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

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

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HERPES ZOSTERS 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 2003 by ICON Group International, Inc. Copyright 2003 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., 1960Herpes Zosters: 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: 0-597-83707-4 1. Herpes Zosters-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 herpes zosters. 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 HERPES ZOSTERS ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Herpes Zosters .............................................................................. 5 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND HERPES ZOSTERS............................................................................. 25 Overview...................................................................................................................................... 25 Finding Nutrition Studies on Herpes Zosters ............................................................................. 25 Federal Resources on Nutrition ................................................................................................... 29 Additional Web Resources ........................................................................................................... 30 CHAPTER 3. ALTERNATIVE MEDICINE AND HERPES ZOSTERS ...................................................... 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 35 General References ....................................................................................................................... 38 CHAPTER 4. CLINICAL TRIALS AND HERPES ZOSTERS ................................................................... 39 Overview...................................................................................................................................... 39 Recent Trials on Herpes Zosters .................................................................................................. 39 Keeping Current on Clinical Trials ............................................................................................. 42 CHAPTER 5. PATENTS ON HERPES ZOSTERS ................................................................................... 45 Overview...................................................................................................................................... 45 Patents on Herpes Zosters ........................................................................................................... 45 Keeping Current .......................................................................................................................... 48 CHAPTER 6. BOOKS ON HERPES ZOSTERS ....................................................................................... 49 Overview...................................................................................................................................... 49 Book Summaries: Online Booksellers........................................................................................... 49 The National Library of Medicine Book Index ............................................................................. 50 Chapters on Herpes Zosters ......................................................................................................... 50 CHAPTER 7. PERIODICALS AND NEWS ON HERPES ZOSTERS ......................................................... 51 Overview...................................................................................................................................... 51 News Services and Press Releases................................................................................................ 51 Academic Periodicals covering Herpes Zosters............................................................................ 53 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 57 Overview...................................................................................................................................... 57 NIH Guidelines............................................................................................................................ 57 NIH Databases............................................................................................................................. 59 Other Commercial Databases....................................................................................................... 62 APPENDIX B. PATIENT RESOURCES ................................................................................................. 63 Overview...................................................................................................................................... 63 Patient Guideline Sources............................................................................................................ 63 Finding Associations.................................................................................................................... 66 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 69 Overview...................................................................................................................................... 69 Preparation................................................................................................................................... 69 Finding a Local Medical Library.................................................................................................. 69 Medical Libraries in the U.S. and Canada ................................................................................... 69 ONLINE GLOSSARIES.................................................................................................................. 75 Online Dictionary Directories ..................................................................................................... 77

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HERPES ZOSTERS DICTIONARY.............................................................................................. 79 INDEX .............................................................................................................................................. 113

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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 herpes zosters 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 herpes zosters, 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 herpes zosters, 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 herpes zosters. 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 herpes zosters, 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 herpes zosters. 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 HERPES ZOSTERS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on herpes zosters.

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

Ramsay Hunt Syndrome: A Challenging Herpes Zoster Virus Infection Source: Geriatrics. 53(5): 93-94, 101-102. April 1998. Summary: Herpes zoster virus infections may present atypically in the older who is frail, especially in those with multiple medical problems. The article reviews Ramsay Hunt syndrome, herpes zoster involvement of the facial and auditory nerves. Ramsay Hunt syndrome may present with facial nerve palsy mimicking Bell's palsy, hearing impairment, dizziness, and eruption on the pinna and in the auditory canal. The author presents the case of an older patient (95 years old) with Ramsay Hunt syndrome. This patient presented in the emergency room and his symptoms were a source of confusion before the correct diagnosis was made. The incidence of herpes zoster increases dramatically with age; postherapeutic pain also tends to persist longer in persons over age 70 than in younger populations. In addition, the impact of herpetic pain on the

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Herpes Zosters

mental status of the patient may mimic many other conditions associated with a confusional state. In this patient, right-sided facial findings, weakness, and confusion resolved within 2 months of a 7-day course of antiviral therapy, initially given IV, then orally after discharge. Although herpes zoster is a self-limiting infection in an immunocompetent patient, acyclovir has been shown to significantly reduce healing time, pain duration, and ocular complications. Recognition of the signs of this syndrome may avoid an extensive and unnecessary work-up that might further complicate the course of this disease. 3 figures. 10 references. •

Otological Complications of Herpes Zoster Source: Annals of Neurology. 35(Supplement): S62-S64. May 1994. Summary: This article considers the otological complications of herpes zoster. The otological complications of varicella-zoster virus (VZV or Ramsay Hunt syndrome) include facial paralysis, tinnitus, hearing loss, hyperacusis (dysacousis), vertigo, dysgeusia, and decreased tearing. Cranial nerves V, IX, and X are often affected. The author notes that MRI testing demonstrates enhancement of the geniculate ganglion and facial nerve. These manifestations are identical to Bell's palsy, but are more severe and carry a graver prognosis. The recovery of hearing loss is problematic and incomplete. Balance problems are severe and in the elderly, often incapacitating. Although steroid treatment dramatically relieves viral-induced vestibular vertigo and reduces the number of facial nerve degeneration, no conclusion can be made about the effect on hearing loss. The author concludes that the medical profession must revert to astute history taking and physical diagnosis, if physicians are to offer early treatment to the 12,500 patients per year who develop VZV cranial neuritis with facial paralysis. 1 figure. 2 tables. 14 references. (AA-M).

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Acute and Chronic Herpes Zoster Source: Postgraduate Medicine. 107(7): 107-108,113-114,117-118. June 2000. Summary: This journal article provides health professionals with information on acute and chronic herpes zoster, focusing on risk factors, clinical features, diagnosis, disease course, treatment, and prevention. The disease is more common among immunocompromised persons than among those who have adequate immune mechanisms. The incidence of herpes zoster is two to four times higher in white patients than in African Americans, but it is approximately equal in men and women. The thorax, neck, face, and lumbosacral area, in descending order of frequency, are the primary sites of cutaneous involvement. Although sensory nerves are usually affected, an occasional patient may experience motor nerve deficits. Acute manifestations include as few as one but typically more patches of grouped vesicles on an erythematous base. An acute attack of herpes zoster runs its course from vesicle to eschar in 7 to 10 days, and cutaneous healing is usually complete in an additional 2 weeks. Postherpetic neuralgia is persistence of pain beyond healing of the integument or symptoms lasting more than 1 to 3 months after disease onset. Allodynia is another common manifestation. Therapy in the acute phase of the disease is directed at preventing postherpetic neuralgia, whereas treatment in the chronic phase is aimed at minimizing already existing pain. Acute disease in most younger immunocompetent patients can be treated with topical soaks and locally applied drying salves. Instituting treatment within 48 to 72 hours of disease onset usually results in early resolution of cutaneous eruptions and a shortened duration of neurologic symptoms. The oral antiviral agents famciclovir and valacyclovir hydrochloride seem to be somewhat more effective than acyclovir. Although short-term analgesic therapy may relieve pain, it rarely eradicates it.

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Inoculation with varicella vaccine in patients between ages 55 and 65 may confer protection against viral reappearance and markedly attenuate the problem of postherpetic neuralgia. 5 figures, 1 table, and 7 references.

Federally Funded Research on Herpes Zosters The U.S. Government supports a variety of research studies relating to herpes zosters. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to herpes zosters. 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 herpes zosters. The following is typical of the type of information found when searching the CRISP database for herpes zosters: •

Project Title: ABT 606 VS ACYCLOVIR FOR TREATMENT OF HERPES ZOSTER Principal Investigator & Institution: Tyring, Dr Stephen.; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2001 Summary: The hypothesis to be tested is that ABT-606 has potential application in the treatment of VZV infections. This is a positive control, double-blind, double-dummy, randomized, four-arm, parallel, multicenter clinical trial in patients 50 years and older with active uncomplicated herpes zoster infection. To be eligible patients must enroll within 72 hours of the appearance of zosteriform rash/vesicles. The study is divided into two periods; the Acute Assessment Period (days 1-28) and the Follow-up Perod (days 29-end of study). Approximately 400 patients who satisfy the entry criteria will be randomized in a balanced fashion so that 100 patients are randomized to each treatment arm. It is expected that each site will enroll 2-10 patients. The total duration of the study is six months. The significance of this study is that ABT-606 may be an effective and safe alternative to acyclovir for the treatment of shingles. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEURALGIA

ANALGESIA

IN

HERPES

ZOSTER

AND

POSTHERPETIC

Principal Investigator & Institution: Dworkin, Robert H.; Professor; Anesthesiology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2004

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

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Herpes Zosters

Summary: (provided by applicant): Herpes zoster is a common and painful neurological disease that is caused by reactivation of the varicella-zoster virus. Herpes zoster pain that persists after healing of the acute infection is termed postherpetic neuralgia (PHN), a chronic pain syndrome that is often refractory to all treatment. The prevalence of PHN is expected to increase substantially in the coming decades because the incidence of herpes zoster and the risk of PHN will both increase as the population ages. Although research to improve treatment is continuing, as many as half of all patients do not currently obtain relief. For this reason, the development of interventions that prevent PHN would lead to major reductions in disability, distress, and use of health care resources. On the basis of the results of research on risk factors for PHN and its pathophysiologic mechanisms, it can be hypothesized that combined antiviral and analgesic treatment begun as soon as possible after the -onset of herpes zoster will reduce the risk of PHN. The specific aim of this planning grant is to develop the protocol and procedures for a clinical trial to test this hypothesis. The proposed trial will have the following major objectives: The primary aim will be to test the hypothesis that the risk of PHN is reduced by half in herpes zoster patients treated with an antiviral agent and an opioid analgesic compared with patients treated with the antiviral agent and matching placebo. Support for this hypothesis would have a major impact on the treatment of patients with herpes zoster and lead to a substantial reduction in the prevalence of PHN. A second major aim that will be accomplished by the proposed trial is determining whether the initiation of central mechanisms of chronic neuropathic pain can be prevented by attenuating acute pain. The answer to this question will provide important information about mechanisms of prolonged pain and have major implications for its prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIORAL INTERVENTION FOR HERPES ZOSTER RISK IN AGING Principal Investigator & Institution: Irwin, Michael R.; Professor; Veterans Medical Research Fdn/San Diego Foundation of San Diego San Diego, Ca 92161 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2001 Summary: Description (adapted from investigator's abstract): The incidence and severity of herpes zoster (HZ) or shingles increase markedly with increasing age due to a decline in varicella zoster virus (VZV) specific immunity. Considerable evidence shows that psychosocial stresses in the older adult correlate with impairments of cellular immunity. Moreover, preliminary data generated by the PI and co-investigators indicate that the presence of depressive symptoms in older adults is associated with a decline of VZV responder cell frequency (VZV-RCF) and response to ZVZ vaccination. Taken together, the untoward effects of age and depressive symptoms on VZV immunity raise the question as to whether a behavioral intervention might augment VZZV specific immunity in the older adult. The PI presents preliminary studies showing that the administration of a relaxation-response based intervention, Tai Chi Chih (TCC), results in improvement in health functioning and VZV specific immunity in older adults as compared to a control group. TCC is a slow moving meditation comprised of twenty separate standardized movements for use in elderly populations. The investigators propose a clinical trial whose aims include 1) to determine whether the practice of TCC for 16 weeks influences unstimulated and vaccine-stimulated VZV specific immunity in adults 60 years of age and older; 2) to demonstrate that TCC can produce significant changes in psychological adaptation, health behaviors, health functioning and well being; 3) to assess whether changes in psychological adaptation, health behaviors and

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health functioning correlate with changes in VZV immunity following TCC in older adults. The investigators hypothesize that this behavioral intervention that prioritizes treatment of excessive physiological arousal can influence one's effective state with effects on cellular immunity. By standardization of training and practice schedules, TCC offers an important advantage over prior relaxation response based therapies. Focus on older adults at increased risk for HZ, assay of ZVZV specific immunity, and evaluation of an integrated in vivo immune response has implications for understanding the impact of behavioral factors and a behavioral intervention on a clinically relevant end point and response of the immune system to infectious pathogens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HERPES ZOSTER AND MEDICATIONS IN THE ELDERLY Principal Investigator & Institution: Schmader, Kenneth E.; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (Applicant s abstract) The overall purpose of this award application is to support the patient-oriented research and mentoring program of an academic geriatrician in order to further develop his research and mentoring skills, generate new knowledge in clinical geriatrics and develop other clinical investigators in geriatrics. The candidate is a mid-career clinician and investigator at Duke University and Durham VA Medical Centers with a strong commitment, funding and publication record in patientoriented research in herpes zoster and medications in the elderly and a history of mentoring house staff and junior faculty in clinical research. The research plan is structured along two complementary areas of investigation involving zoster and medications in the elderly. The objectives of his zoster research program are the optimal management of zoster and postherpetic neuralgia in the elderly. A series of studies is proposed that is centered around his work in the Shingles Prevention Study, a large multicenter clinical trial to determine whether immunization with live attenuated varicella-zoster vaccine can reduce the incidence and/or severity of zoster and PHN in the elderly. Additional research opportunities are available in treatment trials of zoster and studies of genetics and zoster. The objectives of his drug-related research program is to optimize pharmacotherapy in the elderly by reducing polypharmacy, inappropriate prescribing and adverse drug reactions. The basis for a program of drug-related studies is the GEM Drug Study, a multicenter trial to determine if Geriatric Evaluation and Management (GEM) care reduces adverse drug reactions and inappropriate prescribing in the elderly compared to usual care. The candidate will recruit and select advisees from a rich pool of beginning clinical investigators at Duke University Medical Center and mentor them in the context of the above research projects using one-one teaching, the Duke Clinical Research Training Program (CRTP) and other research educational experiences at Duke. The Duke CRTP and Faculty Development Programs will provide opportunities for the candidate s research, mentoring and leadership career development. The award will allow the candidate to devote additional time to patientoriented research and mentoring by relieving the candidate of clinical and administrative responsibilities in the Division of Geriatrics, the Duke Geriatric Evaluation and Treatment Clinic and Durham VAMC. The award fits into past and future career development by providing a bridge from earlier academic activities to the expansion of mentoring and research skills and to program leadership in geriatrics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HERPES ZOSTER: THERAPY AND PROPHYLAXIS IN HIV INFECTION Principal Investigator & Institution: Brady, Kathleen A.; Medicine; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: (adapted from the application s abstract): This award will prepare Kathleen A. Brady, M.D., for a career as an independent investigator in HIV epidemiology with a special emphasis on the prevention and treatment of long term complications of HIV infection. She proposes a comprehensive, interdisciplinary program that will provide her with the skills and experience necessary for independent clinical research. The training component includes advanced education in clinical epidemiology and dual mentorship from an internationally known infectious disease epidemiologist and a highly experienced HIV clinical researcher. The research component will focus on herpes zoster in the HIV-infected host. Herpes zoster has been a well recognized complication of HIV infection since the early stages of the HIV epidemic. With the introduction of protease inhibitors several years ago combination antiretroviral therapy has become routine and has improved the clinical course of HIV infection. However although many other opportunistic infections have significantly declined with these powerful new therapies, herpes zoster remains a problem for HIV-infected patients. The precise magnitude of this problem has not been determined. The proposed research will: (a) examine the impact of combination antiretroviral therapy on the incidence of herpes zoster in HIV-infected adults; (b) establish the risk factors for herpes zoster in these same patients; and (c) utilize this information to design a safety and immunogenicity trial of live-attenuated varicella vaccine in patients infected with HIV. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PAIN & NEURAL DYSFUNCTION FROM ACUTE HERPES ZOSTER Principal Investigator & Institution: Rowbotham, Michael C.; Associate Professor; Neurology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2004 Summary: Pain, nerve trunk inflammation, and neuronal injury are hallmarks of acute herpes zoster (AHZ or 'shingles'). The majority of patients with AHZ recover uneventfully, but a minority develop enduring neuropathic pain - in the form of postherpetic neuralgia (PHN). Age, initial pain severity, and psychosocial factors have been established as risk factors for PHN in longitudinal studies, but evolution of neural dysfunction and deafferentation, the hallmarks of the chronic neuropathic pain of PHN, have received little study. We hypothesize that the development of post-herpetic neuralgia strongly depends on two factors: 1) the severity of the initial neural injury and 2) the ability to recover from the initial neural injury. To test this hypothesis, we will prospectively follow 200 patients with AHZ at high risk for development of PHN. Study participants will be followed closely from 2 weeks after the onset of AHZ to 6 months post-zoster, a time when PHN is well established and unlikely to remit spontaneously. Evolution of pain and neural injury will be evaluated at 2 weeks, 1 month, 3 months, and 6 months after the onset of AHZ. At study visits, assessments will include ratings of pain intensity, mood, quality of life, allodynia severity, mapping the extent of skin affected by lesions, pain, and allodynia, quantitative tests of sensory function, and response to controlled applications of capsaicin. Loss and possible recovery of cutaneous nerve fibers will be documented through serial skin punch biopsies stained

Studies

9

for the axonal marker PGP 9.5 in affected and normal skin. Abnormal neural function in remaining fibers will be evident as allodynia, hyperalgesia to mechanical and thermal stimuli, and hyperalgesia to capsaicin application. Signs of loss of primary afferent nociceptor function will be evident as inability to perceive noxious heat and capsaicin. The importance of neural dysfunction and neuronal loss as risk factors for PHN will be compared to risk factors found in other studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VA CSP #4 3 VARICELLA ZOSTER VACCINE FOR PREVENTION OF HERPES ZOSTER Principal Investigator & Institution: Wright, Peter F.; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2001 Summary: The immunization w/live, attenuated (Oka/Merck) varicella-zoster vaccine will reduce significantly the burden of illness associated w/HZ. This hypothesis will be tested by comparing the burden of illness due to HZ in the total population of vaccine and placebo recipients. The burben of illness due to HZ is defined by the areas under worst pain (rated on a 0 to 10 scale) versus time curves measured during the 6 month period following HZ rash onset in subjects who develop HZ. Subjects who do not develop HZ will be assigned a score of zero in the burden of illness analysis. The burden illness defined in this manner is sensitive to the incidence, the severity, and the duration of HZ-associated pain (149). The study is designed to have 98 percent power to detect a 50 percent reduction in mean burden of illness in the vaccine group relative to the placebo group. B. SPECIFIC AIM: The primary objective of this study is to determine whether immunization w/live-attenuated varicella-zoster vaccine (OKA/Merck Strain) can reduce the incidence and/or severity of herpes zoster (HZ) and its complications, primarily post-herpetic neuralgia (PHN), in persons 60 years of age and older. This will be accomplished by comparing a measure of the burden of illness due to HZ and PHN in vaccine and placebo recipients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: VARICELLA ZOSTER VACCINE FOR PREVENTION OF HERPES ZOSTER/COMPLICATIONS Principal Investigator & Institution: Smith, Jean; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2001 Summary: This study addresses the lack of therapy for post-herpetic neuralgia. It proposes that Varicella vaccine will significantly reduce the burden of illness due to herpes zoster and will protect against neuralgia. Enrolled subjects, all over the age of 60, will receive either vaccine or placebo (double-blinded) and then followed for three years or until 360 cases of herpes zoster have occurred. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

10 Herpes Zosters

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

Antigen detection: the method of choice in comparison with virus isolation and serology for laboratory diagnosis of herpes zoster in human immunodeficiency virusinfected patients. by Dahl H, Marcoccia J, Linde A.; 1997 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=229577

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Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up. by Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA.; 2000 Sep 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27491

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Sorivudine versus Acyclovir for Treatment of Dermatomal Herpes Zoster in Human Immunodeficiency Virus-Infected Patients: Results from a Randomized, Controlled Clinical Trial. by Gnann JW Jr, Crumpacker CS, Lalezari JP, Smith JA, Tyring SK, Baum KF, Borucki MJ, Joseph WP, Mertz GJ, Steigbigel RT, Cloud GA, Soong SJ, Sherrill LC, DeHertogh DA, Whitley RJ, Group TC.; 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105759

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Spinal Cord Involvement in Uncomplicated Herpes Zoster. by Steiner I, SteinerBirmanns B, Levin N, Hershko K, Korn-Lubetzki I, Biran I.; 2001 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=96158

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Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. by Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ.; 1995 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162779

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 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

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

A case of acute dacryoadenitis associated with herpes zoster ophthalmicus. Author(s): Obata H, Yamagami S, Saito S, Sakai O, Tsuru T. Source: Japanese Journal of Ophthalmology. 2003 January-February; 47(1): 107-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12586188&dopt=Abstract

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A rather rare encounter with herpes zoster in a male infant. Author(s): Kashima M. Source: The Journal of Dermatology. 2003 April; 30(4): 348-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707476&dopt=Abstract

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Allografting of peripheral blood stem cell mobilized from a donor developing herpes zoster virus infection. Author(s): Imai T, Maeda Y, Fujii N, Takenaka K, Shinagawa K, Ishimaru F, Ikeda K, Niiya K, Harada M. Source: American Journal of Hematology. 2002 October; 71(2): 140-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353321&dopt=Abstract

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An unusual presentation of herpes zoster ophthalmicus: orbital myositis preceding vesicular eruption. Author(s): Kawasaki A, Borruat FX. Source: American Journal of Ophthalmology. 2003 September; 136(3): 574-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12967827&dopt=Abstract

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Antiviral therapy for varicella and herpes zoster. Author(s): Arvin AM. Source: Seminars in Pediatric Infectious Diseases. 2002 January; 13(1): 12-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12118839&dopt=Abstract

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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Case Number 22: An interesting case of herpes zoster in rheumatoid arthritis. Author(s): Campalani E, Meenagh GK, Finch MB. Source: Annals of the Rheumatic Diseases. 2002 February; 61(2): 102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11796393&dopt=Abstract

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Cell-mediated immune hypersensitivity is stronger on noninvolved side than involved side in patients with herpes zoster. Author(s): Erdem T, Dane S, Kadi M. Source: The International Journal of Neuroscience. 2003 August; 113(8): 1081-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12888422&dopt=Abstract

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Central retinal artery occlusion in herpes zoster ophthalmicus. Author(s): Ahn M, Cho NC. Source: Journal of Pediatric Ophthalmology and Strabismus. 2002 March-April; 39(2): 123-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11911544&dopt=Abstract

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Childhood herpes zoster. Author(s): Plumb RL. Source: Cutis; Cutaneous Medicine for the Practitioner. 2003 January; 71(1): 86; Author Reply 86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553636&dopt=Abstract

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Clinical applications for change-point analysis of herpes zoster pain. Author(s): Desmond RA, Weiss HL, Arani RB, Soong SJ, Wood MJ, Fiddian PA, Gnann JW, Whitley RJ. Source: Journal of Pain and Symptom Management. 2002 June; 23(6): 510-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067775&dopt=Abstract

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Clinical characteristics of and risk factors for herpes zoster after hematopoietic stem cell transplantation. Author(s): Leung AY, Yuen KY, Cheng VC, Lie AK, Liang R, Kwong YL. Source: Haematologica. 2002 April; 87(4): 444-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11940491&dopt=Abstract

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Clinical correlates of prolonged pain in Japanese patients with acute herpes zoster. Author(s): Kurokawa I, Kumano K, Murakawa K; Hyogo Prefectural PHN Study Group. Source: J Int Med Res. 2002 January-February; 30(1): 56-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11921500&dopt=Abstract

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Clinical practice. Herpes zoster. Author(s): Gnann JW Jr, Whitley RJ. Source: The New England Journal of Medicine. 2002 August 1; 347(5): 340-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12151472&dopt=Abstract

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Colonic pseudo-obstruction due to herpes zoster. Author(s): Rodrigues G, Kannaiyan L, Gopasetty M, Rao S, Shenoy R. Source: Indian J Gastroenterol. 2002 September-October; 21(5): 203-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416757&dopt=Abstract

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Concomitant bilateral herpes zoster ophthalmicus. Author(s): MacMahon EM. Source: The Lancet Infectious Diseases. 2003 January; 3(1): 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505026&dopt=Abstract

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Concomitant bilateral herpes zoster opthalmicus. Author(s): Pervez H, Potti A, Mehdi SA. Source: The Lancet Infectious Diseases. 2002 November; 2(11): 699. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409051&dopt=Abstract

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Consequences and management of pain in herpes zoster. Author(s): Johnson RW. Source: The Journal of Infectious Diseases. 2002 October 15; 186 Suppl 1: S83-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353192&dopt=Abstract

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Contacts with varicella or with children and protection against herpes zoster in adults: a case-control study. Author(s): Thomas SL, Wheeler JG, Hall AJ. Source: Lancet. 2002 August 31; 360(9334): 678-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12241874&dopt=Abstract

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Corneal epithelial keratitis in herpes zoster ophthalmicus: “delayed” and “sine herpete”. A non-contact photomicrographic in vivo study in the human cornea. Author(s): Tabery HM. Source: Eur J Ophthalmol. 2002 July-August; 12(4): 267-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219995&dopt=Abstract

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Corticosteroids for herpes zoster: what do they accomplish? Author(s): Santee JA. Source: American Journal of Clinical Dermatology. 2002; 3(8): 517-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358552&dopt=Abstract

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Detection of varicella-zoster virus DNA in throat swabs of patients with herpes zoster and on air purifier filters. Author(s): Suzuki K, Yoshikawa T, Tomitaka A, Suzuki K, Matsunaga K, Asano Y. Source: Journal of Medical Virology. 2002 April; 66(4): 567-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11857538&dopt=Abstract

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Drug eruption secondary to aciclovir with recall phenomenon in a dermatome previously affected by herpes zoster. Author(s): Carrasco L, Pastor MA, Izquierdo MJ, Farina MC, Martin L, Fortes J, Requena L. Source: Clinical and Experimental Dermatology. 2002 March; 27(2): 132-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952706&dopt=Abstract

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Early diagnosis of herpes zoster by polymerase chain reaction. Author(s): Lilie HM, Wassilew SW, Wolff MH. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 January; 16(1): 53-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952291&dopt=Abstract

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Erythema multiforme after resolution of herpes zoster by acyclovir. Author(s): Onishi I, Kishimoto S. Source: Eur J Dermatol. 2002 July-August; 12(4): 370-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12095886&dopt=Abstract

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Evaluation and management of herpes zoster ophthalmicus. Author(s): Shaikh S, Ta CN. Source: American Family Physician. 2002 November 1; 66(9): 1723-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12449270&dopt=Abstract

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Evaluation of efficacy and tolerance of neuramide in the treatment of herpes zoster and postherpetic neuritis. Author(s): Varotti C, Rafanelli A. Source: Drugs Exp Clin Res. 2001; 27(5-6): 199-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11951578&dopt=Abstract

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Expression of inducible nitric oxide synthase in skin lesions of acute herpes zoster. Author(s): Lim YJ, Chang SE, Choi JH, Sung KJ, Bahk JH, Do SH, Lee DS. Source: Journal of Dermatological Science. 2002 September; 29(3): 201-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12234710&dopt=Abstract

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Foreword: The Fourth International Conference on Varicella, Herpes Zoster and PostHerpetic Neuralgia (PHN). Author(s): Perkin RT. Source: Journal of Medical Virology. 2003; 70 Suppl 1: S1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627477&dopt=Abstract

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Gastrointestinal cancer and herpes zoster in adults. Author(s): Yamamoto M, Mine H, Akazawa K, Maehara Y, Sugimachi K. Source: Hepatogastroenterology. 2003 July-August; 50(52): 1043-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12845977&dopt=Abstract

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Geographic and racial aspects of herpes zoster. Author(s): Nagasako EM, Johnson RW, Griffin DR, Elpern DJ, Dworkin RH. Source: Journal of Medical Virology. 2003; 70 Suppl 1: S20-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627482&dopt=Abstract

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Good cognitive outcome of patients with herpes zoster encephalitis: a follow-up study. Author(s): Wetzel K, Asholt I, Herrmann E, Kratzer C, Masuhr F, Schielke E. Source: Journal of Neurology. 2002 November; 249(11): 1612-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532932&dopt=Abstract

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Granulomatous angiitis of the central nervous system associated with herpes zoster. Author(s): Bhat G, Mathur DS, Saxena GN, Jain S, Singh AP, Bhaduria D. Source: J Assoc Physicians India. 2002 July; 50: 977-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12126361&dopt=Abstract

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Granulomatous folliculitis at sites of herpes zoster scars: Wolf's isotopic response. Author(s): Fernandez-Redondo V, Amrouni B, Varela E, Toribio J. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 November; 16(6): 628-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12482051&dopt=Abstract

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Herpes zoster and aseptic meningitis in a previously healthy child. Author(s): Szinnai G, Farron F, Bar G, Heininger U. Source: European Journal of Pediatrics. 2003 June; 162(6): 434-5. Epub 2003 April 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684902&dopt=Abstract

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Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Author(s): Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJ, Stalman WA, van Essen GA. Source: Family Practice. 2002 October; 19(5): 471-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356697&dopt=Abstract

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Herpes zoster by reactivated vaccine varicella zoster virus in a healthy child. Author(s): Uebe B, Sauerbrei A, Burdach S, Horneff G. Source: European Journal of Pediatrics. 2002 August; 161(8): 442-4. Epub 2002 June 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172829&dopt=Abstract

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Herpes zoster during varicella. Author(s): Baptist EC, Noonan KM. Source: The Pediatric Infectious Disease Journal. 2002 February; 21(2): 178-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840094&dopt=Abstract

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Herpes zoster following sacral nerve stimulation for overactive bladder. Author(s): Rosenblum N, Eilber KS, Raz S. Source: The Journal of Urology. 2003 February; 169(2): 619-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544325&dopt=Abstract

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Herpes zoster guideline of the German Dermatology Society (DDG). Author(s): Gross G, Schofer H, Wassilew S, Friese K, Timm A, Guthoff R, Pau HW, Malin JP, Wutzler P, Doerr HW. Source: Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology. 2003 April; 26(3): 277-89; Discussion 291-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637076&dopt=Abstract

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Herpes zoster induced neuropathic bladder--a case report. Author(s): Tsai HN, Wu WJ, Huang SP, Su CM, Chen CC, Wang CJ, Chou YH, Huang CH. Source: Kaohsiung J Med Sci. 2002 January; 18(1): 39-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12017982&dopt=Abstract

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Herpes zoster infection and postherpetic neuralgia. Author(s): Tenser RB. Source: Curr Neurol Neurosci Rep. 2001 November; 1(6): 526-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898565&dopt=Abstract

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Herpes zoster misdiagnosed as testicular torsion. Author(s): Kumar TS, Saklani AP, Hockey T. Source: Hosp Med. 2003 February; 64(2): 115. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12619344&dopt=Abstract

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Herpes zoster myelitis: report of two cases. Author(s): Amayo EO, Kwasa TO, Otieno CF. Source: East Afr Med J. 2002 May; 79(5): 279-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638816&dopt=Abstract

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Herpes zoster neonatorum. Author(s): Brar BK, Pall A, Gupta RR. Source: The Journal of Dermatology. 2003 April; 30(4): 346-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707475&dopt=Abstract

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Herpes zoster of the head and limbs: electroneuromyographic and clinical findings in 158 consecutive cases. Author(s): Mondelli M, Romano C, Rossi S, Cioni R. Source: Archives of Physical Medicine and Rehabilitation. 2002 September; 83(9): 121521. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235600&dopt=Abstract

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Herpes zoster of the penis: an unusual location for a common eruption. Author(s): Spray A, Glaser DA. Source: Journal of the American Academy of Dermatology. 2002 August; 47(2 Suppl): S177-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140455&dopt=Abstract

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Herpes zoster ophthalmicus and the superior orbital fissure syndrome. Author(s): Yong VK, Yip CC, Yong VS. Source: Singapore Med J. 2001 October; 42(10): 485-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874154&dopt=Abstract

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Herpes zoster ophthalmicus in olmsted county, Minnesota: have systemic antivirals made a difference? Author(s): Severson EA, Baratz KH, Hodge DO, Burke JP. Source: Archives of Ophthalmology. 2003 March; 121(3): 386-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617710&dopt=Abstract

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Herpes zoster ophthalmicus. Author(s): Gurwood AS, Savochka J, Sirgany BJ. Source: Optometry. 2002 May; 73(5): 295-302. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12363229&dopt=Abstract

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Herpes zoster ophthalmicus: how is it identified and treated? Author(s): Temple JJ. Source: Journal of the American Academy of Nurse Practitioners. 2002 July; 14(7): 297303; Quiz 304-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12138524&dopt=Abstract

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Herpes zoster producing temporary erectile dysfunction. Author(s): Rix GH, Carroll DN, MacFarlane JR. Source: International Journal of Impotence Research : Official Journal of the International Society for Impotence Research. 2001 December; 13(6): 352-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11918252&dopt=Abstract

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Herpes zoster vasculitis presenting as giant cell arteritis with bilateral internuclear ophthalmoplegia. Author(s): Al-Abdulla NA, Rismondo V, Minkowski JS, Miller NR. Source: American Journal of Ophthalmology. 2002 December; 134(6): 912-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12470766&dopt=Abstract

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Herpes zoster virus sclerokeratitis and anterior uveitis in a child following varicella vaccination. Author(s): Naseri A, Good WV, Cunningham ET Jr. Source: American Journal of Ophthalmology. 2003 March; 135(3): 415-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614776&dopt=Abstract

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Herpes zoster. Author(s): Crider EF. Source: The New England Journal of Medicine. 2003 May 15; 348(20): 2044-5; Author Reply 2044-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751476&dopt=Abstract

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Herpes zoster. Author(s): Roberts EJ, Heitman B. Source: Dermatology Nursing / Dermatology Nurses' Association. 2003 April; 15(2): 175. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751354&dopt=Abstract

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Herpes zoster. Author(s): Feder HM Jr. Source: The New England Journal of Medicine. 2003 May 15; 348(20): 2044-5; Author Reply 2044-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748328&dopt=Abstract

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Herpes zoster. Treating postherpetic neuralgia. Author(s): Baldwin PD. Source: Clinical Journal of Oncology Nursing. 2002 January-February; 6(1): 55-8, 61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11842491&dopt=Abstract

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Herpes zoster: a previously unrecognized complication of epidural steroids in the treatment of complex regional pain syndrome. Author(s): Parsons SJ, Hawboldt GS. Source: Journal of Pain and Symptom Management. 2003 March; 25(3): 198-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614953&dopt=Abstract

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Herpes zoster-associated trigeminal trophic syndrome: a case report and review. Author(s): Litschel R, Winkler H, Dazert S, Sudhoff H. Source: Eur Arch Otorhinolaryngol. 2003 February;260(2):86-90. Epub 2002 September 04. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582785&dopt=Abstract

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Herpes zoster-associated voiding dysfunction: a retrospective study and literature review. Author(s): Chen PH, Hsueh HF, Hong CZ. Source: Archives of Physical Medicine and Rehabilitation. 2002 November; 83(11): 16248. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422336&dopt=Abstract

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Herpetic neuralgia. Use of combination therapy for pain relief in acute and chronic herpes zoster. Author(s): Bajwa ZH, Ho CC. Source: Geriatrics. 2001 December; 56(12): 18-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766559&dopt=Abstract

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Images in clinical medicine. Herpes zoster ophthalmicus followed by contralateral hemiparesis. Author(s): Nogueira RG, Sheen VL. Source: The New England Journal of Medicine. 2002 April 11; 346(15): 1127. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11948272&dopt=Abstract

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Lidocaine and methylprednisolone in management of herpes zoster and post-herpetic neuralgia. Author(s): Gintautas J, Abraham Y, Doss NW, Ghobriel A, Kashem A, Fogler RJ. Source: Proc West Pharmacol Soc. 2002; 45: 73. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434534&dopt=Abstract

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Loss of urinary voiding sensation due to herpes zoster. Author(s): Hiraga A, Nagumo K, Sakakibara R, Kojima S, Fujinawa N, Hashimoto T. Source: Neurourology and Urodynamics. 2003; 22(4): 335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12808709&dopt=Abstract

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Metameric motor paresis following abdominal herpes zoster. Author(s): Molinero J, Nagore E, Obon L, Miquel FJ, Aliaga A. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 February; 69(2): 143-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868978&dopt=Abstract

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Multifocal chorioretinal atrophy associated with herpes zoster ophthalmicus. Author(s): McKelvie PA, Francis IC, Watson S, Nuovo G. Source: Clinical & Experimental Ophthalmology. 2001 December; 29(6): 429-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11778816&dopt=Abstract

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Multiple epidermoid cysts occurring at site of healed herpes zoster in a renal transplant recipient: an isotopic response? Author(s): Sandhu K, Saraswat A, Handa S. Source: Clinical and Experimental Dermatology. 2003 September; 28(5): 555-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12950353&dopt=Abstract

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Oral antivirals revisited in the treatment of herpes zoster: what do they accomplish? Author(s): Nikkels AF, Pierard GE. Source: American Journal of Clinical Dermatology. 2002; 3(9): 591-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444801&dopt=Abstract

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Oral brivudin in comparison with acyclovir for herpes zoster: a survey study on postherpetic neuralgia. Author(s): Wassilew SW, Wutzler P; Brivddin Herpes Zoster Study Group. Source: Antiviral Research. 2003 June; 59(1): 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834861&dopt=Abstract

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Oral brivudin in comparison with acyclovir for improved therapy of herpes zoster in immunocompetent patients: results of a randomized, double-blind, multicentered study. Author(s): Wassilew SW, Wutzler P; Brivddin Herpes Zoster Study Group. Source: Antiviral Research. 2003 June; 59(1): 49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834860&dopt=Abstract

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Polymorphism of the IL-10 gene is associated with susceptibility to herpes zoster. Author(s): Haanpaa M, Nurmikko T, Hurme M. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(2): 112-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11928840&dopt=Abstract

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Post-surgical herpes zoster of the plantar aspect of the foot. Author(s): Muche JA, Raghavendra M. Source: Journal of Pain and Symptom Management. 2003 September; 26(3): 788-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12967727&dopt=Abstract

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Presentations of cranial nerve involvement in two patients with Herpes zoster ophthalmicus. Author(s): Sodhi PK, Goel JL. Source: J Commun Dis. 2001 June; 33(2): 130-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170933&dopt=Abstract

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Presumed reactivation of herpes zoster ophthalmicus following laser in situ keratomileusis. Author(s): Jarade EF, Tabbara KF. Source: Journal of Refractive Surgery (Thorofare, N.J. : 1995). 2002 January-February; 18(1): 79-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11828912&dopt=Abstract

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Prodromal herpes zoster--a diagnostic challenge in endodontics. Author(s): Fristad I, Bardsen A, Knudsen GC, Molven O. Source: International Endodontic Journal. 2002 December; 35(12): 1012-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653320&dopt=Abstract

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Prognostic value of Hutchinson's sign in acute herpes zoster ophthalmicus. Author(s): Zaal MJ, Volker-Dieben HJ, D'Amaro J. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 2003 March; 241(3): 187-91. Epub 2003 February 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12644941&dopt=Abstract

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Prolonged herpes zoster in a patient infected with the human immunodeficiency virus. Author(s): Matsuo K, Honda M, Shiraki K, Niimura M. Source: The Journal of Dermatology. 2001 December; 28(12): 728-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11804069&dopt=Abstract

22 Herpes Zosters

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Rash severity in herpes zoster: correlates and relationship to postherpetic neuralgia. Author(s): Nagasako EM, Johnson RW, Griffin DR, Dworkin RH. Source: Journal of the American Academy of Dermatology. 2002 June; 46(6): 834-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12063479&dopt=Abstract

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Reactivation of herpes zoster after liver biopsy. Author(s): Levy JM, Smyth SH. Source: Journal of Vascular and Interventional Radiology : Jvir. 2002 February; 13(2 Pt 1): 209-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11830629&dopt=Abstract

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Recurrent herpes zoster revisited. Author(s): Burkhart CN. Source: International Journal of Dermatology. 2002 August; 41(8): 528. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207778&dopt=Abstract

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Reduction of postherpetic neuralgia in herpes zoster. Author(s): Vander Straten M, Carrasco D, Lee P, Tyring SK. Source: Journal of Cutaneous Medicine and Surgery. 2001 September-October; 5(5): 40916. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907852&dopt=Abstract

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Scleromalacia as a complication of herpes zoster ophthalmicus. Author(s): Berry-Brincat A, Von Lany H, Evans N. Source: Eye (London, England). 2003 April; 17(3): 449-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724725&dopt=Abstract

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Spinal cord stimulation in postherpetic neuralgia and in acute herpes zoster pain. Author(s): Harke H, Gretenkort P, Ladleif HU, Koester P, Rahman S. Source: Anesthesia and Analgesia. 2002 March; 94(3): 694-700; Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11867400&dopt=Abstract

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Systemic absorption of topical lidocaine in normal volunteers, patients with postherpetic neuralgia, and patients with acute herpes zoster. Author(s): Campbell BJ, Rowbotham M, Davies PS, Jacob P 3rd, Benowitz NL. Source: Journal of Pharmaceutical Sciences. 2002 May; 91(5): 1343-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11977110&dopt=Abstract

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Systemic and oral alterations in Brazilian patients with cutaneous herpes zoster. Author(s): Gonzaga HF, Jorge MA, Gonzaga LH, Barbosa CA, Chaves MD. Source: Braz Dent J. 2002; 13(1): 49-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11870963&dopt=Abstract

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Testing your diagnostic skills. Case no. 1. Herpes zoster. Author(s): Hashemian M. Source: Todays Fda. 2003 January; 15(1): 16, 19. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593144&dopt=Abstract

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Tooth exfoliation, osteonecrosis and neuralgia following herpes zoster of trigeminal nerve. Author(s): Volvoikar P, Patil S, Dinkar A. Source: Indian J Dent Res. 2002 January-March; 13(1): 11-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420562&dopt=Abstract

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Treatment of herpes zoster and postherpetic neuralgia. Author(s): Johnson RW, Dworkin RH. Source: Bmj (Clinical Research Ed.). 2003 April 5; 326(7392): 748-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676845&dopt=Abstract

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Understanding pain in herpes zoster: an essential for optimizing treatment. Author(s): Wood M. Source: The Journal of Infectious Diseases. 2002 October 15; 186 Suppl 1: S78-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353191&dopt=Abstract

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Use of hospitalization and pharmaceutical prescribing data to compare the prevaccination burden of varicella and herpes zoster in Australia. Author(s): MacIntyre CR, Chu CP, Burgess MA. Source: Epidemiology and Infection. 2003 August; 131(1): 675-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12948367&dopt=Abstract

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Uveitis in Herpes zoster ophthalmicus. Author(s): Thean JH, Hall AJ, Stawell RJ. Source: Clinical & Experimental Ophthalmology. 2001 December; 29(6): 406-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11778812&dopt=Abstract

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Valacyclovir and famciclovir therapy in herpes zoster. Author(s): Jubelt B. Source: Curr Neurol Neurosci Rep. 2002 November; 2(6): 477-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359099&dopt=Abstract

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Valacyclovir in the treatment of genital herpes and herpes zoster. Author(s): Baker DA. Source: Expert Opinion on Pharmacotherapy. 2002 January; 3(1): 51-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772333&dopt=Abstract

24 Herpes Zosters

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Varicella vaccination reduces risk of herpes zoster. Author(s): Quirk M. Source: The Lancet Infectious Diseases. 2002 August; 2(8): 454. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150833&dopt=Abstract

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Varicella zoster viraemia during herpes zoster is not associated with neoplasia. Author(s): Bezold G, Lange M, Pillekamp H, Peter RU. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 July; 16(4): 357-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12224692&dopt=Abstract

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Varicella, herpes zoster and dissemination. Author(s): Thami GP, Kaur S. Source: The Pediatric Infectious Disease Journal. 2003 March; 22(3): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634596&dopt=Abstract

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Vertigo from herpes zoster oticus: superior or inferior vestibular nerve origin? Author(s): Lu YC, Young YH. Source: The Laryngoscope. 2003 February; 113(2): 307-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12567087&dopt=Abstract

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Visceral zoster as the presenting feature of disseminated herpes zoster. Author(s): Stratman E. Source: Journal of the American Academy of Dermatology. 2002 May; 46(5): 771-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12004322&dopt=Abstract

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Visual prognosis in immunocompetent patients with herpes zoster ophthalmicus. Author(s): Zaal MJ, Volker-Dieben HJ, D'Amaro J. Source: Acta Ophthalmologica Scandinavica. 2003 June; 81(3): 216-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780396&dopt=Abstract

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Wolf's isotopic response: a case of zosteriform lichen planus on the site of healed herpes zoster. Author(s): Shemer A, Weiss G, Trau H. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2001 September; 15(5): 445-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763387&dopt=Abstract

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CHAPTER 2. NUTRITION AND HERPES ZOSTERS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and herpes zosters.

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

7 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.

26 Herpes Zosters

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

21 cases of herpes zoster treated by scratching method with three-edged needle. Author(s): Department of Traditional Chinese Medicine, Guangnei Hospital, Beijing. Source: Yuan, F J-Tradit-Chin-Med. 1997 December; 17(4): 282-3 0254-6272

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34 cases of herpes zoster treated by moxibustion at dazhui (du 14). Author(s): Section of Acupuncture, Zhaotong District Hospital, Yunnan Province. Source: Li, H J-Tradit-Chin-Med. 1992 March; 12(1): 71 0254-6272

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A retrospective study on the clinical outcome of herpes zoster in patients treated with acyclovir or valaciclovir vs. patients not treated with antiviral. Author(s): Institute of Dermatology, Singapore, National Skin Centre, Singapore. Source: Goh, C L Khoo, L Int-J-Dermatol. 1998 July; 37(7): 544-6 0011-9059

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Acupuncture treatment of herpes zoster. Author(s): Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese Medicine, Beijing 100700. Source: Hu, J J-Tradit-Chin-Med. 2001 March; 21(1): 78-80 0254-6272

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Acute and chronic herpes zoster. An ancient scourge yields to timely therapy. Author(s): University of Southern California School of Medicine, Los Angeles, USA. [email protected] Source: Landow, K Postgrad-Med. 2000 June; 107(7): 107-8, 113-4, 117-8 0032-5481

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Clinical observation on therapeutic effect of Ji De Sheng She Yao tablet on 16 cases with AIDS complicated by herpes zoster. Author(s): Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Xiyuan, Haidian District, Beijing 100091. Source: Huang, Y Zhang, L Liu, G Huang, W Jia, X Naomi, M J-Tradit-Chin-Med. 2001 March; 21(1): 34-6 0254-6272

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Clinical practice. Herpes zoster. Author(s): Departments of Medicine, University of Alabama at Birmingham, Birmingham, Ala 35294-2170, USA. Source: Gnann, John W Jr Whitley, Richard J N-Engl-J-Med. 2002 August 1; 347(5): 340-6 1533-4406

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Comparative study of the efficacy and safety of valaciclovir versus acyclovir in the treatment of herpes zoster. Author(s): Department of Medicine, Kaohsiung Veterans General Hospital, Taiwan, ROC. Source: Lin, W R Lin, H H Lee, S S Tsai, H C Huang, C K Wann, S R Chen, Y S Chiang, S C Yen, M Y Liu, Y C J-Microbiol-Immunol-Infect. 2001 June; 34(2): 138-42 1684-1182

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Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Author(s): Department of Ophthalmology, Hospital Morvan, Brest, France. Source: Colin, J Prisant, O Cochener, B Lescale, O Rolland, B Hoang Xuan, T Ophthalmology. 2000 August; 107(8): 1507-11 0161-6420

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Corneal complications of herpes zoster ophthalmicus. Prevention and treatment. Author(s): Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina 27710. Source: Cobo, L M Cornea. 1988; 7(1): 50-6 0277-3740

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Corticosteroids for herpes zoster: what do they accomplish? Author(s): School of Pharmacy, Division of Pharmacy Practice, University of MissouriKansas City, 2411 Holmes, Kansas City, MO 64108, USA. [email protected] Source: Santee, J A Am-J-Clin-Dermatol. 2002; 3(8): 517-24 1175-0561

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Cost effectiveness of newer antiviral agents for herpes zoster: is the evidence spotty? Author(s): Department of Medicine, Mercy Hospital of Pittsburgh, PA 15219, USA. [email protected] Source: Smith, K J Roberts, M S J-Infect-Dis. 1998 November; 178 Suppl 1S85-90 00221899

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Effects of topical capsaicin on normal skin and affected dermatomes in herpes zoster. Author(s): Department of Physiology, Monash University, Clayton, Vic. Source: Westerman, R A Roberts, R G Kotzmann, R R Westerman, D A Delaney, C Widdop, R E Carter, B E Clin-Exp-Neurol. 1988; 2571-84 0196-6383

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Evaluating herbal medicine for the management of Herpes zoster in human immunodeficiency virus-infected patients in Kampala, Uganda. Author(s): Traditional and Modern Health Practitioners Together Against AIDS (THETA), Kampala, Uganda. Source: Homsy, J Katabira, E Kabatesi, D Mubiru, F Kwamya, L Tusaba, C Kasolo, S Mwebe, D Ssentamu, L Okello, M King, R J-Altern-Complement-Med. 1999 December; 5(6): 553-65 1075-5535

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Evaluation of acceleration plethysmograms in dermatology--efficacy of lipo PGE1 preparations against herpes zoster and neuralgia following herpes. Author(s): Department of Dermatology, Tokyo Medical College, Japan. Source: Okuda, T Oh i, T Koga, M J-Dermatol. 1997 December; 24(12): 751-7 0385-2407

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Gastrointestinal complications of dermatomal herpes zoster successfully treated with famciclovir and lactulose. Author(s): Department of Dermatology, George Washington University Medical Center, Washington, DC 20037, USA. Source: Hong, J J Elgart, M L J-Am-Acad-Dermatol. 1998 February; 38(2 Pt 1): 279-80 0190-9622

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Granuloma annulare in herpes zoster scars. Author(s): Department of Dermatology, Osaka Teishin Hospital, Japan. Source: Ohata, C Shirabe, H Takagi, K Kawatsu, T J-Dermatol. 2000 March; 27(3): 166-9 0385-2407

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Herpes zoster and lymphopenia associated with sodium stibogluconate therapy for cutaneous leishmaniasis. Author(s): Infectious Disease Service, Walter Reed Army Medical Center, Washington, D.C. 20307-5001, USA. Source: Wortmann, G W Aronson, N E Byrd, J C Grever, M R Oster, C N Clin-Infect-Dis. 1998 September; 27(3): 509-12 1058-4838

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Herpes zoster. Treating postherpetic neuralgia. Author(s): [email protected]. Source: Baldwin, Patricia Donahue Clin-J-Oncol-Nurs. 2002 Jan-February; 6(1): 55-8, 61 1092-1095

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Herpetic neuralgia. Use of combination therapy for pain relief in acute and chronic herpes zoster. Author(s): Harvard Medical School, USA. Source: Bajwa, Z H Ho, C C Geriatrics. 2001 December; 56(12): 18-24 0016-867X

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High-dose oral acyclovir in acute herpes zoster ophthalmicus: the end of the corticosteroid era. Author(s): Hopital Ophtalmique Jules Gonin, Department of Ophthalmology, University of Lausanne, Switzerland. Source: Herbort, C P Buechi, E R Piguet, B Zografos, L Fitting, P Curr-Eye-Res. 1991; 10 Suppl171-5 0271-3683

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Management issues in herpes zoster. Author(s): Centre for Infectious Diseases and Microbiology, Westmead Hospital, New South Wales. Source: Dwyer, D E Aust-Fam-Physician. 1996 March; 25(3): 299-307 0300-8495

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Optic neuropathy secondary to herpes zoster ophthalmicus. Author(s): Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. Source: Menon, V KuMarch, G Tandon, R Indian-J-Ophthalmol. 1995 June; 43(2): 78-9 0301-4738

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Oral corticosteroids for pain associated with herpes zoster. Author(s): Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA. [email protected] Source: Ernst, M E Santee, J A Klepser, T B Ann-Pharmacother. 1998 October; 32(10): 1099-103 1060-0280

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Presumed bilateral herpes zoster ophthalmicus in an AIDS patient: a case report. Author(s): Department of Ophthalmology, Washington Hospital Center, DC, USA. Source: Yau, T H Butrus, S I Cornea. 1996 November; 15(6): 633-4 0277-3740

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Reduction of postherpetic neuralgia in herpes zoster. Author(s): Department of Dermatology, University of Texas Medical Branch, UTMB Center for Clinical Studies, 2060 Space Park Drive, Galveston, TX 77058, USA. Source: Vander Straten, M Carrasco, D Lee, P Tyring, S K J-Cutan-Med-Surg. 2001 SepOctober; 5(5): 409-16 1203-4754

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Reflex sympathetic dystrophy syndrome following herpes zoster. Author(s): Departments of Dermatology and Rehabilitation, Hospital Reina Sofia de Tudela, Tudela, Spain. [email protected] Source: Querol, I Cisneros, T Cutis. 2001 September; 68(3): 179-82 0011-4162

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The cancer patient with chronic pain due to herpes zoster. Author(s): Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta T6G 1Z2, Canada. [email protected] Source: Modi, S Pereira, J Mackey, J R Curr-Rev-Pain. 2000; 4(6): 429-36 1069-5850

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The use of capsaicin in herpes zoster ophthalmicus neuralgia. Author(s): Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel. Source: Frucht Pery, J Feldman, S T Brown, S I Acta-Ophthalmol-Scand. 1997 June; 75(3): 311-3 1395-3907

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Therapeutic approaches to the management of herpes zoster. Author(s): Department of Pediatrics, Microbiology and Medicine, University of Alabama at Birmingham 35233-0011, USA. Source: Whitley, R J Gnann, J W Adv-Exp-Med-Biol. 1999; 458159-65 0065-2598

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Treatment of herpes zoster with Clinacanthus nutans (bi phaya yaw) extract. Author(s): Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand. Source: Sangkitporn, S Chaiwat, S Balachandra, K Na Ayudhaya, T D Bunjob, M Jayavasu, C J-Med-Assoc-Thai. 1995 November; 78(11): 624-7 0125-2208

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Understanding pain in herpes zoster: an essential for optimizing treatment. Author(s): Department of Infection and Tropical Medicine, Heartlands Hospital, Birmingham B9 5SS, United Kingdom. [email protected] Source: Wood, M J-Infect-Dis. 2002 October 15; 186 Suppl 1: S78-82 0022-1899

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Update on drugs for herpes zoster and genital herpes. Source: Anonymous Drug-Ther-Bull. 1998 October; 36(10): 77-9 0012-6543

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Valaciclovir: a review of its use in the management of herpes zoster. Author(s): Adis International Limited, Mairangi Bay, Auckland, New Zealand. [email protected] Source: Ormrod, D Goa, K Drugs. 2000 June; 59(6): 1317-40 0012-6667

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Valacyclovir and famciclovir therapy in herpes zoster. Source: Jubelt, B Curr-Neurol-Neurosci-Repage 2002 November; 2(6): 477-8 1528-4042

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Valacyclovir in the treatment of genital herpes and herpes zoster. Author(s): Division of Infectious Diseases, Department of Obstetrics/Gynaecology, State University of New York at Stony Brook, Stony Brook, New York 11794-8091, USA. Source: Baker, David A Expert-Opin-Pharmacother. 2002 January; 3(1): 51-8 1465-6566

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What are the common acupuncture methods for treating herpes zoster? Source: Hu, J J-Tradit-Chin-Med. 1991 December; 11(4): 302-3 0254-6272

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

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

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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

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

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

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

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

•

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

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

Vitamins Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com

31

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

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

21 cases of herpes zoster treated by scratching method with three-edged needle. Author(s): Yuan F. Source: J Tradit Chin Med. 1997 December; 17(4): 282-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10437213&dopt=Abstract

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34 cases of herpes zoster treated by moxibustion at dazhui (du 14). Author(s): Li H. Source: J Tradit Chin Med. 1992 March; 12(1): 71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1598005&dopt=Abstract

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Acupuncture treatment of herpes zoster. Author(s): Hu J.

32 Herpes Zosters

Source: J Tradit Chin Med. 2001 March; 21(1): 78-80. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360548&dopt=Abstract •

Characteristics of herpes zoster and varicella viruses propagated in vitro. Author(s): Gold E. Source: Journal of Immunology (Baltimore, Md. : 1950). 1965 October; 95(4): 683-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4284677&dopt=Abstract

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Clinical features of human immunodeficiency virus-associated disseminated herpes zoster virus infection--a review of the literature. Author(s): Cohen PR, Grossman ME. Source: Clinical and Experimental Dermatology. 1989 July; 14(4): 273-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2686873&dopt=Abstract

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Clinical observation on therapeutic effect of Ji De Sheng She Yao tablet on 16 cases with AIDS complicated by herpes zoster. Author(s): Huang Y, Zhang L, Liu G, Huang W, Jia X, Naomi M. Source: J Tradit Chin Med. 2001 March; 21(1): 34-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360536&dopt=Abstract

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Clinical profile of herpes zoster ophthalmicus in Ethiopians. Author(s): Bayu S, Alemayehu W. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 June; 24(6): 1256-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9195095&dopt=Abstract

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Comments on the technique of the treatment of herpes zoster. Author(s): Serres G. Source: Zhen Ci Yan Jiu. 1988; 13(1): 6-9, 5. Chinese, English. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3143505&dopt=Abstract

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Concerning the management of pain associated with herpes zoster and of postherpetic neuralgia. Author(s): King RB. Source: Pain. 1988 April; 33(1): 73-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3380554&dopt=Abstract

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Evaluating herbal medicine for the management of Herpes zoster in human immunodeficiency virus-infected patients in Kampala, Uganda. Author(s): Homsy J, Katabira E, Kabatesi D, Mubiru F, Kwamya L, Tusaba C, Kasolo S, Mwebe D, Ssentamu L, Okello M, King R.

Alternative Medicine 33

Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 1999 December; 5(6): 553-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10630349&dopt=Abstract •

Garlic burns mimicking herpes zoster. Author(s): Farrell AM, Staughton RC. Source: Lancet. 1996 April 27; 347(9009): 1195. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8609803&dopt=Abstract

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Herpes zoster and herpes simplex--public health matter; chelatotherapy in these acute neuroviroses. Author(s): Dinu R, Dinu I. Source: Sante Publique (Bucur). 1984; 27(2): 99-114. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6441289&dopt=Abstract

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Herpes zoster in children with stage I-III Hodgkin's disease. Author(s): Goodman R, Jaffe N, Filler R, Cassady JR. Source: Radiology. 1976 February; 118(2): 429-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1250979&dopt=Abstract

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Herpes zoster in patients with carcinoma of the lung. Author(s): Feld R, Evans WK, DeBoer G. Source: The American Journal of Medicine. 1982 December; 73(6): 795-801. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6293307&dopt=Abstract

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Herpes zoster treated by acupuncture. Author(s): Coghlan CJ. Source: Cent Afr J Med. 1992 December; 38(12): 466-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1340799&dopt=Abstract

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Herpes zoster: treatment with Clinacanthus nutans cream. Author(s): Charuwichitratana S, Wongrattanapasson N, Timpatanapong P, Bunjob M. Source: International Journal of Dermatology. 1996 September; 35(9): 665-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876301&dopt=Abstract

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Herpes Zoster-Varicella infections and lymphoma. Author(s): Goffinet DR, Glatstein EJ, Merigan TC. Source: Annals of Internal Medicine. 1972 February; 76(2): 235-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4333227&dopt=Abstract

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Letter: Herpes zoster: transfer factor therapy. Author(s): Drew WL, Blume MR, Miner R, Silverberg I, Rosenbaum EH.

34 Herpes Zosters

Source: Annals of Internal Medicine. 1973 November; 79(5): 747-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4751749&dopt=Abstract •

No alternative to antiviral drugs for acute herpes zoster. Author(s): Dworkin RH. Source: Anesthesia and Analgesia. 1999 December; 89(6): 1585-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10589658&dopt=Abstract

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Observation of the efficacy of Ampelopsis brevipedunculata Trautv. in the treatment of herpes zoster. Author(s): Sun X, Guan YX, Luo XL, Yu YA, Gao HZ. Source: J Tradit Chin Med. 1986 March; 6(1): 17-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3736094&dopt=Abstract

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Percutaneous electrical nerve stimulation: an alternative to antiviral drugs for acute herpes zoster. Author(s): Ahmed HE, Craig WF, White PF, Ghoname ES, Hamza MA, Gajraj NM, Taylor SM. Source: Anesthesia and Analgesia. 1998 October; 87(4): 911-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9768793&dopt=Abstract

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The Ch1VPP regimen, a risk factor for herpes zoster virus infection in patients treated for Hodgkin's disease. Author(s): Norum J, Bremnes RM, Wist E. Source: European Journal of Haematology. 1994 July; 53(1): 51-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8062898&dopt=Abstract

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The efficacy of long-dan-xie-gan-tang in the treatment of herpes zoster: a clinical trial and animal experimental data. Author(s): Shen LL, Wu HS, Wang XY. Source: J Tongji Med Univ. 1986; 6(2): 109-11. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3746978&dopt=Abstract

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Treatment of herpes zoster and postherpetic neuralgia. Author(s): Carmichael JK. Source: American Family Physician. 1991 July; 44(1): 203-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1676237&dopt=Abstract

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Treatment of herpes zoster with Clinacanthus nutans (bi phaya yaw) extract. Author(s): Sangkitporn S, Chaiwat S, Balachandra K, Na-Ayudhaya TD, Bunjob M, Jayavasu C.

Alternative Medicine 35

Source: J Med Assoc Thai. 1995 November; 78(11): 624-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8576675&dopt=Abstract •

What are the common acupuncture methods for treating herpes zoster? Author(s): Hu J. Source: J Tradit Chin Med. 1991 December; 11(4): 302-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1795549&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Aids and Hiv Source: Integrative Medicine Communications; www.drkoop.com Chickenpox and Shingles Source: Integrative Medicine Communications; www.drkoop.com

36 Herpes Zosters

Herpes Zoster and Varicella Viruses Source: Integrative Medicine Communications; www.drkoop.com Hiv and Aids Source: Integrative Medicine Communications; www.drkoop.com Shingles and Chickenpox Source: Integrative Medicine Communications; www.drkoop.com Shingles and Postherpetic Neuralgia Source: Healthnotes, Inc.; www.healthnotes.com Varicella and Herpes Zoster Viruses Source: Integrative Medicine Communications; www.drkoop.com •

Homeopathy Apis Mellifica Source: Healthnotes, Inc.; www.healthnotes.com Arsenicum Album Source: Healthnotes, Inc.; www.healthnotes.com Clematis Source: Healthnotes, Inc.; www.healthnotes.com Iris Versicolor Source: Healthnotes, Inc.; www.healthnotes.com Kalmia Latifolia Source: Healthnotes, Inc.; www.healthnotes.com Mezereum Source: Healthnotes, Inc.; www.healthnotes.com Ranunculus Bulbosus Source: Healthnotes, Inc.; www.healthnotes.com Rhus Toxicodendron Source: Healthnotes, Inc.; www.healthnotes.com

•

Herbs and Supplements Adenosine Monophosphate Source: Healthnotes, Inc.; www.healthnotes.com Adenosine Monophosphate (amp) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10106,00.html

Alternative Medicine 37

Aesculus Alternative names: Horse Chestnut; Aesculus hippocastanum L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Amino Acid K Source: Integrative Medicine Communications; www.drkoop.com Cat's Claw Source: Prima Communications, Inc.www.personalhealthzone.com Cayenne Alternative names: Capsicum annuum, Capsicum frutescens Source: Healthnotes, Inc.; www.healthnotes.com Digestive Enzymes Source: Healthnotes, Inc.; www.healthnotes.com Glandular Extracts Source: Healthnotes, Inc.; www.healthnotes.com Glycyrrhiza1 Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Licorice Alternative names: Glycyrrhiza glabra, Glycyrrhiza uralensis Source: Healthnotes, Inc.; www.healthnotes.com L-lysine Source: Integrative Medicine Communications; www.drkoop.com Lysine Alternative names: Amino Acid K, L-Lysine Source: Integrative Medicine Communications; www.drkoop.com Lysine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,862,00.html Melissa Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10043,00.html Proteolytic Enzymes Source: Prima Communications, Inc.www.personalhealthzone.com Valacyclovir Source: Healthnotes, Inc.; www.healthnotes.com

38 Herpes Zosters

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

39

CHAPTER 4. CLINICAL TRIALS AND HERPES ZOSTERS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning herpes zosters.

Recent Trials on Herpes Zosters The following is a list of recent trials dedicated to herpes zosters.8 Further information on a trial is available at the Web site indicated. •

Controlled Study of NGX-4010 for the Treatment of Postherpetic Neuralgia Condition(s): Herpes Zoster; Neuralgia; Pain; Peripheral Nervous System Diseases Study Status: This study is currently recruiting patients. Sponsor(s): NeurogesX Purpose - Excerpt: The purpose of the study is to assess the efficacy, safety and tolerability of NGX 4010 applied for 60 minutes for the treatment of PHN. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068081

•

Double-Blind, Controlled Dose Finding Study NGX-4010 for the Treatment of Postherpetic Neuralgia Condition(s): Herpes Zoster; Neuralgia; Pain; Peripheral Nervous System Diseases Study Status: This study is currently recruiting patients. Sponsor(s): NeurogesX Purpose - Excerpt: The purpose of the study is to assess the efficacy, safety and tolerability of the high -concentration capsaicin path at three different dose levels (i.e.,

8

These are listed at www.ClinicalTrials.gov.

40 Herpes Zosters

application durations) for the treatment of Postherpetic Neuralgia (PHN). Based on these data, an optimal dose for treatment of PHN will be selected. The study will also provide information about the efficacy, safety and tolerability of repeated treatment(s) with the high-concentration capsaicin patch over one year. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00061776 •

Randomized Study of Two Doses of Oral Valacyclovir in Immunocompromised Patients With Uncomplicated Herpes Zoster Condition(s): Herpes Zoster; Immunologic Deficiency Syndromes Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Research Resources (NCRR); University of Texas Purpose - Excerpt: Objectives: I. Compare the efficacy and safety of two doses of oral valacyclovir in immunocompromised patients with uncomplicated herpes zoster. II. Compare quality of life, pain, and medical resource utilization in patients treated with these 2 regimens. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006131

•

Pilot Study of High-Dose Capsaicin Patches to Treat Postherpetic Neuralgia Pain Condition(s): Neuralgia; Pain; Peripheral Nervous System Diseases; Herpes Zoster Study Status: This study is no longer recruiting patients. Sponsor(s): NeurogesX Purpose - Excerpt: The purpose of this study is to gain initial information on the tolerability of high-dose capsaicin patches in patients with Painful Postherpetic Neuralgia. The study will also collect preliminary information on safety and efficacy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034710

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Shingles Prevention Study Condition(s): Herpes Zoster; Postherpetic neuralgia Study Status: This study is no longer recruiting patients. Sponsor(s): Department of Veterans Affairs; Department of Veterans Affairs Cooperative Studies Program; National Institutes of Health (NIH); SKB; Merck; National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The incidence and severity of HZ (or shingles), as well as the frequency and severity of its complications, increases markedly with increasing age. More than half of all cases occur in persons over the age of 60. Even without

Clinical Trials 41

complications, HZ can interfere with an elderly patient's ability to perform essential activities of daily living, resulting in a loss of independence that is emotionally devastating and frequently irreversible. The most common complication of HZ in elderly persons is postherpetic neuralgia (PHN), which frequently results in disordered sleep, chronic fatigue, anxiety and severe depression. Antiviral therapy has a modest impact on the acute phase of HZ. However, it does not appear to prevent the development of PHN. This study is a 5.5 year randomized, double-blind, placebocontrolled, efficacy trial to determine whether vaccination with live-attenuated Oka/Merck varicella-zoster decreases the incidence and/or severity of herpes zoster (HZ) and its complications in adults 60 years of age and older. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00007501 •

A Comparison of 882C87 Versus Acyclovir in the Treatment of Herpes Zoster in Patients with Weakened Immune Systems Condition(s): HIV Infections; Chickenpox Study Status: This study is completed. Sponsor(s): Glaxo Wellcome Purpose - Excerpt: To determine the efficacy of oral 882C87 compared with oral acyclovir in the treatment of localized herpes zoster in immunocompromised patients. To assess the safety and tolerance of oral 882C87 in immunocompromised patients. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002315

•

Dextromethorphan Versus Placebo for Neuropathic Pain Condition(s): Diabetic Neuropathies; Herpes Zoster; Neuralgia Study Status: This study is completed. Sponsor(s): National Institute of Dental and Craniofacial Research (NIDCR) Purpose - Excerpt: In our current clinical trial, we are comparing the effects of two NMDA receptor antagonists to placebo in patients with painful distal symmetrical diabetic neuropathy or post-herpetic neuralgia. The treatments in this three-period crossover study are dextromethorphan, up to 920 mg/day (about 8 times the antitussive dose), memantine, 30-50 mg/day, and placebo. Memantine is an NMDA antagonist used in Europe to treat Parkinson's disease and Alzheimer's disease. The underlying hypothesis, based on studies of painful neuropathies in animal models, is that neuropathic pain is caused largely by sensitization of central nervous system neurons caused by excitatory amino acid neurotransmitters, acting largely through NMDA receptors. A previous small trial of dextromethorphan suggested efficacy in diabetic neuropathy pain. The study requires one visit to the NIH outpatient Pain Research Clinic, and consists of three 9-week treatment periods. Patients who respond to one of the medications will be invited to participate in further controlled studies of the

42 Herpes Zosters

medication followed by up to several years of open-label treatment under continued observation. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001344 •

Phase III Randomized Controlled Study of Morphine and Nortriptyline in the Management of Postherpetic Neuralgia Condition(s): Pain; Herpes Zoster Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); National Institute of Neurological Disorders and Stroke (NINDS); Johns Hopkins University Purpose - Excerpt: Objectives: I. Determine whether opioid (morphine) treatment results in better management of pain than treatment with tricyclic antidepressant (nortriptyline). II. Assess the effects the two treatments have on affective and cognitive functions. III. Determine whether the presence of psychiatric comorbidity, particularly depression, can predict the outcome of the two treatments. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004390

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “herpes zosters” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

Clinical Trials 43

•

For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

45

CHAPTER 5. PATENTS ON HERPES ZOSTERS 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.9 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 “herpes zosters” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on herpes zosters, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Herpes Zosters By performing a patent search focusing on herpes zosters, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

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

46 Herpes Zosters

example of the type of information that you can expect to obtain from a patent search on herpes zosters: •

Method for the treatment of herpes simplex and herpes zoster Inventor(s): Diethelm; Franz (Triesen, LI) Assignee(s): Hepax Limited (Triesen, LI) Patent Number: 4,913,148 Date filed: November 16, 1988 Abstract: A method for the treatment, by accelerating the healing process, of acute herpes simplex and acute herpes zoster, and by the reduction of post-herpetic neuralgia, subsequent to determining a dermatone on a body, which dermatome includes an area affected by herpes and which comprises a corresponding segment nerve. Two conducting electrodes are applied to the surface of the dermatome including an anode directly on the spiral ganglion of the most proximal portion of the corresponding nerve, and a cathode on the distal part of the dermatome. Electric current having a constant frequency of about 30 Hz and in the shape of monopolar pulses of an approximately square wave-form having a duration of about 0.2 msec. is applied to the electrodes. The current intensity is adjusted in corresponding with the respective skin resistance. Excerpt(s): This invention relates to a method for the treatment of herpes simplex and herpes zoster. In the following description the term herpes, unless specified more precisely, will stand for all virus diseases of the skin and mucous membranes resulting from infection with the herpes simplex virus (herpes simplex) and the varicella virus (herpes zoster), herpes simplex being caused by two different types of virus affecting skin and genital mucosa, respectively. In the case of herpes simplex conventional medical treatment is mostly symptomatic, generally protracted and unrewarding, especially for recurrent forms of the disease. There is a widespread use of virostatic ointments and solutions which must be applied over a period of several weeks. Besides, desiccating and antiseptic preparations are recommended for the affected areas of the skin. Web site: http://www.delphion.com/details?pn=US04913148__

•

Method for treating pain associated with herpes-zoster and post-herpetic neuralgia Inventor(s): Hind; Harry (Los Altos, CA) Assignee(s): Hind Health Care, Inc. (Los Altos, CA) Patent Number: 5,601,838 Date filed: May 18, 1990 Abstract: A method is offered for reducing the pain associated with herpes-zoster and post-herpetic neuralgia. The method consists of administering a composition incorporating a transdermal delivery system for the administration of Lidocaine to areas of the body afflicted by herpes-zoster and post-herpetic neuralgia enclosed with an occlusive dressing or a plaster dressing. Excerpt(s): The subject of this application concerns methods for treatment of pain associated with herpes-zoster and post-herpetic neuralgia. The acute neuralgia produced by recrudescence of latent varicella-zoster virus (familiarly known as chicken

Patents 47

pox virus) is called herpes-zoster, or "shingles". Reactivation of the latent virus in a dorsal root ganglion results in the transport of live virus along the associated sensory nerves (dermatome). In addition to severe pain in the distribution of affected nerves, herpes zoster is also associated with nervous system complications such as myelitis, stroke, ocular damage, skin damage, and, most commonly, post-herpetic neuralgia-defined as pain that persists in the involved dermatome for more than 1 month after healing of the skin lesions. Web site: http://www.delphion.com/details?pn=US05601838__ •

Preparation for the treatment of Herpes zoster and other Herpes infections, as well as method for manufacture thereof Inventor(s): Westhues; Melchior (Munich, DE), Stickl; Helmut (Krailling, DE), Mayr; Anton (Munich, DE) Assignee(s): none reported Patent Number: 4,191,745 Date filed: March 29, 1978 Abstract: The invention provides a novel preparation for treatment of Herpes zoster and other Herpes infections, comprising active principle pox and/or parapox virus of the family: poxviridae, the nucleic acids of which have been selectively damaged and a suitable carrier of said virus. A method for manufacture of the novel preparation of the invention and for treatment of Herpes zoster therewith is also provided. Excerpt(s): In recent years, the so-called factor diseases have been on the increase. These are bacterial, virus and fungus dependent, infectious diseases of mammals induced by so-called "opportunistic germs". These pathogens occur in the organism in a latent form or they exist in symbiosis with our body without causing it harm. If, however, the general resistance should be lowered by whatever factor (e.g. high-energy radiation, antimetabolites, systemic diseases of the immune apparatus, hormones, etc.), then these infectious diseases appear and may lead to symptoms which are difficult to treat. An example for this is Herpes zoster (shingles), which is induced by the varicella-zoster virus. Herpes zoster results, after an attack of chicken pox, from a second exposure of the organism to the varicella-zoster virus and manifests itself as a predominantly neurocutaneous disease. Zoster occurs only in man; this disease does not naturally occur in animals, nor does an experimental animal model exist. A consistent therapy for zoster is not known at the present time. Numerous attempts to develop a treatment for zoster have led to unsatisfactory results, including among others, application of a localized treatment (powder and ointment), use of steroids, and use of analgetic and antirheumatic active principles, as well as of interferonization. Web site: http://www.delphion.com/details?pn=US04191745__

48 Herpes Zosters

•

Treatment of certain skin malignancies and pre-malignant skin lesions, herpes zoster and psoriasis Inventor(s): Miller; Daniel G. (Scarsdale, NY) Assignee(s): Exovir, Inc. (Great Neck, NY) Patent Number: 4,957,734 Date filed: July 6, 1987 Abstract: A composition consisting essentially of human leukocyte interferon and an antiviral surfactant, such as the non-ionic surfactant, nonylphenoxypolyethoxy ethanol, and a physiologically acceptable carrier therefor, has been found to be useful for the treatment of malignant and pre-malignant skin lesions and skin lesions associated with herpes zoster and psoriasis by topically administering or applying the composition to the affected skin area. Excerpt(s): This invention relates to a method for treatment of skin malignancies and pre-malignant skin lesions, including squamous cell carcinoma, basal cell carcinoma, actinic keratosis, and leukoplakia. This invention also relates to a method for treatment of psoriasis and herpes zoster. Basal cell carcinomas, which may appear as small, shiny, firm nodules or ulcerated crusted lesions on the skin, are generally treated by electrodesiccation and curettage, surgical excision or X-ray therapy. In about 5% of cases, recurrences occur. Such recurrences are treated typically with further excision or Moh's chemosurgery, i.e., microscopically controlled excision after chemical fixation of the tissue. Squamous cell carcinoma arises from the malpighian cells of the epithelium. The tumor generally begins as a small red papule or plaque with a scaly or crusted surface. Subsequently, it becomes nodular. Eventually, the lesion ulcerates and invades the underlying tissue. As with basal cell carcinoma, squamous cell carcinoma is heated with electrodesiccation and curettage, surgical excision or X-ray therapy. Web site: http://www.delphion.com/details?pn=US04957734__

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

49

CHAPTER 6. BOOKS ON HERPES ZOSTERS Overview This chapter provides bibliographic book references relating to herpes zosters. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on herpes zosters include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “herpes zosters” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “herpes zosters” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “herpes zosters” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Clinician's Manual on Herpes Zoster Infection by M. Wood, P. Easterbrook; ISBN: 1858730589; http://www.amazon.com/exec/obidos/ASIN/1858730589/icongroupinterna

•

Herpes Zoster and Postherpetic Neuralgia, 2nd Revised and Enlarged Edition by C. Peter N. Watson (Editor), Anne A. Gershon (Editor); ISBN: 0444506799; http://www.amazon.com/exec/obidos/ASIN/0444506799/icongroupinterna

•

Immunity to and Prevention of Herpes Zoster (Springer Life Sciences.) by Anne A. Gershon (Editor), et al; ISBN: 3211835563; http://www.amazon.com/exec/obidos/ASIN/3211835563/icongroupinterna

•

Pointers to the Common Remedies: Chicken Pox, Diphtheria, Erysipelas, Herpes Zoster, Measles, Mumps, Scarlet Fever, Small-pox, Typhoid and Typhoid Conditions, Vaccination, Whooping Cough by M.L. Tyler, Douglas M. Borland (Editor) (1930);

50 Herpes Zosters

ISBN: 0946717451; http://www.amazon.com/exec/obidos/ASIN/0946717451/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “herpes zosters” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •

A case of herpes zoster ophthalmicus, in a patient 80 years of age, causing fatal prostration: with remarks Author: Jeffries, B. Joy (Benjamin Joy),; Year: 1969; [18--]

•

Shingles. (herpes zoster). Author: National Institute of Neurological Diseases and Stroke.; Year: 1944; Bethesda, Md., For sale by the Supt. of Docs., U. S. Govt. Print. Off., Washington, 1970]

Chapters on Herpes Zosters In order to find chapters that specifically relate to herpes zosters, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and herpes zosters 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 “herpes zosters” (or synonyms) into the “For these words:” box.

10

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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CHAPTER 7. PERIODICALS AND NEWS ON HERPES ZOSTERS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover herpes zosters.

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

Early antiviral therapy prevents complications of herpes zoster ophthalmicus Source: Reuters Industry Breifing Date: March 11, 2003

•

Herpes zoster often occurs after HIV-infected patients begin antiretroviral therapy Source: Reuters Medical News Date: July 02, 2001

52 Herpes Zosters

•

Valacyclovir and famciclovir are equally effective against herpes zoster Source: Reuters Industry Breifing Date: October 20, 2000

•

Baseline herpes zoster pain predicts extent of postherpetic neuralgia in AIDS patients Source: Reuters Medical News Date: June 30, 1999

•

Protease inhibitor therapy increases herpes zoster incidence Source: Reuters Medical News Date: January 08, 1999

•

Foscarnet effective for acyclovir-resistant herpes zoster in AIDS patients Source: Reuters Medical News Date: January 01, 1999

•

Herpes zoster common, usually benign in children and adolescents Source: Reuters Medical News Date: November 02, 1998

•

Acyclovir more effective than netivudine for herpes zoster-associated pain Source: Reuters Medical News Date: June 09, 1998

•

Sorivudine, effective for HIV-related herpes zoster, unlikely to be approved Source: Reuters Medical News Date: May 12, 1998

•

Risk Of Herpes Zoster Seen With Initiation Of HIV Protease Inhibitors Source: Reuters Medical News Date: February 05, 1998

•

Sorivudine Effective For HIV-Related Acute Herpes Zoster Source: Reuters Medical News Date: July 04, 1997

•

Oral Acyclovir Reduces Postherpetic Neuralgia In Herpes Zoster Patients Source: Reuters Medical News Date: May 07, 1997

•

Herpes Zoster Does Not Independently Predict Progression To AIDS Source: Reuters Medical News Date: November 27, 1996

•

Bristol-Myers Herpes Zoster Drug Rejected By FDA Advisory Committee Source: Reuters Medical News Date: June 07, 1996

•

Herpes Zoster Complications Increase As HIV Infection Progresses Source: Reuters Medical News Date: April 25, 1996

•

Famciclovir Efficacious In Treatment Of Acute Herpes Zoster Source: Reuters Medical News Date: July 17, 1995

Periodicals and News

53

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 “herpes zosters” (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 “herpes zosters” (or synonyms). If you know the name of a company that is relevant to herpes zosters, 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 “herpes zosters” (or synonyms).

Academic Periodicals covering Herpes Zosters Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to herpes zosters. In addition to

54 Herpes Zosters

these sources, you can search for articles covering herpes zosters 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.”

55

APPENDICES

57

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 Institute11: •

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/

11

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

58 Herpes Zosters

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

59

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 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:13 •

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

12

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

60 Herpes Zosters

•

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 Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “herpes zosters” using the “Detailed Search” option. Go directly to the following hyperlink: 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 the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “herpes zosters” (or synonyms) into the “For these words:” box. The following is a sample result: •

Herpes Zoster (Shingles) Source: Schaumberg, IL: American Academy of Dermatology. 1999. 8 p. Contact: Available from American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumberg, IL 60168. (888)462-DERM ext. 22. Website: www.aad.org. PRICE: Single copy free. Summary: This brochure discusses shingles, a viral infection caused by the same virus that causes chicken pox. Symptoms include burning pain, tingling, fever, headache, or extreme sensitivity on one area of skin generally followed by a red rash that turns into groups of blisters resembling chicken pox. Shingles can appear on the trunk, buttocks, face, arms, or legs. Complications include constant pain or periods of pain that continue after the skin has healed, bacterial infection of blisters that may delay healing, and spread of the virus over the entire body or to internal organs. Diagnosis is made by physical examination and/or examining the blister fluid. Treatment includes pain relievers, cool compresses, oral anti-viral drugs, and corticosteroids. 2 figures.

The NLM Gateway14 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.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “herpes zosters” (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. 14 15

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

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).

Physician Resources

61

Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1 0 413 1 0 415

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 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.18 Simply search by “herpes zosters” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists19 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.20 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.21 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/.

16

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

17

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

18

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. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20

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. 21 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.

62 Herpes Zosters

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/.

63

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 herpes zosters can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to herpes zosters. 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 herpes zosters. 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 “herpes zosters”:

64 Herpes Zosters

•

Other guides Chickenpox http://www.nlm.nih.gov/medlineplus/chickenpox.html Herpes Simplex http://www.nlm.nih.gov/medlineplus/herpessimplex.html HPV http://www.nlm.nih.gov/medlineplus/hpv.html Sexually Transmitted Diseases http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html Shingles http://www.nlm.nih.gov/medlineplus/shinglesherpeszoster.html

Within the health topic page dedicated to herpes zosters, the following was listed: •

General/Overview Herpes Zoster Source: American Academy of Dermatology http://www.aad.org/pamphlets/herpesZoster.html Shingles http://www.nlm.nih.gov/medlineplus/tutorials/shinglesloader.html Shingles: An Unwelcome Encore Source: Food and Drug Administration http://www.fda.gov/fdac/features/2001/301_pox.html

•

Specific Conditions/Aspects Ramsay Hunt Syndrome Type I http://www.ninds.nih.gov/health_and_medical/disorders/ramsay1_doc.htm Shingles (Acute Herpes Zoster) and Postherpetic Neuralgia (PHN) Source: Beth Israel Medical Center, Dept. of Pain Medicine and Palliative Care http://stoppain.org/pain_medicine/shingles.html What You Should Know about Herpes Zoster Ophthalmicus (HZO) Source: American Academy of Family Physicians http://familydoctor.org/handouts/745.html

•

From the National Institutes of Health Shingles http://www.ninds.nih.gov/health_and_medical/disorders/shingles_doc.htm Shingles: Hope Through Research Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/pubs/shingles.htm

Patient Resources

•

65

Latest News Childhood Chickenpox Can Come Back Much Later as Painful Disease Shingles Source: 10/28/2003, Canadian Press http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14446 .html

•

Organizations National Center for Infectious Diseases http://www.cdc.gov/ncidod/index.htm National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/ VZV Research Foundation http://www.vzvfoundation.org/

•

Pictures/Diagrams Photos of Shingles Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/shingles/photos.htm

•

Prevention/Screening Shingles Prevention Study: Common Questions Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/shingles/cq.htm

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

66 Herpes Zosters

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 herpes zosters. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with herpes zosters. 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 herpes zosters. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “herpes zosters” (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

Patient Resources

67

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 “herpes zosters”. 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 “herpes zosters” (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 “herpes zosters” (or a synonym) into the search box, and click “Submit Query.”

69

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.22

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

22

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

70 Herpes Zosters

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)23: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

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

Finding Medical Libraries

71

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

72 Herpes Zosters

•

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

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•

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

•

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

•

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

•

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

•

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/

74 Herpes Zosters

•

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

75

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Herpes Zosters Herpes zoster Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000858.htm

•

Signs & Symptoms for Herpes Zosters Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Blindness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003040.htm Blistering Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003939.htm Blisters Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003939.htm

76 Herpes Zosters

Deafness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Drooping eyelid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003035.htm Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Facial paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003028.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Genital lesions (female or male) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003222.htm Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Joint pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Leukemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001299.htm Loss of taste Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003050.htm Lymph node swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003097.htm Rash Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Reddening of the skin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm Skin lesion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Skin lesions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Tingling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm

Online Glossaries 77

Vesicles Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003939.htm Vision abnormalities Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm •

Diagnostics and Tests for Herpes Zosters CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Tzanck test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003837.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm WBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003643.htm

•

Background Topics for Herpes Zosters Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Analgesics Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Immunity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000821.htm Symptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002293.htm

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

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

•

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

•

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

•

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

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HERPES ZOSTERS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Actinic keratosis: A precancerous condition of thick, scaly patches of skin. Also called solar or senile keratosis. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acyclovir: Functional analog of the nucleoside guanosine. It acts as an antimetabolite, especially in viruses. It is used as an antiviral agent, especially in herpes infections. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent 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] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium

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cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allogeneic: Taken from different individuals of the same species. [NIH] 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 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] Amino Acid Neurotransmitters: Amino acids released by neurons as intercellular messengers. Among the amino acid neurotransmitters are glutamate (glutamic acid) and GABA which are, respectively, the most common excitatory and inhibitory neurotransmitters in the central nervous system. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Angiitis: Inflammation of a vessel, chiefly of a blood or a lymph vessel; called also vasculitis. [EU] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

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Anode: Electrode held at a positive potential with respect to a cathode. [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] Antidepressant: A drug used to treat depression. [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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Antiviral Agents: Agents used in the prophylaxis or therapy of virus diseases. Some of the ways they may act include preventing viral replication by inhibiting viral DNA polymerase; binding to specific cell-surface receptors and inhibiting viral penetration or uncoating; inhibiting viral protein synthesis; or blocking late stages of virus assembly. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspartate: A synthetic amino acid. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH]

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Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Auditory nerve: The eight cranial nerve; also called vestibulocochlear nerve or acoustic nerve. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autologous bone marrow transplantation: A procedure in which bone marrow is removed from a person, stored, and then given back to the person after intensive treatment. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [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

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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] Blast phase: The phase of chronic myelogenous leukemia in which the number of immature, abnormal white blood cells in the bone marrow and blood is extremely high. Also called blast crisis. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [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] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bupivacaine: A widely used local anesthetic agent. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [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-, poly-

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and heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] 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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Central retinal artery: The blood vessel that carries blood into eye; supplies nutrition to the retina. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Chickenpox: A mild, highly contagious virus characterized by itchy blisters all over the body. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH]

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Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [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] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic phase: Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [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] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH]

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Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Consciousness: Sense of awareness of self and of the environment. [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]

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Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [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] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan

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shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysgeusia: A condition characterized by alterations of the sense of taste which may range from mild to severe, including gross distortions of taste quality. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH]

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Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrodesiccation: The drying of tissue by a high-frequency electric current applied with a needle-shaped electrode. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emollient: Softening or soothing; called also malactic. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endodontics: A dental specialty concerned with the maintenance of the dental pulp in a state of health and the treatment of the pulp cavity (pulp chamber and pulp canal). [NIH] Endopeptidases: A subclass of peptide hydrolases. They are classified primarily by their catalytic mechanism. Specificity is used only for identification of individual enzymes. They comprise the serine endopeptidases, EC 3.4.21; cysteine endopeptidases, EC 3.4.22; aspartic endopeptidases, EC 3.4.23, metalloendopeptidases, EC 3.4.24; and a group of enzymes yet to be assigned to any of the above sub-classes, EC 3.4.99. EC 3.4.-. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU]

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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] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] 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. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exfoliation: A falling off in scales or layers. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Facial Nerve Diseases: Diseases of the facial nerve or nuclei. Pontine disorders may affect the facial nuclei or nerve fascicle. The nerve may be involved intracranially, along its course through the petrous portion of the temporal bone, or along its extracranial course. Clinical manifestations include facial muscle weakness, loss of taste from the anterior tongue, hyperacusis, and decreased lacrimation. [NIH] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may

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result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [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] Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from death, the physiological cessation of life and from mortality, an epidemiological or statistical concept. [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]

Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fold: A plication or doubling of various parts of the body. [NIH] Follicles: Shafts through which hair grows. [NIH] Folliculitis: Inflammation of follicles, primarily hair follicles. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored

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in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Geniculate Ganglion: The sensory ganglion of the facial (7th cranial) nerve. The geniculate ganglion cells send central processes to the brain stem and peripheral processes to the taste buds in the anterior tongue, the soft palate, and the skin of the external auditory meatus and the mastoid process. [NIH] Genital: Pertaining to the genitalia. [EU] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Growth: The progressive development of a living being or part of an organism from its

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earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Hematopoietic Stem Cell Transplantation: The transference of stem cells from one animal or human to another (allogeneic), or within the same individual (autologous). The source for the stem cells may be the bone marrow or peripheral blood. Stem cell transplantation has been used as an alternative to autologous bone marrow transplantation in the treatment of a variety of neoplasms. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Herpes Zoster Ophthalmicus: Virus infection of the Gasserian ganglion and its nerve branches characterized by pain and vesicular eruptions with much swelling. Ocular involvement is usually heralded by a vesicle on the tip of the nose. This area is innervated by the nasociliary nerve. [NIH] Herpes Zoster Oticus: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird

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and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperacusis: An abnormally disproportionate increase in the sensation of loudness in response to auditory stimuli of normal volume. Cochlear diseases; vestibulocochlear nerve diseases; facial nerve diseases; stapes surgery; and other disorders may be associated with this condition. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH]

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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] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [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] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] 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]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] 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]

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Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [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]

Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratitis: Inflammation of the cornea. [NIH] Keratomileusis: Carving of the cornea to reshape it. [NIH] Keratosis: Any horny growth such as a wart or callus. [NIH] Lacrimal: Pertaining to the tears. [EU] Lactulose: A mild laxative. [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] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] 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] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or

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site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [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] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lymphopenia: Reduction in the number of lymphocytes. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maxillary Nerve: The intermediate sensory division of the trigeminal (5th cranial) nerve. The maxillary nerve carries general afferents from the intermediate region of the face including the lower eyelid, nose and upper lip, the maxillary teeth, and parts of the dura. [NIH]

Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Memantine: Amantadine derivative that has some dopaminergic effects. It has been proposed as an antiparkinson agent. [NIH]

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Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [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] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] 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] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH]

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Myelitis: Inflammation of the spinal cord. Relatively common etiologies include infections; autoimmune diseases; spinal cord; and ischemia (see also spinal cord vascular diseases). Clinical features generally include weakness, sensory loss, localized pain, incontinence, and other signs of autonomic dysfunction. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] 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] Nasociliary: A branch of the ophthalmic nerve which receives most of the fibers of general sensation from the eyeball. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [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] Neonatorum: Patchy or generalized progressive hardening of the subcutaneous fat, often with fatal outcome, occurring in infants predisposed by reason of prematurity, marasmus, hypothermia, gastro-intestinal or respiratory infection, or gross malformations. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Degeneration: Loss of functional activity and trophic degeneration of nerve axons and their terminal arborizations following the destruction of their cells of origin or interruption of their continuity with these cells. The pathology is characteristic of neurodegenerative diseases. Often the process of nerve degeneration is studied in research on neuroanatomical localization and correlation of the neurophysiology of neural pathways. [NIH]

Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]

Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH]

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Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to 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, 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] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by

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polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmic Artery: Artery originating from the internal carotid artery and distributing to the eye, orbit and adjacent facial structures. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Ophthalmoplegia: Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Osteonecrosis: Death of a bone or part of a bone, either atraumatic or posttraumatic. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overactive bladder: A condition in which the patient experiences two or all three of the following conditions: [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of

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increased lead absorption. [NIH] 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] Papule: A small circumscribed, superficial, solid elevation of the skin. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] 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] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [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]

Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms.

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[NIH]

Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plant Oils: Oils derived from plants or plant products. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [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] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] 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] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Poxviridae: A family of double-stranded DNA viruses infecting mammals (including humans), birds and insects. There are two subfamilies: Chordopoxvirinae, poxviruses of vertebrates, and Entomopoxvirinae, poxviruses of insects. [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] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH]

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Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protease Inhibitors: Compounds which inhibit or antagonize biosynthesis or actions of proteases (endopeptidases). [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH]

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Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychological Adaptation: The alteration of the selective response of a neural unit due to the received signals. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pupil: The aperture in the iris through which light passes. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] 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] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Artery: Central retinal artery and its branches. It arises from the ophthalmic artery, pierces the optic nerve and runs through its center, enters the eye through the porus opticus and branches to supply the retina. [NIH] Retinal Artery Occlusion: Occlusion or closure of the central retinal artery causing sudden, usually nearly complete, loss of vision in one eye. Occlusion of the branch retinal artery causes sudden visual loss in only a portion of the visual field. [NIH]

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Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the

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nerves are not carried properly. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] 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] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Vascular Diseases: Hypoxic-ischemic and hemorrhagic disorders of the spinal cord. Arteriosclerosis, emboli, and vascular malformations are potential causes of these conditions. [NIH] Spiral Ganglion: The sensory ganglion of the cochlear nerve. The cells of the spiral ganglion send fibers peripherally to the cochlear hair cells and centrally to the cochlear nuclei of the brain stem. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells

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resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Stapes: One of the three ossicles of the middle ear. It transmits sound vibrations from the incus to the internal ear. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] 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] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other 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] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Symbiosis: The living together of organisms of different species. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Taste Buds: Small sensory organs which contain gustatory receptor cells, basal cells, and supporting cells. Taste buds in humans are found in the epithelia of the tongue, palate, and pharynx. They are innervated by the chorda tympani nerve (a branch of the facial nerve) and the glossopharyngeal nerve. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of

Dictionary 109

collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [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] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translation: The process whereby the genetic information present in the linear sequence of

110 Herpes Zosters

ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the trigeminal ganglion and project to the trigeminal nucleus of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Varicella: Chicken pox. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH]

Dictionary 111

Venous: Of or pertaining to the veins. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibular Nerve: The vestibular part of the 8th cranial nerve (vestibulocochlear nerve). The vestibular nerve fibers arise from neurons of Scarpa's ganglion and project peripherally to vestibular hair cells and centrally to the vestibular nuclei of the brain stem. These fibers mediate the sense of balance and head position. [NIH] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viraemia: The presence of virus in blood or blood plasma. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Virus Diseases: A general term for diseases produced by viruses. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] 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]

Xenograft: The cells of one species transplanted to another species. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

112 Herpes Zosters

Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH]

113

INDEX A Abdominal, 20, 75, 79, 102 Acetylcholine, 79, 100 Acoustic, 79, 82, 111 Actinic keratosis, 48, 79 Activities of Daily Living, 41, 79 Acyclovir, 4, 5, 10, 14, 20, 26, 28, 41, 52, 79 Adaptation, 6, 79 Adjustment, 79 Adrenal Cortex, 79, 87, 104 Afferent, 9, 79, 90 Affinity, 79, 88, 107 Agar, 79, 103 Algorithms, 80, 83 Alkaloid, 80, 83, 98 Allergen, 80, 106 Allogeneic, 80, 93 Alpha Particles, 80, 105 Alternative medicine, 53, 80 Amino acid, 41, 80, 81, 92, 97, 102, 104, 107, 110 Amino Acid Neurotransmitters, 41, 80 Anal, 80, 91 Analgesic, 4, 6, 80, 85, 96, 98, 101 Analog, 79, 80, 87 Anatomical, 80, 84, 95 Androgens, 79, 80, 87 Angiitis, 15, 80 Animal model, 41, 47, 80 Annealing, 80, 103 Anode, 46, 81 Antibody, 79, 81, 86, 94, 95, 106, 107 Antidepressant, 42, 81 Antigen, 10, 79, 81, 86, 94, 95, 106, 107 Anti-inflammatory, 81, 87, 92 Anti-Inflammatory Agents, 81, 87 Antimetabolite, 79, 81 Antineoplastic, 81, 87 Antiseptic, 46, 81 Antitussive, 41, 81, 88, 101 Antiviral, 4, 6, 11, 20, 26, 27, 34, 41, 48, 51, 79, 81, 95 Antiviral Agents, 4, 27, 81 Anxiety, 41, 81 Aponeurosis, 81, 92 Aqueous, 81, 82, 89 Arginine, 81, 100 Arterial, 81, 92, 94, 104

Arteries, 81, 83, 87, 98 Arteritis, 18, 81 Artery, 81, 83, 87, 97, 101, 105 Aseptic, 15, 81 Aspartate, 81, 88 Assay, 7, 81 Atrophy, 20, 81 Atypical, 82, 100 Auditory, 3, 82, 92, 93, 94, 97 Auditory nerve, 3, 82, 97 Autoimmune disease, 82, 99 Autologous, 82, 93 Autologous bone marrow transplantation, 82, 93 Autonomic, 79, 82, 99, 102 Axonal, 9, 82 Axons, 82, 99, 101 B Bacteria, 81, 82, 98, 109, 110 Bacterial Physiology, 79, 82 Bactericidal, 82, 90 Bacteriophage, 82, 103 Basal cell carcinoma, 48, 82 Basal cells, 82, 108 Basal Ganglia, 82, 92 Base, 4, 82, 92, 96 Benign, 52, 82, 92, 93, 99 Bilateral, 13, 18, 28, 82, 102 Bile, 82, 91, 96, 108 Biological response modifier, 82, 95 Biopsy, 22, 82 Biotechnology, 10, 50, 53, 59, 82 Bladder, 16, 83, 95, 110 Blast phase, 83, 85 Blister, 60, 83 Blood pressure, 83, 92, 94, 107 Blood vessel, 83, 84, 89, 96, 107, 108, 109, 110 Body Fluids, 83, 107 Bone Marrow, 82, 83, 85, 93, 94, 97 Bowel, 80, 83, 88, 96 Bowel Movement, 83, 88 Bradykinin, 83, 100 Brain Stem, 83, 85, 92, 107, 110, 111 Branch, 28, 73, 83, 97, 99, 102, 105, 107, 108 Bupivacaine, 83, 96 Burns, 33, 83 Burns, Electric, 83

114 Herpes Zosters

C Capsaicin, 8, 27, 28, 39, 40, 83 Carbohydrate, 83, 87, 92 Carbon Dioxide, 84, 91 Carcinogenic, 84, 95, 108 Carcinoma, 33, 48, 84 Cardiac, 84, 89, 96, 99, 108 Carotene, 84, 105 Case report, 16, 19, 28, 84, 91 Catecholamine, 84, 102 Cathode, 46, 81, 84 Cell, 6, 11, 12, 18, 48, 81, 82, 84, 86, 87, 90, 91, 92, 93, 94, 95, 99, 100, 103, 105, 111 Cell Transplantation, 84, 93 Cellulose, 84, 91 Central Nervous System, 15, 41, 79, 80, 84, 88, 92, 93, 98, 101, 103, 107 Central Nervous System Infections, 84, 93 Central retinal artery, 12, 84, 105 Cerebral, 82, 83, 84, 91 Cerebral Cortex, 84, 91 Chickenpox, 35, 36, 41, 64, 65, 84 Chin, 26, 29, 31, 32, 34, 35, 84, 98 Chlorophyll, 85, 91 Cholesterol, 82, 85, 108 Chronic, 4, 6, 8, 19, 26, 27, 28, 41, 83, 85, 95, 104, 108 Chronic lymphocytic leukemia, 85 Chronic myelogenous leukemia, 83, 85 Chronic phase, 4, 85 CIS, 85, 105 Clinical Medicine, 19, 85 Clinical trial, 5, 6, 7, 34, 39, 41, 42, 59, 85, 87, 88, 104, 105 Cloning, 83, 85 Cochlear, 85, 94, 107, 109, 111 Cochlear Diseases, 85, 109 Cochlear Nerve, 85, 107, 111 Codeine, 85, 87, 101 Cofactor, 85, 104 Collagen, 80, 85, 103 Combination Therapy, 19, 27, 85 Comorbidity, 42, 86 Complement, 27, 86, 106 Complementary and alternative medicine, 31, 38, 86 Complementary medicine, 31, 86 Computational Biology, 59, 86 Cones, 86, 105 Conjunctiva, 86, 110 Consciousness, 80, 86 Contraindications, ii, 86

Contralateral, 19, 87 Control group, 6, 87 Cornea, 13, 26, 28, 87, 93, 96, 106, 110, 112 Coronary, 87, 98 Coronary Thrombosis, 87, 98 Corpus, 87, 102, 104 Cortical, 87, 90 Corticosteroid, 28, 87, 103 Cranial, 4, 21, 82, 85, 87, 90, 92, 93, 96, 97, 99, 100, 101, 102, 110, 111 Craniocerebral Trauma, 87, 93, 109 Curettage, 48, 87 Curette, 87 Cutaneous, 4, 8, 12, 20, 22, 27, 87, 94, 96 Cyclic, 87, 93, 100 D Denaturation, 87, 103 Dendrites, 87, 100 Dermatology, 11, 13, 14, 15, 16, 17, 18, 20, 21, 22, 24, 26, 27, 28, 32, 33, 60, 64, 87 Dermis, 87, 109 Dextromethorphan, 41, 87 Diagnostic procedure, 45, 53, 88 Digestion, 82, 83, 88, 96, 108 Digestive system, 43, 88 Digestive tract, 88, 107, 108 Direct, iii, 85, 88, 105 Discrete, 88, 93, 108, 112 Disinfectant, 88, 90 Distal, 41, 46, 82, 88, 89, 104 Dizziness, 3, 88, 111 Dorsal, 47, 88, 103 Double-blind, 5, 9, 20, 41, 88 Double-blinded, 9, 88 Drug Tolerance, 88, 109 Dura mater, 88, 98, 101 Dysgeusia, 4, 88 Dystrophy, 28, 88 E Efferent, 88, 90, 98 Efficacy, 14, 26, 27, 34, 39, 40, 41, 88 Elastic, 89, 108 Electrode, 81, 84, 89 Electrodesiccation, 48, 89 Electrolyte, 87, 89, 98, 107 Emollient, 89, 101 Emulsion, 89, 91 Encephalitis, 15, 89 Encephalitis, Viral, 89 Endocrine Glands, 89 Endodontics, 21, 89 Endopeptidases, 89, 104

Index 115

Endothelium, 89, 100 Endothelium-derived, 89, 100 Environmental Health, 58, 60, 89 Enzymatic, 80, 84, 86, 89, 103, 105 Enzyme, 89, 93, 103, 104, 111 Epidemic, 8, 89 Epidermis, 82, 83, 87, 90 Epidermoid carcinoma, 90, 107, 108 Epidural, 19, 90 Epithelial, 13, 90 Epithelial Cells, 90 Epithelium, 48, 89, 90, 93, 96, 112 Erectile, 18, 90, 102 Erection, 90 Erythrocytes, 83, 90, 106 Esophagus, 88, 90, 108 Ethanol, 48, 90 Excitatory, 41, 80, 90, 92 Exfoliation, 23, 90 Extensor, 90, 104 Extracellular, 90, 107 Extremity, 90, 102 F Facial, 3, 4, 76, 90, 92, 94, 97, 101, 108 Facial Expression, 90 Facial Nerve, 3, 4, 90, 94, 108 Facial Nerve Diseases, 90, 94 Facial Paralysis, 4, 90 Family Planning, 59, 91 Fat, 83, 84, 87, 91, 92, 99, 106, 108 Fatal Outcome, 91, 99 Fatigue, 41, 91 Fissure, 17, 91 Fixation, 48, 91, 106 Fold, 91 Follicles, 91 Folliculitis, 15, 91 Fovea, 91 Fungi, 91, 98, 111 Fungus, 47, 91 G Gallbladder, 79, 88, 91 Ganglia, 79, 92, 99, 102 Ganglion, 47, 92, 93, 101, 107, 110, 111, 112 Gas, 84, 92, 94, 100 Gastrointestinal, 15, 27, 83, 90, 92, 107 Gastrointestinal tract, 90, 92, 107 Gene, 21, 50, 83, 92 Genetic Code, 92, 101 Genetic testing, 92, 103 Genetics, 7, 92 Geniculate Ganglion, 4, 92

Genital, 23, 29, 46, 76, 92 Glucocorticoids, 79, 87, 92 Glutamate, 80, 88, 92 Glutamic Acid, 80, 92, 100 Glycine, 80, 92, 100 Gonadal, 92, 108 Governing Board, 92, 103 Graft, 92, 94 Growth, 80, 81, 92, 95, 96, 97, 99, 110 Guanylate Cyclase, 93, 100 H Hair Cells, 85, 93, 107, 111 Hair follicles, 87, 91, 93 Headache, 60, 93 Headache Disorders, 93 Health Behavior, 6, 93 Health Status, 93 Hematopoietic Stem Cell Transplantation, 12, 93 Hemiparesis, 19, 93 Hemorrhage, 87, 93, 108 Heredity, 92, 93 Herpes Zoster Ophthalmicus, 11, 12, 13, 14, 20, 21, 22, 24, 26, 28, 32, 50, 51, 64, 93 Herpes Zoster Oticus, 24, 93 Homologous, 93, 106 Hormonal, 81, 87, 94 Hormone, 87, 94, 104, 106 Host, 8, 82, 94, 110 Hydrogen, 82, 83, 87, 94, 98, 100, 104 Hydroxyproline, 80, 85, 94 Hyperacusis, 4, 90, 94 Hyperalgesia, 9, 94 Hypersensitivity, 12, 80, 94, 106 Hypertension, 94, 96 Hypesthesia, 94, 100 Hypothermia, 94, 99 I Id, 30, 35, 66, 72, 74, 94 Illusion, 94, 111 Immune response, 7, 81, 82, 87, 94, 106, 110, 111 Immune Sera, 94 Immune system, 7, 94, 110, 111 Immunity, 6, 49, 77, 94, 109 Immunization, 7, 9, 94, 106 Immunocompromised, 4, 40, 41, 94 Immunodeficiency, 10, 21, 27, 32, 94 Immunologic, 40, 94, 95 Impairment, 3, 95, 98 Impotence, 18, 90, 95 In situ, 21, 95

116 Herpes Zosters

In vitro, 32, 95, 103, 107 In vivo, 7, 13, 95 Incontinence, 95, 99 Indicative, 49, 95, 102, 110 Infarction, 87, 95, 98 Infection, 3, 4, 5, 6, 8, 11, 16, 23, 29, 32, 34, 46, 49, 52, 60, 81, 82, 89, 93, 94, 95, 96, 97, 99, 100, 101, 106, 108, 111, 112 Infiltration, 93, 95, 104, 112 Inflammation, 8, 80, 81, 89, 91, 93, 95, 96, 98, 99, 100, 101, 103, 106, 110 Initiation, 6, 52, 95 Innervation, 90, 95, 101 Interferon, 48, 95 Interferon-alpha, 95 Intestinal, 84, 95, 99 Intestines, 79, 92, 95 Intracellular, 95, 100 Intracranial Hypertension, 93, 96, 102, 109 Invasive, 94, 96 Ions, 21, 82, 89, 94, 96, 98 Iris, 36, 87, 96, 105, 110 Ischemia, 81, 96, 99 K Kb, 58, 96 Keratitis, 13, 96 Keratomileusis, 21, 96 Keratosis, 79, 96 L Lacrimal, 90, 96 Lactulose, 27, 96 Large Intestine, 88, 95, 96, 105 Latent, 46, 47, 96 Laxative, 80, 96 Leishmaniasis, 27, 96 Leukoplakia, 48, 96 Levorphanol, 87, 96 Library Services, 72, 96 Lidocaine, 19, 22, 46, 96 Liver, 22, 79, 82, 88, 89, 91, 92, 96 Localization, 96, 99 Localized, 41, 47, 91, 95, 97, 99, 103 Longitudinal Studies, 8, 97 Lymph, 76, 80, 89, 97 Lymphatic, 89, 95, 97, 109 Lymphocytes, 81, 85, 92, 94, 97, 109, 111 Lymphoid, 97 Lymphoma, 33, 97 Lymphopenia, 27, 97 Lysine, 37, 97 M Malignant, 48, 81, 97, 99

Malnutrition, 81, 97 Manifest, 82, 97 Mannans, 91, 97 Mastication, 97, 110 Maxillary, 97, 110 Maxillary Nerve, 97, 110 Meatus, 92, 97 Mediate, 85, 97, 111 Medical Records, 97, 106 Medical Staff, 88, 97 MEDLINE, 59, 97 Medullary, 88, 97 Memantine, 41, 97 Membrane, 86, 98, 105 Meninges, 84, 87, 88, 98 Meningitis, 15, 98 Mental, iv, 4, 5, 43, 58, 61, 84, 91, 98, 104, 105 Mental Disorders, 43, 98, 104 Mental Health, iv, 5, 43, 58, 61, 98, 105 Metabolite, 98, 100 Methylprednisolone, 19, 98 MI, 77, 98 Microbiology, 28, 79, 82, 98 Mineralocorticoids, 79, 87, 98 Modification, 80, 98, 105 Molecular, 59, 61, 83, 86, 98, 109, 110 Molecular Structure, 98, 110 Molecule, 81, 82, 86, 89, 98, 105 Morphine, 42, 85, 98, 99, 101 Morphological, 91, 98 Motor nerve, 4, 98 Mucinous, 92, 98 Mucocutaneous, 96, 98 Mucosa, 46, 98 Muscular Diseases, 91, 98, 102 Muscular Dystrophies, 88, 98 Myelitis, 17, 47, 99 Myocardium, 98, 99 Myositis, 11, 99 N Narcotic, 96, 98, 99 Nasociliary, 93, 99 NCI, 1, 42, 57, 85, 99 Need, 3, 50, 60, 67, 99, 109 Neonatorum, 17, 99 Neoplasia, 24, 99 Neoplasms, 81, 93, 99 Neoplastic, 97, 99 Nerve Degeneration, 4, 99 Nerve Fibers, 8, 85, 99, 111

Index 117

Nervous System, 47, 79, 84, 93, 99, 100, 102 Neural, 8, 79, 99, 105 Neural Pathways, 99 Neuralgia, 4, 8, 9, 15, 19, 22, 23, 27, 28, 39, 40, 41, 46, 99, 103 Neuritis, 4, 14, 100, 111 Neurologic, 4, 100 Neuromuscular, 79, 91, 100, 101 Neuromuscular Junction, 79, 100, 101 Neuronal, 8, 100 Neurons, 41, 80, 85, 87, 90, 92, 99, 100, 111 Neuropathy, 28, 41, 100 Neurophysiology, 99, 100 Neurosyphilis, 100, 102 Neurotoxicity, 88, 100 Neurotransmitter, 79, 80, 83, 92, 100 Neutrons, 80, 100, 105 Nitric Oxide, 14, 100 Nitrogen, 80, 91, 100 Nortriptyline, 42, 100 Nuclear, 82, 92, 100 Nuclei, 80, 85, 90, 91, 100, 101, 104, 107, 111 Nucleic acid, 47, 92, 100 Nucleus, 85, 87, 97, 100, 101, 104, 108, 110, 111 O Ocular, 4, 47, 93, 101 Ointments, 46, 101 Ophthalmic, 28, 99, 101, 105, 110 Ophthalmic Artery, 101, 105 Ophthalmology, 11, 12, 17, 18, 20, 21, 23, 26, 28, 91, 101 Ophthalmoplegia, 18, 101 Opiate, 98, 101 Opium, 98, 101 Opportunistic Infections, 8, 101 Opsin, 101, 105, 106 Optic Nerve, 101, 105, 106 Orbit, 101 Orbital, 11, 17, 101 Osteonecrosis, 23, 101 Outpatient, 41, 101 Overactive bladder, 16, 101 P Pachymeningitis, 98, 101 Palate, 92, 101, 108 Palsy, 3, 4, 101 Pancreas, 79, 88, 102 Papule, 48, 102 Paralysis, 4, 76, 91, 93, 101, 102

Paraparesis, 102 Paresis, 20, 91, 100, 102 Paresthesias, 100, 102 Patch, 40, 96, 102, 109 Pathologic, 82, 87, 94, 102, 104 Penis, 17, 102 Peptide, 80, 89, 102, 104 Peripheral blood, 11, 93, 95, 102 Peripheral Nervous System, 39, 40, 100, 101, 102 Phallic, 91, 102 Pharmacologic, 102, 109 Pharmacotherapy, 7, 23, 102 Physical Examination, 60, 102 Physiologic, 102, 105 Pigments, 84, 102, 105 Pituitary Gland, 87, 103 Plant Oils, 101, 103 Plaque, 48, 103 Plasma, 98, 103, 111 Platelet Aggregation, 100, 103 Platelets, 100, 103, 107 Pneumonia, 86, 103 Polymerase, 14, 81, 103 Polymerase Chain Reaction, 14, 103 Pons, 83, 91, 103 Posterior, 80, 88, 96, 101, 102, 103, 106 Postherpetic Neuralgia, 4, 6, 7, 10, 16, 19, 20, 22, 23, 27, 28, 32, 34, 36, 39, 40, 41, 42, 49, 52, 64, 103 Poxviridae, 47, 103 Practice Guidelines, 61, 103 Precancerous, 79, 103 Prednisolone, 98, 103 Prevalence, 6, 10, 104 Procaine, 96, 104 Progesterone, 104, 108 Progression, 52, 80, 104 Progressive, 88, 92, 98, 99, 104, 110 Prophylaxis, 81, 104, 110 Prospective study, 10, 104 Protease, 8, 52, 85, 104 Protease Inhibitors, 8, 52, 104 Protein S, 50, 81, 83, 92, 104 Proteins, 80, 81, 85, 86, 98, 100, 102, 103, 104, 107 Protocol, 6, 104 Protons, 80, 94, 104, 105 Protozoa, 96, 104 Proximal, 46, 88, 104 Psoriasis, 48, 104 Psychiatric, 42, 98, 104

118 Herpes Zosters

Psychiatry, 91, 104 Psychic, 98, 105 Psychological Adaptation, 6, 105 Public Health, 29, 33, 61, 105 Public Policy, 59, 105 Pulmonary, 83, 105, 108 Pupil, 87, 105 Q Quality of Life, 8, 40, 105 R Radiation, 47, 105 Randomized, 5, 10, 20, 40, 41, 42, 88, 105 Reactivation, 6, 21, 22, 47, 105 Receptor, 41, 79, 81, 88, 105, 107, 108 Rectum, 83, 88, 92, 95, 96, 105 Refer, 1, 86, 88, 91, 93, 96, 100, 105, 109, 111 Refractory, 6, 105 Regimen, 34, 88, 102, 105 Restoration, 105 Retina, 84, 86, 101, 105, 110 Retinal, 101, 105, 106 Retinal Artery, 105 Retinal Artery Occlusion, 105 Retinol, 105, 106 Retrospective, 19, 26, 106 Retrospective study, 19, 26, 106 Rheumatism, 106 Rheumatoid, 12, 106 Rheumatoid arthritis, 12, 106 Rhodopsin, 101, 105, 106 Risk factor, 4, 6, 8, 12, 34, 104, 106 S Salivary, 88, 90, 106 Salivary glands, 88, 90, 106 Saponins, 106, 108 Sclera, 86, 106, 110 Screening, 85, 106 Secretion, 87, 92, 98, 106 Self Care, 79, 106 Senile, 79, 106 Sensibility, 94, 106 Sensitization, 41, 106 Sensory loss, 99, 106 Septic, 81, 107 Sequencing, 103, 107 Serology, 10, 107 Serotonin, 100, 102, 107 Serum, 86, 94, 98, 107 Smooth muscle, 98, 107 Social Environment, 105, 107 Sodium, 27, 98, 107

Solvent, 90, 107 Spatial disorientation, 88, 107 Specialist, 66, 107 Species, 80, 83, 84, 96, 107, 108, 110, 111 Spinal cord, 22, 83, 84, 85, 88, 90, 92, 98, 99, 100, 101, 102, 107 Spinal Cord Vascular Diseases, 99, 107 Spiral Ganglion, 46, 85, 107, 111 Squamous, 48, 90, 107, 108 Squamous cell carcinoma, 48, 90, 107 Squamous cells, 107, 108 Stapes, 94, 108 Stem Cells, 93, 108 Sterile, 81, 108 Steroid, 4, 106, 108 Stomach, 79, 88, 90, 92, 94, 95, 108 Strand, 103, 108 Stress, 84, 106, 108 Stroke, 42, 43, 47, 50, 58, 64, 65, 108 Subacute, 95, 108 Subarachnoid, 93, 108 Subclinical, 95, 108 Subcutaneous, 99, 108 Suppression, 87, 108 Surfactant, 48, 108 Symbiosis, 47, 108 Symptomatic, 46, 77, 108 Systemic, 17, 22, 47, 83, 95, 96, 103, 108, 109 Systemic disease, 47, 108 T Taste Buds, 92, 108 Tendon, 92, 108 Testicular, 17, 109 Testis, 109 Thermal, 9, 100, 103, 109 Thorax, 4, 109 Thrombosis, 104, 108, 109 Thymus, 94, 97, 109 Tin, 60, 76, 109 Tinnitus, 4, 109, 111 Tolerance, 14, 41, 109 Tooth Preparation, 79, 109 Topical, 4, 22, 27, 90, 109 Torsion, 17, 95, 109 Toxic, iv, 94, 100, 109 Toxicology, 60, 109 Toxin, 109 Trace element, 109 Transdermal, 46, 109 Transfection, 83, 109 Transfer Factor, 33, 94, 109

Index 119

Translation, 80, 109 Transplantation, 94, 110 Tricyclic, 42, 110 Trigeminal, 19, 23, 97, 110 Trigeminal Nerve, 23, 110 Trophic, 19, 99, 110 Tumour, 92, 110 Tungsten, 84, 110 Tunica, 98, 110 U Unconscious, 94, 110 Urethra, 102, 110 Urinary, 20, 95, 110 Urine, 83, 95, 110 Uvea, 110 Uveitis, 18, 23, 110 V Vaccination, 6, 18, 24, 41, 49, 110 Vaccine, 5, 6, 7, 8, 9, 16, 104, 110 Varicella, 4, 5, 6, 7, 8, 9, 11, 13, 14, 15, 16, 18, 23, 24, 32, 33, 36, 41, 46, 47, 110 Vascular, 22, 87, 89, 93, 95, 100, 107, 110 Vasculitis, 18, 80, 110 Vasodilators, 100, 110 Venous, 104, 111 Vertigo, 4, 24, 111 Vesicular, 11, 93, 111 Vestibular, 4, 24, 93, 111 Vestibular Nerve, 24, 111

Vestibule, 111 Vestibulocochlear Nerve, 82, 85, 94, 109, 111 Vestibulocochlear Nerve Diseases, 94, 109, 111 Veterinary Medicine, 59, 111 Viraemia, 24, 111 Viral, 4, 5, 60, 81, 89, 111 Virus, 3, 4, 6, 10, 11, 14, 16, 18, 21, 27, 32, 34, 46, 47, 60, 81, 82, 84, 93, 95, 103, 111, 112 Virus Diseases, 46, 81, 111 Visceral, 24, 96, 111 Visual field, 105, 111 Vitro, 111 Vivo, 111 W White blood cell, 81, 83, 85, 97, 111 X Xenograft, 80, 111 Y Yeasts, 91, 111 Z Zoster, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, 31, 32, 33, 34, 35, 36, 39, 40, 41, 42, 46, 47, 48, 49, 50, 51, 52, 60, 64, 75, 93, 112

120 Herpes Zosters

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

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

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Genital Herpes - 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

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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

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

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

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

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

Genital Herpes - 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

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