 60, 71, 78, 79 Steroid, 14, 19, 64, 66, 78, 79 Stomach, 59, 65, 67, 68, 70, 73, 78, 79 Stool, 69, 71, 79 Stress, 4, 15, 22, 28, 46, 73, 76, 79, 80 Stress incontinence, 46, 79 Stress urinary, 15, 80 Stroke, 36, 62, 80 Stromal, 65, 80 Stupor, 71, 73, 80 Subacute, 69, 80 Subclinical, 69, 80 Subcutaneous, 60, 65, 80 Suction, 66, 80 Suppositories, 67, 80 Symphysis, 76, 80 Symptomatic, 5, 80 Synapse, 59, 80 Systemic, 5, 27, 32, 60, 62, 65, 69, 77, 78, 80 Systemic disease, 5, 80 Systolic, 68, 80 T Talc, 14, 80 Testicles, 47, 78, 80 Therapeutics, 32, 80 Thermal, 43, 45, 74, 80 Thorax, 59, 80 Threshold, 68, 80 Tin, 20, 22, 44, 80 Tissue, 19, 27, 60, 61, 63, 65, 66, 70, 71, 72, 73, 75, 78, 79, 80, 81 Tolerance, 67, 81 Tomography, 63, 81 Topical, 47, 81 Toxic, iv, 27, 64, 81 Toxicity, 27, 65, 72, 81 Toxicology, 38, 81 Toxins, 27, 60, 69, 81 Trace element, 80, 81

Tramadol, 14, 81 Transfection, 61, 81 Translation, 60, 81 Transurethral, 22, 43, 45, 76, 81 Transurethral resection, 22, 43, 45, 76, 81 Transurethral Resection of Prostate, 76, 81 Transurethral resection of the prostate, 22, 43, 45, 81 Trauma, 27, 81 Tumor marker, 61, 81 Type 2 diabetes, 18, 19, 20, 23, 44, 46, 81 U Unconscious, 69, 81 Urea, 27, 71, 81, 82 Uremia, 70, 82 Ureter, 6, 71, 78, 82 Urethra, 18, 28, 47, 61, 75, 76, 81, 82 Urge urinary incontinence, 15, 82 Urinalysis, 18, 48, 82 Urinary, 5, 6, 10, 14, 17, 19, 22, 42, 43, 44, 45, 46, 47, 61, 64, 69, 74, 76, 78, 80, 81, 82 Urinary Retention, 47, 82 Urinary tract, 5, 17, 19, 43, 46, 47, 61, 82 Urinary tract infection, 5, 18, 19, 43, 47, 61, 82 Urinate, 21, 22, 28, 42, 45, 46, 48, 82, 83 Urine, 4, 5, 6, 18, 21, 27, 28, 42, 43, 46, 47, 60, 61, 64, 69, 70, 71, 74, 77, 78, 79, 80, 82 Urogenital, 82 Urogenital Diseases, 82 Urologic Diseases, 18, 82 Uterus, 63, 65, 72, 74, 76, 78, 82 V Vaccines, 82, 83 Vagina, 63, 72, 78, 82 Vaginal, 46, 82 Vascular, 43, 60, 64, 69, 82 Vein, 70, 75, 82 Venules, 62, 82 Veterinary Medicine, 37, 82 Virulence, 81, 82 Virus, 19, 67, 83 Void, 28, 83 Volition, 70, 83 W Watchful waiting, 21, 43, 45, 83 Weight Gain, 20, 83 White blood cell, 5, 60, 71, 72, 83 Womb, 78, 82, 83 X X-ray, 63, 66, 67, 70, 77, 83

90

Frequent Urination

Index 91

92

Frequent Urination

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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