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

IMPETIGO A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. P...

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IMPETIGO A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Impetigo: 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: 0-597-83990-5 1. Impetigo-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 impetigo. 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 IMPETIGO .................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Impetigo ........................................................................................ 5 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND IMPETIGO......................................................................................... 37 Overview...................................................................................................................................... 37 Finding Nutrition Studies on Impetigo ....................................................................................... 37 Federal Resources on Nutrition ................................................................................................... 40 Additional Web Resources ........................................................................................................... 40 CHAPTER 3. ALTERNATIVE MEDICINE AND IMPETIGO .................................................................. 41 Overview...................................................................................................................................... 41 National Center for Complementary and Alternative Medicine.................................................. 41 Additional Web Resources ........................................................................................................... 43 General References ....................................................................................................................... 44 CHAPTER 4. PATENTS ON IMPETIGO ............................................................................................... 45 Overview...................................................................................................................................... 45 Patents on Impetigo ..................................................................................................................... 45 Patent Applications on Impetigo.................................................................................................. 49 Keeping Current .......................................................................................................................... 50 CHAPTER 5. BOOKS ON IMPETIGO................................................................................................... 51 Overview...................................................................................................................................... 51 Book Summaries: Federal Agencies.............................................................................................. 51 Book Summaries: Online Booksellers........................................................................................... 52 The National Library of Medicine Book Index ............................................................................. 52 Chapters on Impetigo ................................................................................................................... 53 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 59 Overview...................................................................................................................................... 59 NIH Guidelines............................................................................................................................ 59 NIH Databases............................................................................................................................. 61 Other Commercial Databases....................................................................................................... 63 The Genome Project and Impetigo ............................................................................................... 63 APPENDIX B. PATIENT RESOURCES ................................................................................................. 67 Overview...................................................................................................................................... 67 Patient Guideline Sources............................................................................................................ 67 Finding Associations.................................................................................................................... 70 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 73 Overview...................................................................................................................................... 73 Preparation................................................................................................................................... 73 Finding a Local Medical Library.................................................................................................. 73 Medical Libraries in the U.S. and Canada ................................................................................... 73 ONLINE GLOSSARIES.................................................................................................................. 79 Online Dictionary Directories ..................................................................................................... 81 IMPETIGO DICTIONARY ............................................................................................................ 83 INDEX .............................................................................................................................................. 127

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

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

Periodontal and Soft-Tissue Abnormalities Source: Dental Clinics of North America. 39(4): 837-850. October 1995. Summary: This article reviews periodontal and soft-tissue abnormalities as they may be found in young children. Topics include normal gingival tissues and gingivitis in young children; periodontitis and tooth loss in young children, including that caused by neutropenia, Papillon-Lefevre syndrome, metabolic disorders, histiocytosis X, and hypophosphatasia; congenital lesions; developmental lesions including geographic tongue, fissured tongue, retrocuspid papillae, and gingival fibromatosis; benign tumors, including hemangioma, lymphangioma, mucocele, and fibroma; odontogenic cysts, including parulis, eruption cyst and hematoma; infectious diseases, such as herpes virus infection, Coxsackie virus, hand-foot-and-mouth disease, recurrent aphthous ulceration, candidiasis, impetigo, and HIV infection; hematologic diseases, notably leukemias; and

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factitial injuries. The author recommends periodic review of soft-tissue lesions to help the dental team recognize both common and rare abnormalities affecting young children. 5 figures. 14 references. •

Common Bacterial Skin Infections Source: American Family Physician. 66(1): 119-124. July 1, 2002. Summary: This journal article discusses the etiology, presentation, and treatment of cellulitis, erysipelas, impetigo, folliculitis, and furuncles and carbuncles. Cellulitis is an infection of the dermis and subcutaneous tissue that has poorly demarcated borders and is usually caused by Streptococcus or Staphylococcus species. Erysipelas is a superficial form of cellulitis with sharply demarcated borders and is caused almost exclusively by Streptococcus. Impetigo is caused by Streptococcus or Staphylococcus and can lead to lifting of the stratum corneum resulting in the commonly seen bullous effect. Folliculitis is an inflammation of the hair follicles. When the infection is bacterial rather than mechanical in nature, it is most commonly caused by Staphylococcus. If the infection of the follicle is deeper and involves more follicles, it moves into the furuncle and carbuncle stages and usually requires incision and drainage. All of these infections are typically diagnosed by clinical presentation and treated empirically. If antibiotics are required, one that is active against gram-positive organisms such as penicillinaseresistant penicillins, cepahalosporins, macrolides, or fluoroquinolones should be chosen. Children, patients with diabetes, or patients with immunodeficiencies are more susceptible to gram-negative infections and may require treatment with a second- or third-generation cephalosporin. 6 figures, 1 table, and 27 references. (AAM).

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Skin and Wound Infections: An Overview Source: American Family Physician. 57(10): 2424-2432. May 15, 1998. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article for health professionals presents an overview of skin and wound infections, focusing on their features and treatment. Skin infections are common and may be caused by bacteria, fungi, or viruses. Breaks in the skin integrity, particularly those that inoculate pathogens into the dermis, frequently cause or exacerbate skin infections. Bacterial skin infections caused by corynebacteria include erythrasma, trichomycosis axillaris, and pitted keratolysis. Staphylococci may cause impetigo, ecthyma, and folliculitis. Streptococcal skin infections include impetigo and erysipelas. Human papillomavirus skin infections present as several different types of warts, depending on the surface infected and its relative moisture, and the patterns of pressure. The many dermatomycoses include tinea capitis, tinea barbae, tinea cruris, tinea manus, tinea pedis, and tinea unguium. Candidal infections occur in moist areas, such as the vulva, mouth, penis, skinfolds, and diaper area. Wounds caused by wood splinters or thorns may results in sporotrichosis. Animal bites may result in complex, serious infections, requiring tetanus and, possibly, rabies prophylaxis in addition to appropriate antibiotic therapy. 3 figures and 28 references. (AA-M).

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Defining Pseudofolliculitis Barbae in 2001: A Review of the Literature and Current Trends Source: Journal of the American Academy of Dermatology. 46(2): S113-S119. February 2002.

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Summary: This journal article provides health professionals with information on the epidemiology, etiology, pathogenesis, clinical manifestations, differential diagnosis, classification, dermatopathology, diagnosis, and treatment of pseudofolliculitis barbae (PFB). This chronic inflammatory and potentially disfiguring condition is most often seen in men and women of African American and Hispanic origin who have tightly curled hair and who shave or tweeze frequently. The etiology is multifactorial. The shape of the hair follicle, the hair cuticle, and the direction of hair growth all play a role in the inflammatory response once the hair is shaven or plucked and left to grow. This reaction often produces painful, pruritic, and sometimes hyperpigmented papules in the beard distribution. The result is an unappealing cosmetic appearance, often with emotionally distressing consequences for affected people. The diagnosis is made clinically. The differential diagnosis of PFB includes true folliculitis, acne vulgaris, tinea barbae, impetigo, and sarcoidal papules. Currently, prevention and early intervention are the mainstays of therapy. Many treatment options are available; however, none has been completely curative. Various hair releasing techniques have been recommended. Electric clippers are associated with what is felt to be the overall best outcome, but the 1 millimeter hair stubble that is left is often unacceptable to those who prefer a clean shaven appearance. Chemical depilatories are also recommended for hair removal in patients with PFB. These are available in powder, lotion, cream, and paste forms. A recent product of hair removal research and development is eflornithine hydrochloride cream 13.9 percent. Various topical agents may help decrease irritation after hair removal and are useful additions in the management of PFB. Neutral pH or more acidic emollients such as hydrocortisone cream, 10 percent urea cream, and lactic acid may be helpful. Other helpful topical agents are topical antibiotics, chemical peels, and liquid nitrogen. Hair removal techniques such as electrolysis and surgical depilation have also been used. The only definitive cure for PFB is permanent removal of the hair follicle. 3 figures, 3 tables, and 29 references. (AA-M).

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

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

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Project Title: IN VIVO ANALYSIS OF VIRULENCE EXPRESSION IN MODEL OF GROUP A STREPTOCOCCAL DISEAS Principal Investigator & Institution: Mciver, Kevin S.; Assistant Professor; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001; Project Start 01-JUN-1997; Project End 31-MAY-2006 Summary: The group A streptococcus (Streptococcus pyogenes, GAS) is unsurpassed among bacterial pathogens in its ability to cause a variety of skin infections ranging from the self-limiting impetigo to fulminant soft issue destruction and necrotizing fasciitis. GAS pathogenes is a multi- factorial process, involving numerous virulence components are involved in the specific response of the bacterial to different environments encountered within the host. However, we know very little about when these different virulence products are produced during infection. The overall aim of this pilot proposal will be to establish an in vivo receptor system based on the Green Fluorescent Protein (GFP) to assay GAS virulence gene expression during skin disease in an animal model. The specific aims of the project will be as follows: 1. To construct GAS vectors for transcriptional fusions to gfp and test their capabilities in vitro. 2. To establish in vivo conditions for assaying GFP expression in a mouse model for streptococcal invasive skin disease. 3. To assay in vivo expression of known virulence genes in a mouse model of streptococcal invasive skin disease. These studies will hopefully lead to the establishment of a useful model system for directly examining the host/pathogen interplay between GAS and human host during invasive skin infections. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INTERACTION OF GROUP A STREP WITH THE PLASMINOGEN SYSTEM Principal Investigator & Institution: Boyle, Michael D.; Professor; Microbiology and Immunology; Medical College of Ohio at Toledo Research & Grants Admin. Toledo, Oh 436145804 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 30-JUN-2003 Summary: (Adapted from the applicant's abstract): Group A streptococci are significant human pathogens associated with a variety of diseases including pharyngitis, impetigo, and invasive infections such as cellulitis and bacteremia. Recently, the incidence and severity of streptococcal disease has increased and the exact nature of the invasive phenotype has not been fully elucidated. Studies in Dr. Boyle's laboratory have shown that group A streptococci can interact with the human plasmin(ogen) system by a number of different mechanisms to acquire surface proteolytic enzymatic activity, which cannot be inhibited by physiological protease inhibitors like alpha-2 antiplasmin. These pathways include direct binding of plasmin to surface binding proteins, as well as a more complicated pathway involving two host proteins (plasminogen and fibrinogen) and two bacterial proteins (the secreted bacterial plasminogen activator, streptokinase (SK), and a surface fibrinogen-binding protein). Preliminary evidence, using a mouse model of skin infection, suggests that acquisition of this host protease activity enhances the ability of group A streptococci to cause a systemic infection. The significance of the interaction of group A streptococci with the human plasmin(ogen) system will be studied by: 1) establishing the host and bacterial factors required for acquiring surface plasminogen activator and plasmin(ogen)-dependent enzymatic activity under conditions that would exist in the infected host; and 2) determining the consequences of the acquired enzymatic activity in a mouse model of skin infection. These studies will use an established mouse model of skin infection using outbred CD1 mice as well as

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studies in transgenic plasminogen gene knock-out mice reconstituted with mouse or human plasminogen. Regulation of key bacterial factors involved in acquisition of host plasmin(ogen)-dependent activity under conditions that mimic those group A streptococci could encounter in the infected host will also be analyzed. These studies will lead to a clearer understanding of the interaction of group A streptococci with the human plasmin(ogen) system and the importance of this interaction on the course, severity, and nature of invasive infections. With the reported increase in mortality and morbidity associated with invasive streptococcal infections, a more comprehensive understanding of the pathogenic process is important. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: KERATINOCYTE RESPONSE TO INFECTION BY STREPTOCOCCUS PYOGENES Principal Investigator & Institution: Caparon, Michael G.; Associate Professor; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001 Summary: The Gram-positive bacterium Streptococcus pyogenes (group A streptococcus) is one of the most important pathogens that can infect the skin where it causes numerous diseases ranging from the relatively superficial impetigo to lifethreatening necrotizing faciitis. Since it is likely that an encounter between an keratinocyte and S. pyogenes represents an early event of all streptococcal skin disease, an analysis of the molecular basis of the interaction and its consequences will provide a powerful model for understanding the contribution of the keratinocyte to defense against microorganisms. Initial studies have revealed that the manner by which keratinocytes sense and respond to the presence of S. pyogenes is influenced through the expression of at least two streptococcal proteins. The first is an adhesin known as M protein that directs attachment of the bacterium to the keratinocyte and the second is streptolysin O (SLO), a membrane-active pore-forming toxin. Furthermore, expression of the genes that encode these streptococcal proteins is highly regulated by S. pyogenes. Preliminary evidence suggests that expression of SLO is developmentally regulated and may involve a bacterial autocrine factor. An understanding of how bacterial and host cell regulatory networks interact to influence the course of infection will provide insight into how keratinocytes help to orchestrate host defense responses. This proposal will examine the regulatory events involving SLO and their effect on infection of keratinocytes by: 1.) Identification of the streptococcal regulatory genes which control expression of SLO. This will be essential for understanding the signals by S. pyogenes in the skin. 2) Analyzing how the regulation of SLO and expression of the adhesin interact to induce distinct patters of keratinocyte responses in existing cell culture models; and 3.) Examining the role of SLO and the adhesin in manipulating keratinocyte function in an advanced organotypic model of streptococcal skin infection. This latter aim welldefined utilize mutant streptococci and the resource of this Program's Histology Core. This project will combine Dr. Caparon's knowledge of streptococcal genetics with the expertise of the other members of this Program in the biology of the keratinocyte. This collaboration is an important component of this program, which will be valuable for understanding the behavior of keratinocytes under any circumstance when they are exposed to bacteria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MECHANISMS OF BLISTER FORMATION BY STAPHYLOCOCCAL TOXINS Principal Investigator & Institution: Stanley, John R.; Milton B. Hartzell Professor; Dermatology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: Exfoliative toxin A (ETA), produced by Staphylococcus aureus, causes staphylococcal scalded skin syndrome (SSSS) and its more localized form, bullous impetigo. The crystal structure of ETA suggests that it is a serine protease with an inactive catalytic site which becomes activated when ETA binds a specific receptor. In pemphigus foliaceus autoantibodies that cause dysfunction of Dsg 1 cause blisters identical to those caused by ETA in the superficial epidermis of mouse and man. Therefore, we hypothesize that Dsg 1 specifically binds and activates ETA, which in turn cleaves the bound Dsg 1, resulting in blister formation. We propose that another staphylococcal toxin, exfoliative toxin B (ETB), that also causes bullous impetigo and SSSS, is also activated by, and cleaves, Dsg 1. Finally, we hypothesize that binding of ETA to Dsg 1 and/or cleavage of Dsg 1 by ETA might elicit an autoimmune response against Dsg 1, thus suggesting a mechanism for autoantibody production in PF patients. We have shown that ETA cleaves Dsg 1. Specific aim 1 will characterize this cleavage by determining if cleavage is dependent on Dsg 1 conformation, and by defining the site of cleavage and the domains of Dsg 1 needed for cleavage. Aim 2 will characterize binding of ETA to Dsg 1, and define the domains of each necessary. Aim 3 will determine, using Dsg 3 knockout and involucrin-Dsg 3 transgenic mice, if compensation by Dsg 3 can compensate for ETA-induced loss of function of Dsg 1, thereby explaining the sites of blister localization. Aim 4 contains studies designed to define the kinetics of Dsg 1 cleavage by ETA. Aim 5 will extend the results of the previous aims to include the mechanisms of action of ETB. The final aim will determine if patients with bullous impetigo and SSSS develop an antibody response against Dsg 1, if patients with pemphigus foliaceus have an enhanced immune response against ETA and ETB, and if mice injected with ETA develop an immune response against Dsg 1. These studies will provide insight regarding the molecular pathophysiology of a very common disease, bullous impetigo, and, for the first time, identify a potential trigger or exacerbating factor in a tissue-specific autoimmune disease, pemphigus. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR ANALYSIS OF STAPHYLOCOCCAL EXFOLIATIVE TOXIN A Principal Investigator & Institution: Plano, Lisa R.; Pediatrics; University of MiamiMedical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Staphylococcal scalded skin syndrome, SSSS, is a disease primarily of the young and immunocompromised that is rarely seen in healthy adults. SSSS is characterized by specific exfoliation of the upper epidermis in the stratum granulosum of the skin at a site distal to a focus of infection with exfoliative toxin (ET) producing Staphylococcus aureus. The exact mechanism of the relative protection of adults or susceptibility of newborns is not known. In an animal model these skin manifestations result from the injection of one of two species-specific exfoliative toxins, ETA or ETB. The mechanism by which these toxins result in exfoliation is now assumed to involve cleavage of desmoglein 1 (Dsgl), a desmosomal protein member of the cadherin family of cell adhesion molecules, by a unique serine

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protease activity of the exfoliative toxins. Cleavage of this protein fits the clinical picture of SSSS as it is primarily expressed at this layer of this skin. Our hypothesis is that characteristics of the interaction between the exfoliative toxins of S. aureus and their target desmoglein 1 explain the species, target and age specificity of these toxins as well as contribute to the pathogenicity of these bacteria. We propose in this study to use molecular techniques to characterize the interaction between the toxin, ETA and the target, Dsgl of humans and mice. The goal is to determine the domains or amino acids of Dsgl needed for recognition and cleavage by ETA and the domains or amino acids of ETA responsible for target binding and localization to the skin. Results from these analyses will provide insight into the mechanism for the age and species specificity of this unique serine protease. We further propose to develop an animal model of staphylococcal impetigo to address the role of the exfoliative toxins in pathogenesis of these bacteria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TISSUE-SPECIFIC INFECTION BY GROUP A STREPTOCOCCI Principal Investigator & Institution: Bessen, Debra E.; Associate Professor; Microbiology and Immunology; New York Medical College Valhalla, Ny 10595 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Group A streptococci (GAS) are among the most prevalent of bacterial pathogens, infecting only humans. A hallmark feature of GAS is its molecular and biological diversity among strains. Although GAS can give rise to serious illness, such as autoimmune sequelae and severe invasive disease, most often it causes only a mild infection at superficial sites - the oropharynx (strep throat) or epidermis (impetigo). The throat and skin are the primary tissue reservoirs for GAS, whereby the organism is most successful in reproductive growth and transmission to new hosts. Based on decades of field work, it has become widely recognized that many strains differ in their tissue site preference, giving rise to the concept of distinct throat and skin strains. This recognition strongly suggests that there is an underlying genetic organization that imparts a higher biological order to the diverse strains of this species. A long-term goal is to determine the molecular basis for throat and skin tropisms among GAS. In Preliminary Findings, a diverse set of throat and skin strains were analyzed for linkage disequilibrium between different combinations of loci/alleles, leading to the identification of genes which are likely to be critical for tissue-specific adaptations. The Specific Aims of this proposal are to test the role of the tissue-specific virulence factor candidates in an in vivo mouse model that closely mimics superficial skin infection in humans. Isogenic mutants, and chimeric GAS constructs having a throat gene on a skin strain background, will be constructed and compared for virulence. GAS products to be tested for tissue-specific functions include streptokinase (a plasminogen activator), plasminogen-binding M protein (PAM), the cysteine proteinase SpeB, and transcriptional regulators of GAS virulence gene expression (RofA/Nra and Mga). A better understanding of the molecular basis for throat- and skin-specific infection might aid in the development of vaccines which target essential adaptive traits and thereby, break the chain of transmission. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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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 “impetigo” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for impetigo in the PubMed Central database: •

Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial. by Koning S, van Suijlekom-Smit LW, Nouwen JL, Verduin CM, Bernsen RM, Oranje AP, Thomas S, van der Wouden JC.; 2002 Jan 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64791

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Humanized In Vivo Model for Streptococcal Impetigo. by Scaramuzzino DA, McNiff JM, Bessen DE.; 2000 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=97500

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Molecular mechanisms of blister formation in bullous impetigo and staphylococcal scalded skin syndrome. by Hanakawa Y, Schechter NM, Lin C, Garza L, Li H, Yamaguchi T, Fudaba Y, Nishifuji K, Sugai M, Amagai M, Stanley JR.; 2002 Jul 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151035

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Selective Distribution of a High-Affinity Plasminogen-Binding Site among Group A Streptococci Associated with Impetigo. by Svensson MD, Sjobring U, Bessen DE.; 1999 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=96672

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Staphylococcus aureus Isolated in Cases of Impetigo Produces Both Epidermolysin A or B and LukE-LukD in 78% of 131 Retrospective and Prospective Cases. by Gravet A, Couppie P, Meunier O, Clyti E, Moreau B, Pradinaud R, Monteil H, Prevost G.; 2001 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=88548

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web 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 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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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 impetigo, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “impetigo” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for impetigo (hyperlinks lead to article summaries): •

A bacteriologically controlled, randomized study comparing the efficacy of 2% mupirocin ointment (Bactroban) with oral erythromycin in the treatment of patients with impetigo. Author(s): McLinn S. Source: Journal of the American Academy of Dermatology. 1990 May; 22(5 Pt 1): 883-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2112166&dopt=Abstract

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A case of impetigo herpetiformis with hypercalcitoninemia. Author(s): Nitta Y, Yasue T. Source: The Journal of Dermatology. 1985 December; 12(6): 526-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3913690&dopt=Abstract

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A case of impetigo herpetiformis with unusual clinical features. Author(s): Chang SE, Cho SY, Bae JY, Choi JH, Sung KJ, Moon KC, Koh JK. Source: The Journal of Dermatology. 2001 June; 28(6): 335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476115&dopt=Abstract

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A case of recurrent impetigo herpetiformis with a positive family history. Author(s): Erbagci Z, Erkilic S. Source: Int J Clin Pract. 2000 November; 54(9): 619-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11220992&dopt=Abstract

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A clinical trial of hydrocortisone/potassium hydroxyquinoline sulphate ('Quinocort') in the treatment of infected eczema and impetigo in general practice. Author(s): Jaffe GV, Grimshaw JJ. Source: Pharmatherapeutica. 1986; 4(10): 628-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3299393&dopt=Abstract

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A comparative study of Fucidin Ointment and Cicatrin Cream in the treatment of impetigo. Author(s): Cassels-Brown G. Source: Br J Clin Pract. 1981 April; 35(4): 153-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7028065&dopt=Abstract

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A controlled study of penicillin prophylaxis against streptococcal impetigo. Author(s): Ferrieri P, Dajani AS, Wannamaker LW. Source: The Journal of Infectious Diseases. 1974 April; 129(4): 429-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4593872&dopt=Abstract

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A fusidic acid-resistant clone of Staphylococcus aureus associated with impetigo bullosa is spreading in Norway. Author(s): Tveten Y, Jenkins A, Kristiansen BE. Source: The Journal of Antimicrobial Chemotherapy. 2002 December; 50(6): 873-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461006&dopt=Abstract

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A systematic review and meta-analysis of treatments for impetigo. Author(s): George A, Rubin G. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 June; 53(491): 480-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939895&dopt=Abstract

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A three-year study of impetigo in Sydney. Author(s): Rogers M, Dorman DC, Gapes M, Ly J. Source: The Medical Journal of Australia. 1987 July 20; 147(2): 63-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3299015&dopt=Abstract

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An epidemic of bullous impetigo arising from a central admission-observation nursery. Author(s): Light IJ, Brackvogel V, Walton RL, Sutherland JM. Source: Pediatrics. 1972 January; 49(1): 15-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5059306&dopt=Abstract

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An epidemic of bullous impetigo in a newborn nursery due to Staphylococcus aureus: epidemiology and control measures. Author(s): Hlady WG, Middaugh JP. Source: Alaska Med. 1986 October-December; 28(4): 99-103. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3565708&dopt=Abstract

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Antibiotic susceptibilities of Staphylococcus aureus strains derived from furuncle and bullous impetigo. Author(s): Dekio S, Hirata T, Jidoi J, Ozasa S, Ohno H. Source: The Journal of Dermatology. 1985 February; 12(1): 47-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3894459&dopt=Abstract

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Anticardiolipin antibodies in acute poststreptococcal glomerulonephritis and streptococcal impetigo. Author(s): Ardiles L, Ramirez P, Moya P, Caorsi I, Mezzano S. Source: Nephron. 1999 September; 83(1): 47-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10461035&dopt=Abstract

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Antimicrobial resistance of Staphylococcus aureus isolated from impetigo patients between 1994 and 2000. Author(s): Nishijim S, Ohshima S, Higashida T, Nakaya H, Kurokawa I. Source: International Journal of Dermatology. 2003 January; 42(1): 23-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581136&dopt=Abstract

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Appearance of nephritis associated with type 57 streptococcal impetigo in North America. Author(s): Ferrieri P, Dajani AS, Chapman SS, Jensen JB, Wannamaker LW. Source: The New England Journal of Medicine. 1970 October 15; 283(16): 832-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4917722&dopt=Abstract

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Association between lesional or non lesional S. aureus strains from patients with impetigo and exfoliative toxin production. No association with SmaI PFGE patterns. Author(s): Capoluongo E, Giglio A, Belardi M, Leonetti F, Frasca A, Giannetti A, Ameglio F. Source: New Microbiol. 2000 January; 23(1): 21-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10946402&dopt=Abstract

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Bacteriology and urinary examination in impetigo contagiosa. A prospective study in a Swedish urban area. Author(s): Bojs G, Juhlin I, Moller H. Source: Acta Dermato-Venereologica. 1973; 53(6): 481-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4129598&dopt=Abstract

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Biofilm formation of Staphylococcus aureus strains isolated from impetigo and furuncle: role of fibrinogen and fibrin. Author(s): Akiyama H, Ueda M, Kanzaki H, Tada J, Arata J. Source: Journal of Dermatological Science. 1997 November; 16(1): 2-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9438901&dopt=Abstract

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Bockhart's impetigo: complication of waterbed use. Author(s): Hsu S, Halmi BH. Source: International Journal of Dermatology. 1999 October; 38(10): 769-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10561049&dopt=Abstract

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Bullous impetigo and localized scalded skin syndrome in the elderly. Author(s): Alcalay J, David M, Sandbank M. Source: Isr J Med Sci. 1987 April; 23(4): 300-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3623889&dopt=Abstract

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Bullous impetigo caused by group A streptococci. A case report. Author(s): Helsing P, Gaustad P. Source: Acta Dermato-Venereologica. 1992; 72(1): 50-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1350146&dopt=Abstract

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Bullous impetigo caused by Streptococcus salivarius: a case report. Author(s): Brook I. Source: Journal of Clinical Pathology. 1980 November; 33(11): 1099-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7002959&dopt=Abstract

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Bullous impetigo due to group II Staphylococcus aureus. An epidemic in a normal newborn nursery. Author(s): Albert S, Baldwin R, Czekajewski S, Van Soestbergen A, Nachman R, Robertson A. Source: Am J Dis Child. 1970 July; 120(1): 10-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5422851&dopt=Abstract

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Bullous impetigo in homosexual men--a risk marker for HIV-1 infection? Author(s): Donovan B, Rohrsheim R, Bassett I, Mulhall BP. Source: Genitourinary Medicine. 1992 June; 68(3): 159-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1607190&dopt=Abstract

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Bullous impetigo. Author(s): Scales JW, Fleischer AB Jr, Krowchuk DP. Source: Archives of Pediatrics & Adolescent Medicine. 1997 November; 151(11): 1168-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9369884&dopt=Abstract

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Bullous impetigo. Occurrence of localized scalded skin syndrome in an adult. Author(s): Elias PM, Levy SW. Source: Archives of Dermatology. 1976 June; 112(6): 856-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=782365&dopt=Abstract

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Case #11: Impetigo. Author(s): Haring JI. Source: Rdh. 1995 November; 15(11): 12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9534473&dopt=Abstract

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Case report: benign recurrent abducens nerve palsy in children: another triggering factor: impetigo. Author(s): Bleik JH, Chedid P, Salame S. Source: Binocul Vis Strabismus Q. 1998 Spring-Fall; 13(1 1St Qtr): 53-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9852427&dopt=Abstract

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Clinicopathological case 3: pemphigus foliaceus; bullous impetigo; subcorneal pustular dermatoses. Author(s): Hoque S, Hextall J, Hay R. Source: Clinical and Experimental Dermatology. 2003 July; 28(4): 465-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823325&dopt=Abstract

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Clonal association of Staphylococcus aureus causing bullous impetigo and the emergence of new methicillin-resistant clonal groups in Kansai district in Japan. Author(s): Yamaguchi T, Yokota Y, Terajima J, Hayashi T, Aepfelbacher M, Ohara M, Komatsuzawa H, Watanabe H, Sugai M. Source: The Journal of Infectious Diseases. 2002 May 15; 185(10): 1511-6. Epub 2002 April 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11992289&dopt=Abstract

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Comparative and non-comparative studies of the efficacy and tolerance of tioconazole cream 1% versus another imidazole and/or placebo in neonates and infants with candidal diaper rash and/or impetigo. Author(s): Gibbs DL, Kashin P, Jevons S. Source: J Int Med Res. 1987 January-February; 15(1): 23-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3817280&dopt=Abstract

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Comparison of amoxicillin and clavulanic acid (augmentin) for the treatment of nonbullous impetigo. Author(s): Dagan R, Bar-David Y. Source: Am J Dis Child. 1989 August; 143(8): 916-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2667333&dopt=Abstract

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Comparison of mupirocin and erythromycin in the treatment of impetigo. Author(s): Britton JW, Fajardo JE, Krafte-Jacobs B. Source: The Journal of Pediatrics. 1990 November; 117(5): 827-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2121951&dopt=Abstract

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Comparison of oral cephalexin, topical mupirocin and topical bacitracin for treatment of impetigo. Author(s): Bass JW, Chan DS, Creamer KM, Thompson MW, Malone FJ, Becker TM, Marks SN. Source: The Pediatric Infectious Disease Journal. 1997 July; 16(7): 708-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9239775&dopt=Abstract

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Confocal laser scanning microscopic observation of glycocalyx production by Staphylococcus aureus in skin lesions of bullous impetigo, atopic dermatitis and pemphigus foliaceus. Author(s): Akiyama H, Hamada T, Huh WK, Yamasaki O, Oono T, Fujimoto W, Iwatsuki K. Source: The British Journal of Dermatology. 2003 March; 148(3): 526-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653745&dopt=Abstract

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Cost-effectiveness of erythromycin versus mupirocin for the treatment of impetigo in children. Author(s): Rice TD, Duggan AK, DeAngelis C. Source: Pediatrics. 1992 February; 89(2): 210-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1734386&dopt=Abstract

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Diagnosis and treatment of impetigo. Author(s): Schachner L, Gonzalez A. Source: Journal of the American Academy of Dermatology. 1989 January; 20(1): 132. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2913075&dopt=Abstract

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Diagnosis and treatment of impetigo. Author(s): Coskey RJ, Coskey LA. Source: Journal of the American Academy of Dermatology. 1987 July; 17(1): 62-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3611455&dopt=Abstract

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DNA heterogeneity of Staphylococcus aureus strains evaluated by SmaI and SgrAI pulsed-field gel electrophoresis in patients with impetigo. Author(s): Capoluongo E, Giglio A, Leonetti F, Belardi M, Giannetti A, Caprilli F, Ameglio F. Source: Research in Microbiology. 2000 January-February; 151(1): 53-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10724484&dopt=Abstract

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Double-blind study comparing erythromycin and mupirocin for treatment of impetigo in children: implications of a high prevalence of erythromycin-resistant Staphylococcus aureus strains. Author(s): Dagan R, Bar-David Y. Source: Antimicrobial Agents and Chemotherapy. 1992 February; 36(2): 287-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1605593&dopt=Abstract

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Ecological contrasts between bacterial species commonly found in impetigo. Author(s): Wannamaker LW. Source: Contrib Microbiol Immunol. 1973; 1: 561-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4805321&dopt=Abstract

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Effects of serum albumin on coagulase release from Staphylococcus aureus derived from bullous impetigo. Author(s): Dekio S, Jidoi J. Source: The Journal of Dermatology. 1984 June; 11(3): 233-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6386912&dopt=Abstract

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Endemic occurrence of glomerulonephritis associated with streptococcal impetigo. Author(s): Kobayashi S, Ikeda T, Okada H, Suzuki Y, Ishii M, Ohtake T, Oda T, Hishida A. Source: American Journal of Nephrology. 1995; 15(4): 356-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7573198&dopt=Abstract

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Epidemic bullous impetigo in a nursery due to a nasal carrier of Staphylococcus aureus: role of epidemiology and control measures. Author(s): Nakashima AK, Allen JR, Martone WJ, Plikaytis BD, Stover B, Cook LN, Wright SP. Source: Infect Control. 1984 July; 5(7): 326-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6376403&dopt=Abstract

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Epidemiological aspects of impetigo contagiosa in western Sweden. Author(s): Mobacken H, Holst R, Wengstrom C, Holm SE. Source: Scandinavian Journal of Infectious Diseases. 1975; 7(1): 39-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1096293&dopt=Abstract

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Etiology and therapy of impetigo: reconsidered. Author(s): Barton LL, Friedman AD. Source: Am J Dis Child. 1990 March; 144(3): 274. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2305731&dopt=Abstract

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Evaluation of bacitracin ointment in the treatment of impetigo. Author(s): Koranyi KI, Burech DL, Haynes RE. Source: Ohio State Med J. 1976 June; 72(6): 368-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=958658&dopt=Abstract

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Evaluation of the efficacy of josamycin in the treatment of impetigo in children and its in vitro activity on erythromycin resistant Staphylococcus aureus strains. Author(s): Mosca A, Del Prete R, Mazzotta F, Bonifazi E, Miragliotta G. Source: Journal of Chemotherapy (Florence, Italy). 1995 November; 7 Suppl 4: 158-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8904141&dopt=Abstract

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Extremely low levels of epidermal skin-derived antileucoproteinase/elafin in a patient with impetigo herpetiformis. Author(s): Kuijpers AL, Schalkwijk J, Rulo HF, Peperkamp JJ, van de Kerkhof PC, de Jong EM. Source: The British Journal of Dermatology. 1997 July; 137(1): 123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9274639&dopt=Abstract

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Falsely normal direct immunofluorescent microscopic fundings in bullous impetigo. Author(s): Rappaport MJ, Ahmed AR. Source: Archives of Dermatology. 1981 September; 117(9): 524. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7027964&dopt=Abstract

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Follicular impetigo as presenting sign of systemic lupus erythematosus. Author(s): Lazzari T, Parodi A, Rebora A. Source: Dermatologica. 1991; 182(4): 233-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1884859&dopt=Abstract

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Fusidic acid cream for impetigo. Emergence of resistance to fusidic acid limits its use. Author(s): Weston VC, Boswell TC, Finch RG, Perkins W. Source: Bmj (Clinical Research Ed.). 2002 June 8; 324(7350): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053928&dopt=Abstract

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Fusidic acid cream for impetigo. Findings cannot be extrapolated. Author(s): Owen SE, Cheesbrough JS. Source: Bmj (Clinical Research Ed.). 2002 June 8; 324(7350): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053931&dopt=Abstract

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Fusidic acid cream for impetigo. Fusidic acid should be used with restraint. Author(s): Brown EM, Wise R. Source: Bmj (Clinical Research Ed.). 2002 June 8; 324(7350): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12052817&dopt=Abstract

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Fusidic acid cream for impetigo. Judicious use is advisable. Author(s): Sule O, Brown N, Brown DF, Burrows N. Source: Bmj (Clinical Research Ed.). 2002 June 8; 324(7350): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053927&dopt=Abstract

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Fusidic acid cream for impetigo. Problem may be clinically important. Author(s): Stoddart B, Collyns T, Denton M. Source: Bmj (Clinical Research Ed.). 2002 June 8; 324(7350): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053929&dopt=Abstract

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Fusidic acid cream for impetigo. Resistance trends must be monitored. Author(s): Zadik P, Young N. Source: Bmj (Clinical Research Ed.). 2002 June 8; 324(7350): 1394. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053930&dopt=Abstract

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Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial. Author(s): Koning S, van Suijlekom-Smit LW, Nouwen JL, Verduin CM, Bernsen RM, Oranje AP, Thomas S, van der Wouden JC. Source: Bmj (Clinical Research Ed.). 2002 January 26; 324(7331): 203-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11809642&dopt=Abstract

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Generalized pustular psoriasis of pregnancy (impetigo herpetiformis). Author(s): Breier-Maly J, Ortel B, Breier F, Schmidt JB, Honigsmann H. Source: Dermatology (Basel, Switzerland). 1999; 198(1): 61-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10026404&dopt=Abstract

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Group A streptococcal pharyngeal carriage and impetigo in two northern native communities. Author(s): Nicolle LE, Law B, Postl B, Urias B, Ling N, Fast M. Source: Arctic Med Res. 1988; 47 Suppl 1: 669-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3078513&dopt=Abstract

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Group A streptococcal pharyngeal carriage, pharyngitis, and impetigo in two northern Canadian native communities. Author(s): Nicolle LE, Postl B, Urias B, Law B, Ling N. Source: Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 1990 June; 13(3): 99-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2194720&dopt=Abstract

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Haemolysin and enzyme patterns of coagulase-positive staphylococci isolated from toxic epidermal necrolysis, Ritter's disease and impetigo contagiosa. Author(s): Arbuthnott JP, Gemmell CG, Kent J, Lyell A. Source: Journal of Medical Microbiology. 1969 November 4; 2(4): 479-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4252396&dopt=Abstract

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Has impetigo in children disappeared? Author(s): Verbov J. Source: The Practitioner. 1987 May 8; 231(1429): 645. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3422896&dopt=Abstract

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Hormonal treatment of impetigo herpetiformis. Author(s): Gligora M, Kolacio Z. Source: The British Journal of Dermatology. 1982 August; 107(2): 253. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7104221&dopt=Abstract

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How I treat furuncles, carbuncles and impetigo. Author(s): Landau JW. Source: Postgraduate Medicine. 1967 May; 41(5): A127-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6044109&dopt=Abstract

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How I treat impetigo. Author(s): Goette, DK. Source: Med Times. 1980 August; 108(8): 22-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7401998&dopt=Abstract

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Humanized in vivo model for streptococcal impetigo. Author(s): Scaramuzzino DA, McNiff JM, Bessen DE. Source: Infection and Immunity. 2000 May; 68(5): 2880-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10768985&dopt=Abstract

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Hydrogen peroxide cream: an alternative to topical antibiotics in the treatment of impetigo contagiosa. Author(s): Christensen OB, Anehus S. Source: Acta Dermato-Venereologica. 1994 November; 74(6): 460-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7701881&dopt=Abstract

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Hypocalcemia in impetigo herpetiformis: a secondary transient phenomenon? Author(s): Thio HB, Vermeer BJ. Source: Archives of Dermatology. 1991 October; 127(10): 1587-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1929474&dopt=Abstract

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Impetigo and its treatment. Author(s): Carruthers R, Cox GE. Source: The Medical Journal of Australia. 1987 July 20; 147(2): 56-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3600454&dopt=Abstract

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Impetigo and other skin infections. Author(s): Ascher DP, Delaney RA. Source: Military Medicine. 1987 July; 152(7): 381. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3112643&dopt=Abstract

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Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin. Author(s): Barton LL, Friedman AD, Sharkey AM, Schneller DJ, Swierkosz EM. Source: Pediatric Dermatology. 1989 June; 6(2): 134-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2501775&dopt=Abstract

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Impetigo contagiosa in children. Author(s): Hughes WT. Source: Gp. 1969 March; 36(3): 78-83. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5779210&dopt=Abstract

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Impetigo contagiosa. Author(s): Derrick CW Jr, Dillon HC Jr. Source: American Family Physician. 1971 October; 4(4): 75-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5000340&dopt=Abstract

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Impetigo contagiosa: a comparison of erythromycin and dicloxacillin therapy. Author(s): Barton LL, Friedman AD, Portilla MG. Source: Pediatric Dermatology. 1988 May; 5(2): 88-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3045781&dopt=Abstract

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Impetigo contagiosa: etiology, complications, and comparison of therapeutic effectiveness of erythromycin and antibiotic ointment. Author(s): Hughes WT, Wan RT. Source: Am J Dis Child. 1967 April; 113(4): 449-53. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4290285&dopt=Abstract

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Impetigo contagiosa: suppurative and non-suppurative complications. I. Clinical, bacteriologic, and epidemiologic characteristics of impetigo. Author(s): Dillon HC Jr. Source: Am J Dis Child. 1968 May; 115(5): 530-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4868792&dopt=Abstract

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Impetigo

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Impetigo contagiosa--etiology in Iraq. Author(s): Dilaimy M, Al-Talib AM, Ghazala K, Thiab TM. Source: Cutis; Cutaneous Medicine for the Practitioner. 1979 March; 23(3): 332-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=253634&dopt=Abstract

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Impetigo herpetiformis and hypoparathyroidism. Author(s): Moynihan GD, Ruppe JP Jr. Source: Archives of Dermatology. 1985 October; 121(10): 1330-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2994578&dopt=Abstract

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Impetigo herpetiformis and pustular psoriasis during pregnancy. Author(s): Pierard GE, Pierard-Franchimont C, de la Brassinne M. Source: The American Journal of Dermatopathology. 1983 June; 5(3): 215-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6625114&dopt=Abstract

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Impetigo herpetiformis and RhE isoimmunization: a case report. Author(s): Trevisan G, Kokelj F. Source: Cutis; Cutaneous Medicine for the Practitioner. 1996 July; 58(1): 87-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8823557&dopt=Abstract

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Impetigo herpetiformis and Staphylococcus aureus lymphadenitis in a pregnant adolescent. Author(s): Rackett SC, Baughman RD. Source: Pediatric Dermatology. 1997 September-October; 14(5): 387-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9336813&dopt=Abstract

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Impetigo herpetiformis as a cause of postpartum fever. Author(s): Ross MG, Tucker DC, Hayashi RH. Source: Obstetrics and Gynecology. 1984 September; 64(3 Suppl): 49S-51S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6472749&dopt=Abstract

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Impetigo herpetiformis associated with hypocalcemia of congenital rickets. Author(s): Holm AL, Goldsmith LA. Source: Archives of Dermatology. 1991 January; 127(1): 91-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1846069&dopt=Abstract

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Impetigo herpetiformis at the 36th week of gestation. Author(s): Aka N, Kuscu NK, Yazicioglu E. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2000 May; 69(2): 153-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10802084&dopt=Abstract

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Impetigo herpetiformis during pregnancy: case report and review of the literature. Author(s): Wolf Y, Groutz A, Walman I, Luxman D, David MP. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1995 March; 74(3): 229-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7900530&dopt=Abstract

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Impetigo herpetiformis during the puerperium. Author(s): Katsambas A, Stavropoulos PG, Katsiboulas V, Kostakis P, Panayiotopoulos A, Christofidou E, Petridis A. Source: Dermatology (Basel, Switzerland). 1999; 198(4): 400-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10449943&dopt=Abstract

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Impetigo herpetiformis in two successive pregnancies. Author(s): Beveridge GW, Harkness RA, Livingstone JR. Source: The British Journal of Dermatology. 1966 February; 78(2): 106-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4286099&dopt=Abstract

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Impetigo herpetiformis or generalized pustular psoriasis? Author(s): Oosterling RJ, Nobrega RE, Du Boeuff JA, Van Der Meer JB. Source: Archives of Dermatology. 1978 October; 114(10): 1527-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=718194&dopt=Abstract

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Impetigo herpetiformis unresponsive to therapy in a pregnant adolescent. Author(s): Arslanpence I, Dede FS, Gokcu M, Gelisen O. Source: Journal of Pediatric and Adolescent Gynecology. 2003 June; 16(3): 129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804935&dopt=Abstract

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Impetigo herpetiformis with lowered serum level of vitamin D and its diminished intestinal absorption. Author(s): Ott F, Krakowski A, Tur E, Lipitz R, Weisman Y, Brenner S. Source: Dermatologica. 1982 May; 164(5): 360-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7095227&dopt=Abstract

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Impetigo herpetiformis. Author(s): Bajaj AK, Swarup V, Gupta OP, Gupta SC. Source: Dermatologica. 1977; 155(5): 292-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=902841&dopt=Abstract

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Impetigo herpetiformis. Report of a case treated with photochemotherapy (PUVA). Author(s): El-Din Selim MM, Rehak A, Abdel-Hafez K, Al-Saleh K. Source: Dermatol Monatsschr. 1982 January; 168(1): 44-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7084529&dopt=Abstract

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Impetigo

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Impetigo herpetiformis: a variant of pustular psoriasis or a separate entity? Author(s): Lotem M, Katzenelson V, Rotem A, Hod M, Sandbank M. Source: Journal of the American Academy of Dermatology. 1989 February; 20(2 Pt 2): 338-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2644321&dopt=Abstract

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Impetigo herpetiformis: response to steroids and etretinate. Author(s): Gimenez Garcia R, Gimenez Garcia MC, Llorente de la Fuente A. Source: International Journal of Dermatology. 1989 October; 28(8): 551-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2583898&dopt=Abstract

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Impetigo in childhood: changing epidemiology and new treatments. Author(s): Dagan R. Source: Pediatric Annals. 1993 April; 22(4): 235-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8510990&dopt=Abstract

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Impetigo in newborn infants associated with a plastic bell clamp circumcision. Author(s): Stranko J, Ryan ME, Bowman AM. Source: Pediatr Infect Dis. 1986 September-October; 5(5): 597-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3763425&dopt=Abstract

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Impetigo in the Waikato. Author(s): Young BH. Source: N Z Med J. 1965 November; 64(399): Suppl 399: 45-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4221564&dopt=Abstract

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Impetigo neonatorum associated with late onset group B streptococcal meningitis. Author(s): Guha A, Eisenhut M, Shears P, Dalzell M. Source: The Journal of Infection. 2003 August; 47(2): 185-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860158&dopt=Abstract

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Impetigo on the areola and nipple. Author(s): Thorley V. Source: Breastfeed Rev. 2000 July; 8(2): 25-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10941320&dopt=Abstract

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Impetigo therapy. Author(s): Friedman AD. Source: The Pediatric Infectious Disease Journal. 1990 December; 9(12): 933-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2126137&dopt=Abstract

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Impetigo. Author(s): Malcolm B. Source: The Practitioner. 1998 May; 242(1586): 405. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492953&dopt=Abstract

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Impetigo. Author(s): Shriner DL, Schwartz RA, Janniger CK. Source: Cutis; Cutaneous Medicine for the Practitioner. 1995 July; 56(1): 30-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7555098&dopt=Abstract

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Impetigo. Author(s): Esterly NB, Nelson DB, Dunne WM Jr. Source: Am J Dis Child. 1991 February; 145(2): 125-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1899777&dopt=Abstract

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Impetigo. Author(s): Sprung E. Source: Nurs Care. 1976 May; 9(5): 19. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1046196&dopt=Abstract

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Impetigo. Bacteriologic features and renal involvement. Author(s): Shuler SE. Source: Calif Med. 1966 August; 105(2): 113-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5946549&dopt=Abstract

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Impetigo. Current etiology and comparison of penicillin, erythromycin, and cephalexin therapies. Author(s): Demidovich CW, Wittler RR, Ruff ME, Bass JW, Browning WC. Source: Am J Dis Child. 1990 December; 144(12): 1313-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2244610&dopt=Abstract

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Impetigo: a reassessment of etiology and therapy. Author(s): Schachner L, Gonzalez A. Source: Pediatric Dermatology. 1988 May; 5(2): 139. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3412994&dopt=Abstract

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Impetigo: a reassessment of etiology and therapy. Author(s): Barton LL, Friedman AD. Source: Pediatric Dermatology. 1987 November; 4(3): 185-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3122189&dopt=Abstract

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Impetigo: an overview. Author(s): Darmstadt GL, Lane AT. Source: Pediatric Dermatology. 1994 December; 11(4): 293-303. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7899177&dopt=Abstract

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Impetigo: an update. Author(s): Brown J, Shriner DL, Schwartz RA, Janniger CK. Source: International Journal of Dermatology. 2003 April; 42(4): 251-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694487&dopt=Abstract

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Impetigo: etiology and therapy. Author(s): Hirschmann JV. Source: Curr Clin Top Infect Dis. 2002; 22: 42-51. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520646&dopt=Abstract

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Impetigo:an assessment of etiology and appropriate therapy in infants and children. Author(s): Pruksachatkunakorn C, Vaniyapongs T, Pruksakorn S. Source: J Med Assoc Thai. 1993 April; 76(4): 222-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8113643&dopt=Abstract

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Importance of side effects in treating impetigo. Author(s): Boelaert J. Source: Pharmacoeconomics. 1992 June; 1(6): 461-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10147114&dopt=Abstract

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Incidence of circulating immune complexes in patients with acute poststreptococcal glomerulonephritis and in patients with streptococcal impetigo. Author(s): Mezzano S, Olavarria F, Ardiles L, Lopez MI. Source: Clinical Nephrology. 1986 August; 26(2): 61-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3530567&dopt=Abstract

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Increasing incidence of streptococcal impetigo in atopic dermatitis. Author(s): Adachi J, Endo K, Fukuzumi T, Tanigawa N, Aoki T. Source: Journal of Dermatological Science. 1998 May; 17(1): 45-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9651828&dopt=Abstract

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Increasing the antibiotic spectrum in the treatment of impetigo. Author(s): Bronfin DR. Source: Am J Dis Child. 1990 March; 144(3): 274. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2305732&dopt=Abstract

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Is penicillin still the drug of choice for non-bullous impetigo? Author(s): Feder HM Jr, Abrahamian LM, Grant-Kels JM. Source: Lancet. 1991 September 28; 338(8770): 803-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1681172&dopt=Abstract

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Letter: Epidemiological aspects of impetigo contagiosa in Western Sweden. Author(s): Mobacken H, Holst R, Wengstrom C, Holm SE. Source: Scandinavian Journal of Infectious Diseases. 1975; 7(4): 281. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1209171&dopt=Abstract

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Letter: Impetigo neonatorum congenita due to group B beta-hemolytic streptococcus infection. Author(s): Belgaumkar TK. Source: The Journal of Pediatrics. 1975 June; 86(6): 982-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1127538&dopt=Abstract

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Letter: Prevalence of streptococci and staphylococci in lesions of impetigo. Author(s): Noble WC, Presbury D, Connor BL, Savin JA, Taplin D, Lansdell L. Source: The British Journal of Dermatology. 1974 July; 91(1): 115-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4852898&dopt=Abstract

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Letter: Telephoners' impetigo. Author(s): Garcia RL, Bishop ME. Source: Archives of Dermatology. 1976 August; 112(8): 1178. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=952547&dopt=Abstract

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Microbiology of nonbullous impetigo. Author(s): Brook I, Frazier EH, Yeager JK. Source: Pediatric Dermatology. 1997 May-June; 14(3): 192-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9192410&dopt=Abstract

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Molecular mechanisms of blister formation in bullous impetigo and staphylococcal scalded skin syndrome. Author(s): Hanakawa Y, Schechter NM, Lin C, Garza L, Li H, Yamaguchi T, Fudaba Y, Nishifuji K, Sugai M, Amagai M, Stanley JR. Source: The Journal of Clinical Investigation. 2002 July; 110(1): 53-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12093888&dopt=Abstract

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Mupirocin in the treatment of impetigo. Author(s): Booth JH, Benrimoj SI. Source: International Journal of Dermatology. 1992 January; 31(1): 1-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1737680&dopt=Abstract

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Mupirocin vs terbinafine in impetigo. Author(s): Ciftci E, Guriz H, Aysev AD. Source: Indian J Pediatr. 2002 August; 69(8): 679-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356219&dopt=Abstract

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Mupirocin: a new topical therapy for impetigo. Author(s): Putnam CD, Reynolds MS. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 1989 July-August; 3(4): 224-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2502615&dopt=Abstract

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Natural history of impetigo. I. Site sequence of acquisition and familial patterns of spread of cutaneous streptococci. Author(s): Ferrieri P, Dajani AS, Wannamaker LW, Chapman SS. Source: The Journal of Clinical Investigation. 1972 November; 51(11): 2851-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5080412&dopt=Abstract

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Natural history of impetigo. II. Etiologic agents and bacterial interactions. Author(s): Dajani AS, Ferrieri P, Wannamaker LW. Source: The Journal of Clinical Investigation. 1972 November; 51(11): 2863-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4263498&dopt=Abstract

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New approach to the therapy of Bockhart's impetigo by electrodesiccation. Author(s): Prasad BN. Source: Indian J Dermatol. 1974 April; 19(3): 66-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4547739&dopt=Abstract

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New findings in impetigo. Author(s): Scillia T, Skehan M, Smith LG. Source: J Med Soc N J. 1974 August; 71(8): 569-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4604816&dopt=Abstract

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New type of exfoliatin obtained from staphylococcal strains, belonging to phage groups other than group II, isolated from patients with impetigo and Ritter's disease. Author(s): Kondo I, Sakurai S, Sarai Y. Source: Infection and Immunity. 1974 October; 10(4): 851-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4139120&dopt=Abstract

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Oral manifestations of impetigo: report of two cases. Author(s): Macko D, Krutchkoff D, Poole A. Source: J Pedod. 1977 Summer; 1(4): 318-26. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=270584&dopt=Abstract

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Orthotic collar in the treatment of intertriginous impetigo. Author(s): Hartman LA, Miller HN, Zack A. Source: Physical Therapy. 1976 August; 56(8): 928-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=940849&dopt=Abstract

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Paediatric dermatology. Impetigo. Author(s): Hogan P. Source: Aust Fam Physician. 1998 August; 27(8): 735-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9735496&dopt=Abstract

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Predisposing factors of the skin surface in persons with impetigo contagiosa. Author(s): Gloor M, Weigel HJ, Friederich HC. Source: Archives of Dermatological Research. 1975 November 14; 254(1): 95-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1200716&dopt=Abstract

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Prescribing antibiotics for impetigo. Author(s): Carruthers R. Source: Drugs. 1988 September; 36(3): 364-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3056694&dopt=Abstract

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Production of staphylococcal impetigo-like lesion on human skin explants in culture. Author(s): Abe Y, Akiyama H, Arata J. Source: Journal of Dermatological Science. 1993 June; 5(3): 150-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8241071&dopt=Abstract

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Pyoderma among Hajj Pilgrims in Makkah. Author(s): Fatani MI, Bukhari SZ, Al-Afif KA, Karima TM, Abdulghani MR, Al-Kaltham MI. Source: Saudi Med J. 2002 July; 23(7): 782-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174224&dopt=Abstract

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Randomized clinical trial of topical mupirocin versus oral erythromycin for impetigo. Author(s): Goldfarb J, Crenshaw D, O'Horo J, Lemon E, Blumer JL. Source: Antimicrobial Agents and Chemotherapy. 1988 December; 32(12): 1780-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3149884&dopt=Abstract

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Recurrent impetigo herpetiformis in a pregnant adolescent: case report. Author(s): Sahin HG, Sahin HA, Metin A, Zeteroglu S, Ugras S. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2002 March 10; 101(2): 201-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858900&dopt=Abstract

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Re-emergence of bullous impetigo. Author(s): Placzek M. Source: British Medical Journal (Clinical Research Ed.). 1982 January 23; 284(6311): 272. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6799136&dopt=Abstract

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Re-emergence of bullous impetigo. Author(s): Lissauer TJ, Sanderson PJ, Valman HB. Source: British Medical Journal (Clinical Research Ed.). 1981 December 5; 283(6305): 1509-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6799044&dopt=Abstract

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Response of impetigo herpetiformis to ampicillin. Author(s): Beer WE, Jones OV. Source: Trans St Johns Hosp Dermatol Soc. 1972; 58(1): 89-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5038609&dopt=Abstract

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Review of mupirocin ointment in the treatment of impetigo. Author(s): Leyden JJ. Source: Clinical Pediatrics. 1992 September; 31(9): 549-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1468173&dopt=Abstract

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Roles of the plasminogen activator streptokinase and the plasminogen-associated M protein in an experimental model for streptococcal impetigo. Author(s): Svensson MD, Sjobring U, Luo F, Bessen DE. Source: Microbiology (Reading, England). 2002 December; 148(Pt 12): 3933-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480897&dopt=Abstract

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S. aureus PFGE patterns of lesional or non lesional strains from patients with impetigo: association of individual bands with lesional or non lesional areas. Author(s): Capoluongo E, Giglio A, Belardi M, Leonetti F, Giannetti A, Ameglio F. Source: New Microbiol. 2000 January; 23(1): 29-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10946403&dopt=Abstract

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Selective distribution of a high-affinity plasminogen-binding site among group A streptococci associated with impetigo. Author(s): Svensson MD, Sjobring U, Bessen DE. Source: Infection and Immunity. 1999 August; 67(8): 3915-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10417156&dopt=Abstract

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Sensitivity of antibacterials of Staphylococcus aureus isolated from impetigo patients. Author(s): Nishijima S, Nakagawa M. Source: J Int Med Res. 1997 July-August; 25(4): 210-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9283995&dopt=Abstract

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Sequential bullous impetigo and cutaneous Herpes simplex virus infection. Author(s): Harrison CJ, Marks MI. Source: Pediatr Infect Dis. 1982 November-December; 1(6): 413-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6761658&dopt=Abstract

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Severity of nonbullous Staphylococcus aureus impetigo in children is associated with strains harboring genetic markers for exfoliative toxin B, Panton-Valentine leukocidin, and the multidrug resistance plasmid pSK41. Author(s): Koning S, van Belkum A, Snijders S, van Leeuwen W, Verbrugh H, Nouwen J, Op 't Veld M, van Suijlekom-Smit LW, van der Wouden JC, Verduin C. Source: Journal of Clinical Microbiology. 2003 July; 41(7): 3017-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843036&dopt=Abstract

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Skin complications of heroin addiction. Bullous impetigo. Author(s): Young AW Jr. Source: N Y State J Med. 1973 June 15; 73(12): 1681-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4513637&dopt=Abstract

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Some aspects of impetigo herpetiformis. Author(s): Oumeish OY, Farraj SE, Bataineh AS. Source: Archives of Dermatology. 1982 February; 118(2): 103-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7059209&dopt=Abstract

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Staphylococcus aureus in impetigo. Author(s): Dagan R. Source: Am J Dis Child. 1991 November; 145(11): 1223. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1951204&dopt=Abstract

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Staphylococcus aureus isolated in cases of impetigo produces both epidermolysin A or B and LukE-LukD in 78% of 131 retrospective and prospective cases. Author(s): Gravet A, Couppie P, Meunier O, Clyti E, Moreau B, Pradinaud R, Monteil H, Prevost G. Source: Journal of Clinical Microbiology. 2001 December; 39(12): 4349-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11724844&dopt=Abstract

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Streptococcal ecthymatous impetigo. Author(s): Kelley C, Taplin D, Allen AM. Source: Aerosp Med. 1972 March; 43(3): 262. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5043629&dopt=Abstract

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Streptococcal impetigo among aboriginal children in Malaysia. Author(s): Norazah A, Normaznah Y, Kamel AG, Rohani MY. Source: Southeast Asian J Trop Med Public Health. 1995 December; 26(4): 803-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9139400&dopt=Abstract

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Streptococcal impetigo and acute glomerulonephritis in children in Cairo. Author(s): el Tayeb SH, Nasr EM, Sattallah AS. Source: The British Journal of Dermatology. 1978 January; 98(1): 53-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=341956&dopt=Abstract

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Streptococcal impetigo induces Th1-preponderant activation of T lymphocytes with subsequent anergy to superantigenic exotoxins in patients with atopic dermatitis. Author(s): Tokura Y, Ishii-Ginoza M, Seo N, Ito T, Sakurai M, Furukawa F, Takigawa M. Source: The British Journal of Dermatology. 1998 February; 138(2): 357-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9602892&dopt=Abstract

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Streptococcal types in impetigo and acute glomerulonephritis among children in Addis Ababa. Author(s): Axemo P, FREIJ L, Hadgu P, Holm SE, Islander G, Larsson A, Nilsson L. Source: Scandinavian Journal of Infectious Diseases. 1976; 8(3): 161-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=788141&dopt=Abstract

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Studies in children with impetigo. Bacteriology, serology, and incidence of glomerulonephritis. Author(s): Hall WD, Blumberg RW, Moody MD. Source: Am J Dis Child. 1973 June; 125(6): 800-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4350681&dopt=Abstract

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Study of impetigo and the resistance pattern of the isolates to various antibiotics. Author(s): Ahmad A, Khan KA, Haroon TS. Source: J Pak Med Assoc. 1987 May; 37(5): 129-32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3123738&dopt=Abstract

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Successful treatment of impetigo herpetiformis with oral cyclosporine during pregnancy. Author(s): Imai N, Watanabe R, Fujiwara H, Ito M, Nakamura A. Source: Archives of Dermatology. 2002 January; 138(1): 128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11790187&dopt=Abstract

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The aetiology of impetigo contagiosa. Author(s): el-Zawahry M, Aziz AA, Soliman M. Source: The British Journal of Dermatology. 1972 November; 87(5): 420-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4567095&dopt=Abstract

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The antibacterial activity of tea in vitro and in vivo (in patients with impetigo contagiosa). Author(s): Sharquie KE, al-Turfi IA, al-Salloum SM. Source: The Journal of Dermatology. 2000 November; 27(11): 706-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11138536&dopt=Abstract

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The effect of antibacterial soap on impetigo incidence, Karachi, Pakistan. Author(s): Luby S, Agboatwalla M, Schnell BM, Hoekstra RM, Rahbar MH, Keswick BH. Source: The American Journal of Tropical Medicine and Hygiene. 2002 October; 67(4): 430-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452499&dopt=Abstract

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The epidemiology of impetigo and acute glomerulonephritis. Results of serological typing of group A streptococci. Author(s): Dillon HC Jr, Moody MD, Maxted WR, Parker MT. Source: American Journal of Epidemiology. 1967 November; 86(3): 710-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6081387&dopt=Abstract

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The epidermolytic toxin of Staphylococcus aureus: its failure to bind to cells and its detection in blister fluids of patients with bullous impetigo. Author(s): Baker DH, Dimond RL, Wuepper KD. Source: The Journal of Investigative Dermatology. 1978 October; 71(4): 274-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=701847&dopt=Abstract

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The influence of hexachlorophene scrubs on the response to placebo or penicillin therapy in impetigo. Author(s): Ruby RJ, Nelson JD. Source: Pediatrics. 1973 December; 52(6): 854-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4203555&dopt=Abstract

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Therapy of impetigo and furunculosis. Author(s): Fritsch WC. Source: Jama : the Journal of the American Medical Association. 1970 December 7; 214(10): 1862-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5537340&dopt=Abstract

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Tinea corporis with secondary impetigo associated with silicone gel sheeting. Author(s): Wilson RW, Kois J, Zubowicz VN. Source: Plastic and Reconstructive Surgery. 1999 January; 103(1): 340. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9915216&dopt=Abstract

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Topical antibiotic treatment of impetigo with mupirocin. Author(s): Eells LD, Mertz PM, Piovanetti Y, Pekoe GM, Eaglstein WH. Source: Archives of Dermatology. 1986 November; 122(11): 1273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3096221&dopt=Abstract

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Topical mupirocin treatment of impetigo is equal to oral erythromycin therapy. Author(s): Mertz PM, Marshall DA, Eaglstein WH, Piovanetti Y, Montalvo J. Source: Archives of Dermatology. 1989 August; 125(8): 1069-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2502950&dopt=Abstract

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Towards evidence based emergency medicine: best BETS from the Manchester Royal Infirmary. Oral or topical antibiotics for impetigo. Author(s): McVicar J. Source: Journal of Accident & Emergency Medicine. 1999 September; 16(5): 364-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10505921&dopt=Abstract

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Toxin in bullous impetigo and staphylococcal scalded-skin syndrome targets desmoglein 1. Author(s): Amagai M, Matsuyoshi N, Wang ZH, Andl C, Stanley JR. Source: Nature Medicine. 2000 November; 6(11): 1275-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11062541&dopt=Abstract

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Treatment of impetigo and ecthyma. Author(s): Linder CW. Source: The Journal of Family Practice. 1978 October; 7(4): 697-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=359752&dopt=Abstract

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Treatment of impetigo and ecthyma. A comparison of sulconazole with miconazole. Author(s): Nolting S, Strauss WB. Source: International Journal of Dermatology. 1988 December; 27(10): 716-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3069760&dopt=Abstract

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Treatment of impetigo. Author(s): Stringer HC. Source: Drugs. 1973; 6(5): 413-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4787758&dopt=Abstract

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Treatment of impetigo: a review. Author(s): Baltimore RS. Source: Pediatr Infect Dis. 1985 September-October; 4(5): 597-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4047974&dopt=Abstract

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Trioleoylglycerol lipolysis by Staphylococcus aureus strains from recurrent furunculosis, pyomyositis, impetigo and osteomyelitis. Author(s): Hedstrom SA, Nilsson-Ehle P. Source: Acta Pathol Microbiol Immunol Scand [b]. 1983 June; 91(3): 169-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6880741&dopt=Abstract

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Twin sisters with impetigo herpetiformis. Author(s): Vicdan K, Gokay Z, Var T, Danisman N, Gokmen O. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1995 December; 63(2): 195-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8903778&dopt=Abstract

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Twins with impetigo herpetiformis. Author(s): Alli N, Lenk N. Source: International Journal of Dermatology. 1996 February; 35(2): 149-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8850053&dopt=Abstract

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Two sisters with impetigo herpetiformis. Author(s): Tada J, Fukushiro S, Fujiwara Y, Akagi Y, Kodama H, Nohara N. Source: Clinical and Experimental Dermatology. 1989 January; 14(1): 82-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2805396&dopt=Abstract

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Ultrastructure of pustules in impetigo herpetiformis. Author(s): Yamada M, Yoshinaga H. Source: Journal of Cutaneous Pathology. 1976; 3(1): 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=932250&dopt=Abstract

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Vacuoles in the upper part of the epidermis as a clue to eventuation of superficial pemphigus and bullous impetigo. Author(s): Kouskoukis CE, Ackerman AB. Source: The American Journal of Dermatopathology. 1984 April; 6(2): 183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6731731&dopt=Abstract

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Vesicles and bulla in an infant. Bullous varicella (chicken pox complicated by bullous impetigo). Author(s): White GM, Broska P. Source: Archives of Dermatology. 1994 January; 130(1): 107, 110. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8285728&dopt=Abstract

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What histologic finding distinguishes superficial pemphigus and bullous impetigo? Author(s): Kouskoukis CE, Ackerman AB. Source: The American Journal of Dermatopathology. 1984 April; 6(2): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6375421&dopt=Abstract

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What's your assessment? Impetigo. Author(s): Bielan B. Source: Dermatology Nursing / Dermatology Nurses' Association. 1999 October; 11(5): 354-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10670342&dopt=Abstract

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

Finding Nutrition Studies on Impetigo 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 “impetigo” (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.

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

A bacteriologically controlled, randomized study comparing the efficacy of 2% mupirocin ointment (Bactroban) with oral erythromycin in the treatment of patients with impetigo. Author(s): Scottsdale Pediatrics, AZ 85251. Source: McLinn, S J-Am-Acad-Dermatol. 1990 May; 22(5 Pt 1): 883-5 0190-9622

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Comparison of mupirocin and erythromycin in the treatment of impetigo. Author(s): Department of Pediatrics, Naval Hospital, Portsmouth, Virginia 23708-5000. Source: Britton, J W Fajardo, J E Krafte Jacobs, B J-Pediatr. 1990 November; 117(5): 827-9 0022-3476

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Comparison of oral cephalexin, topical mupirocin and topical bacitracin for treatment of impetigo. Author(s): Department of Pediatrica, Tripler Army Medical Center, Honolulu, HI 968595000, USA. [email protected] Source: Bass, J W Chan, D S Creamer, K M Thompson, M W Malone, F J Becker, T M Marks, S N Pediatr-Infect-Dis-J. 1997 July; 16(7): 708-10 0891-3668

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Cost-effectiveness of erythromycin versus mupirocin for the treatment of impetigo in children. Author(s): Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD. Source: Rice, T D Duggan, A K DeAngelis, C Pediatrics. 1992 February; 89(2): 210-4 00314005

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Double-blind study comparing erythromycin and mupirocin for treatment of impetigo in children: implications of a high prevalence of erythromycin-resistant Staphylococcus aureus strains. Author(s): Pediatric Infectious Disease Unit, Soroka University Medical Center, BeerSheva, Israel. Source: Dagan, R Bar David, Y Antimicrob-Agents-Chemother. 1992 February; 36(2): 287-90 0066-4804

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Endemic occurrence of glomerulonephritis associated with streptococcal impetigo. Author(s): Department of Medicine, NTT Izu Teishin Hospital, Shizuoka, Japan. Source: Kobayashi, S Ikeda, T Okada, H Suzuki, Y Ishii, M Ohtake, T Oda, T Hishida, A Am-J-Nephrol. 1995; 15(4): 356-60 0250-8095

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Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin. Author(s): St. Louis University School of Medicine, Department of Pediatrics/Adolescent Medicine, Missouri. Source: Barton, L L Friedman, A D Sharkey, A M Schneller, D J Swierkosz, E M PediatrDermatol. 1989 June; 6(2): 134-8 0736-8046

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Impetigo herpetiformis associated with hypocalcemia of congenital rickets. Author(s): Department of Dermatology, University of Rochester School of Medicine, NY 14642. Source: Holm, A L Goldsmith, L A Arch-Dermatol. 1991 January; 127(1): 91-5 0003-987X

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Importance of side effects in treating impetigo. Author(s): Unit for Renal and Infectious Diseases, Algemeen Ziekenhuis, Bruges, Belgium. Source: Boelaert, J Pharmacoeconomics. 1992 June; 1(6): 461-2 1170-7690

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Is penicillin still the drug of choice for non-bullous impetigo? Author(s): Department of Family Medicine, University of Connecticut Health Center, Farmington 06032. Source: Feder, H M Abrahamian, L M Grant Kels, J M Lancet. 1991 September 28; 338(8770): 803-5 0140-6736

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Mupirocin in the treatment of impetigo. Author(s): Department of Pharmacy, University of Queensland, St. Lucia, Australia. Source: Booth, J H Benrimoj, S I Int-J-Dermatol. 1992 January; 31(1): 1-9 0011-9059

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Mupirocin vs terbinafine in impetigo. Author(s): Pediatric Clinic of Elmadag State Hospital, Ankara, Turkey. [email protected] Source: Ciftci, E Guriz, H Aysev, A D Indian-J-Pediatr. 2002 August; 69(8): 679-82 00195456

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Paediatric dermatology. Impetigo. Author(s): Department of Dermatology; New Childrens Hospital, Westmead, NSW. Source: Hogan, P Aust-Fam-Physician. 1998 August; 27(8): 735-6 0300-8495

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Randomized clinical trial of topical mupirocin versus oral erythromycin for impetigo. Author(s): Division of Pediatric Pharmacology and Critical Care, Rainbow Babies and Childrens Hospital, Cleveland, Ohio. Source: Goldfarb, J Crenshaw, D O'Horo, J Lemon, E Blumer, J L Antimicrob-AgentsChemother. 1988 December; 32(12): 1780-3 0066-4804

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Recurrent impetigo herpetiformis in a pregnant adolescent: case report. Author(s): Department of Obstetrics and Gynecology, University of Yuzuncu Yil, Medical Faculty, Van, Turkey. [email protected] Source: Sahin, H Guler Sahin, Huseyin Avni Metin, Ahmet Zeteroglu, Sahin Ugras, Serdar Eur-J-Obstet-Gynecol-Reprod-Biol. 2002 March 10; 101(2): 201-3 0301-2115

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Review of mupirocin ointment in the treatment of impetigo. Author(s): Department of Dermatology, University of Pennsylvania, Philadelphia. Source: Leyden, J J Clin-Pediatr-(Phila). 1992 September; 31(9): 549-53 0009-9228

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The antibacterial activity of tea in vitro and in vivo (in patients with impetigo contagiosa). Author(s): Department of Dermatology and Venereology, Baghdad University, P.O. Box 61072, Postal Cade 12114, Medical Collection Post Office, Medical City, Baghdad, Iraq. Source: Sharquie, K E al Turfi, I A al Salloum, S M J-Dermatol. 2000 November; 27(11): 706-10 0385-2407

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Topical mupirocin treatment of impetigo is equal to oral erythromycin therapy. Author(s): Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine, FL 33101. Source: Mertz, P M Marshall, D A Eaglstein, W H Piovanetti, Y Montalvo, J ArchDermatol. 1989 August; 125(8): 1069-73 0003-987X

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Topical mupirocin vs. systemic erythromycin treatment for pyoderma. Author(s): Scottsdale Pediatrics, AZ 85251. Source: McLinn, S Pediatr-Infect-Dis-J. 1988 November; 7(11): 785-90 0891-3668

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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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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CHAPTER 3. ALTERNATIVE MEDICINE AND IMPETIGO Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to impetigo. 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 impetigo 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 “impetigo” (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 impetigo: •

An inhibitor of Staphylococcus aureus exfoliative toxin. Author(s): Al-Sulami AA, Al-Rubiay KK, Affat AM. Source: East Mediterr Health J. 2001 January-March; 7(1-2): 121-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596961&dopt=Abstract

•

Contrasting molecular epidemiology of group A streptococci causing tropical and nontropical infections of the skin and throat. Author(s): Bessen DE, Carapetis JR, Beall B, Katz R, Hibble M, Currie BJ, Collingridge T, Izzo MW, Scaramuzzino DA, Sriprakash KS. Source: The Journal of Infectious Diseases. 2000 October; 182(4): 1109-16. Epub 2000 September 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10979907&dopt=Abstract

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•

Endemic occurrence of glomerulonephritis associated with streptococcal impetigo. Author(s): Kobayashi S, Ikeda T, Okada H, Suzuki Y, Ishii M, Ohtake T, Oda T, Hishida A. Source: American Journal of Nephrology. 1995; 15(4): 356-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7573198&dopt=Abstract

•

Herbal medicines for treatment of bacterial infections: a review of controlled clinical trials. Author(s): Martin KW, Ernst E. Source: The Journal of Antimicrobial Chemotherapy. 2003 February; 51(2): 241-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562687&dopt=Abstract

•

Molecular epidemiology of impetiginous group A streptococcal infections in aboriginal communities of northern Australia. Author(s): Gardiner DL, Sriprakash KS. Source: Journal of Clinical Microbiology. 1996 June; 34(6): 1448-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8735096&dopt=Abstract

•

New antimicrobial agents. Author(s): Goldfarb J. Source: Pediatric Clinics of North America. 1995 June; 42(3): 717-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7761149&dopt=Abstract

•

The antibacterial activity of tea in vitro and in vivo (in patients with impetigo contagiosa). Author(s): Sharquie KE, al-Turfi IA, al-Salloum SM. Source: The Journal of Dermatology. 2000 November; 27(11): 706-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11138536&dopt=Abstract

•

The influence of hexachlorophene scrubs on the response to placebo or penicillin therapy in impetigo. Author(s): Ruby RJ, Nelson JD. Source: Pediatrics. 1973 December; 52(6): 854-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4203555&dopt=Abstract

•

Treatment of bacterial, fungal, and parasitic infections in the HIV-infected host. Author(s): Berger TG. Source: Semin Dermatol. 1993 December; 12(4): 296-300. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7508736&dopt=Abstract

•

Zinc supplementation and growth of the fetus and low birth weight infant. Author(s): Castillo-Duran C, Weisstaub G.

Alternative Medicine 43

Source: The Journal of Nutrition. 2003 May; 133(5 Suppl 1): 1494S-7S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12730451&dopt=Abstract •

Zinc supplementation during pregnancy and effects on growth and morbidity in low birthweight infants: a randomised placebo controlled trial. Author(s): Osendarp SJ, van Raaij JM, Darmstadt GL, Baqui AH, Hautvast JG, Fuchs GJ. Source: Lancet. 2001 April 7; 357(9262): 1080-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11297959&dopt=Abstract

•

Zinc supplementation impairs monocyte function. Author(s): Schlesinger L, Arevalo M, Arredondo S, Lonnerdal B, Stekel A. Source: Acta Paediatrica (Oslo, Norway : 1992). 1993 September; 82(9): 734-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8241668&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/

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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The following is a specific Web list relating to impetigo; 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: •

Alternative Therapy Shiatsu Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,733,00.html

•

Chinese Medicine Hezi Alternative names: Medicine Terminalia Fruit; Fructus Chebulae Source: Chinese Materia Medica Jiusheng San Alternative names: Jiusheng Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Maohezi Alternative names: Belleric Terminalia Fruit; Fructus Terminaliae Billericae Source: Chinese Materia Medica Songhuafen Alternative names: Pine Pollen; Pollen Pini Source: Chinese Materia Medica

•

Herbs and Supplements Blue Flag Alternative names: Iris versicolor Source: Healthnotes, Inc.; www.healthnotes.com Plantain Alternative names: Plantago lanceolata, Plantago major Source: Healthnotes, Inc.; www.healthnotes.com

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

45

CHAPTER 4. PATENTS ON IMPETIGO Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “impetigo” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on impetigo, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Impetigo By performing a patent search focusing on impetigo, 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

8Adapted

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

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

Antiodor, antimicrobial and preservative compositions and methods of using same Inventor(s): Van Scott; Eugene J. (Abington, PA), Yu; Ruey J. (Ambler, PA) Assignee(s): TriStrata, Inc. (Princeton, NJ) Patent Number: 5,641,475 Date filed: November 1, 1994 Abstract: Therapeutic treatment as well as prophylactic measures are provided by topical application of compositions containing an aryl 2-acetoxyethanoic acid to eradicate or prevent the development of axillary foul odor, foot malodor and other body odors, e.g. scalp, and skin, nail and follicular infections caused by microorganisms. The compositions are antimicrobial against several organisms that infect the skin and are specifically effective against P. acnes. The compositions are therapeutically effective against folliculitis and perifolliculitis and are useful for other skin lesions, nail and mucosal infections such as impetigo, seborrheic dermatitis, erythrasma and trichomycosis axillaris, associated with or caused by microorganisms. The therapeutic effect of the composition may be synergized or amplified by incorporating a cosmetic or dermatologic agent into the formulation for topical treatment of cosmetic and dermatologic indications. The compositions are also useful as preservatives in food products, cosmetic and pharmaceutical formulations, and industrial preparations. Excerpt(s): The invention relates to antiodor, antimicrobial and preservative compositions for prophylactic measures as well as topical treatment of skin foul odor and infections caused by microorganisms. More particularly, the invention is directed to compositions useful for topical application to treat and to prevent the development of axillary foul odor, foot malodor and other body foul odor, and to alleviate skin disorders associated with microbial infections, and also useful as preservatives in food products and cosmetic and pharmaceutical formulations. In human skin, sebaceous glands, eccrine sweat glands and apocrine glands secrete various chemicals onto the skin surface. These chemicals include sodium chloride, potassium bicarbonate, lactic acid, urea, squalene, proteins, carbohydrates, triglycerides and other lipids. Although body odor may be partially due to certain chemicals secreted by sebaceous glands and eccrine sweat glands, major axillary foul odor is due to secretions of the apocrine glands, which contain special nutrient materials for microorganisms. Apocrine glands are located primarily in the axillae, anogenital region, mammary areolae, ear canals, eyelids, and are scattered on parts of the face, anterior chest and abdomen. In general, the apocrine duct opens into the upper end of the hair follicle although it may occasionally open directly onto the skin surface. In contrast to the eccrine glands, which produce a clear watery liquid, the apocrine glands secrete a milky fluid that has a pH range of 5 to 6.5 and initially consists of lipids, proteins and carbohydrates. Although fresh apocrine secretions do not have an objectionable odor, the secreted compounds are found to undergo decomposition by both chemical and microbial actions, and the degradation products are responsible for the offensive odors. Chemical substances identified as contributing to this unpleasant odor include lower organic acids such as butanoic, isopentanoic, hexanoic and octanoic acids; mercaptans; indoles; amines; hydrogen sulfide; ammonia; and phosphine. Although gram-positive bacteria, thriving on substances found on the moist skin surface, appear to be responsible for the production of malodor, the precise mechanisms of odor production are still unclear.

Patents 47

Web site: http://www.delphion.com/details?pn=US05641475__ •

Bis(triamcinolone acetonide)-4,4'-methylenebis-(3-methoxy-2-naphthoate) Inventor(s): Agusti; Agustin (Barcelona, ES) Assignee(s): J. Uriach & Cia. S.A. (Barcelona, ES) Patent Number: 4,107,161 Date filed: March 18, 1974 Abstract: Bis(triamcinolone acetonide) 4,4'-methylene-bis(3-methoxy-2-naphthoate), method of preparing the same by preparing a reactive derivative of 4,4'-methylenebis(3-methoxy-2-naphthoic acid) and reacting such derivative with triamcinoline acetonide. The triamcinolone acetonide derivative is particularly suitable for use in the treatment of dermatosis, eczema, neurodermatitis, impetigo, psoriasis, pruritis, erythema and the like. Excerpt(s): This invention relates to a new triamcinolone acetonide derivative, and methods for making and using the same. More particularly the invention relates to bis(triamcinolone acetonide) 4,4'-methylene-bis(3-methoxy-2-naphthoate) and the use thereof in treating a broad range of dermatological conditions. It is well known that triamcinolone acetonide, or 9.alpha.-fluoro-1l.beta.,21-dihydroxy-16.alpha.,17.alpha.isopropylidenedi oxy-1,4pregnadiene-3,20-dione, has proved particularly useful in the treatment of dermatological conditions. The compound has been proved to have marked efficacy in the treatment of dermatosis, eczema, neurodermitis, impetigo, psoriasis, pruritis and other related diseases. However, in the long term topical treatment of large areas, especially with children and where there are skin lesions, there arise a great variety of general secondary reactions due to the percutaneous absorption of the corticoid. Thus the drug is known to induce natriuresis negative sodium balance with weight loss in most patients. Nearly every side effect seen with hydrocortisone has been seen with triamcinolone acetonide but the relative frequencies are less. These undesirable results are particularly associated with long therapy. Triamcinolone acetonide is a fluorinated derivative of prednisone, the fluorine atom in the 9.alpha. position of the corticosteroid ring system increasing the activity of the glucocorticoid and reducing the action on the metabolism of electrolytes. Web site: http://www.delphion.com/details?pn=US04107161__

•

Method for treating dermatological conditions including impetigo Inventor(s): Bass; Ralph L. (3708 Sweeten Creek Rd., Chapel Hill, NC 27514), Taylor; Lesli A. (3708 Sweeten Creek Rd., Chapel Hill, NC 27514) Assignee(s): none reported Patent Number: 5,869,104 Date filed: September 19, 1997 Abstract: A method for the topical treatment of skin affected with a dermatological condition selected from the group consisting of impetigo, epidermolysis bullosa, eczema, neurodermatitis, psoriasis, pruritis, erythema, hidradenitis suppurativa, warts, diaper rash, jock itch, and combinations thereof. For most conditions, sodium chloride, in a substantially pure form as a solid block, is topically applied to the affected skin by

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gently gliding the block over the affected skin in a manner insufficient to cause abrasion and debridement of the affected skin. For certain conditions, such as epidermolysis bullosa, sodium chloride in the form of an aqueous solution preferably should be used. The applied sodium chloride is left on the skin. Excerpt(s): The present invention relates, in general, to a method for the topical treatment of human skin. More particularly, the present invention relates to an improved method for the topical treatment of human skin affected with a dermatological condition selected from the group consisting of impetigo, epidermolysis bullosa, dermatosis, eczema, neurodermatitis, psoriasis, pruritis, erythema, hidradenitis suppurativa, warts, diaper rash, jock itch, and combinations thereof by gently applying sodium chloride on the affected skin. As is well known, skin conditions are typically treated with antibiotics (oral and/or topical). Often, the antibiotic becomes ineffective over time (typically, within about 6 months after initiating use) due to mutations of the microorganisms causing the skin condition. Of interest, Agusti U.S. Pat. No. 3,899,581, U.S. Pat. No. 4,107,161, and Reissue Pat. No. 29,799 (a Divisional of the patent application that issued as U.S. Pat. No. 4,107,161) show triamcinolone acetonide for the topical treatment of dermatosis, eczema, neurodermatitis, impetigo, psoriasis, pruritis, and erythema. On the other hand, Tegeler et al. U.S. Pat. No. 5,360,811 (Parent) and U.S. Pat. No. 5,550,247 (Divisional) show various 1,3-propanediols substituted with 1-alkyl-, 1-alkynyl-, or 1-alkynylaryl-2-amino- in a topical application to inhibit bacterial and fungal growth. Web site: http://www.delphion.com/details?pn=US05869104__ •

Pharmaceutical composition for skin diseases Inventor(s): Chang; Man Sik (Seoul, KR), Choi; Wahn Soo (Seoul, KR), Chun; Jae Kwang (Kyunggi-do, KR), Chun; Jong Ok (Kyunggi-do, KR), Chung; Kae Jong (Seoul, KR), Kim; Sung Chul (Kyunggi-do, KR) Assignee(s): Yungjin Pharmaceutical Co., Ltd. (Seoul, KR) Patent Number: 5,731,007 Date filed: July 25, 1996 Abstract: The present invention relates to novel pharmaceutical composition for skin diseases, in particular to novel pharmaceutical composition useful for treatment of skin diseases; e.g. burns, wounds, general operative wounds, pernio, decubitus, folliculitis, impetigo, intertrigo, radiation ulcer, acne vulgaris or infectious eczematous dermatitis comprising deproteinized dialysate of calf's blood with tissue regenerative activity and aminoglycoside antibiotic with bacterial infection inhibitory activity as active ingredients. Excerpt(s): The present invention relates to novel pharmaceutical composition for skin diseases, in particular which comprises deproteinized dialysate of calf's blood and aminoglycoside antibiotic as active ingredients. It is known that skin diseases, e.g. burns, wounds, general operative wounds, pernio, decubitus, folliculitis, impetigo, intertrigo, radiation ulcer, acne vulgaris or infectious eczematous dermatitis develop erythema, swelling, bulla, erosion, or ulcer etc., being accompanied with bacterial infections. For the treatement of those skin diseases, tissue regeneration activators which can accelerate regeneration of the necrotinized tissue and fibroblast proliferation have been developed ›Acta. Therapeutica Vol. 10,107-115 (1984)!. However, it has been

Patents 49

pointed out as demerits that those activators are unable to prevent appropriately bacterial infections in foci during the treatment. Web site: http://www.delphion.com/details?pn=US05731007__

Patent Applications on Impetigo As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to impetigo: •

Pharmaceutical compositions and methods for managing skin conditions Inventor(s): Murad, Howard; (Marina del Rey, CA) Correspondence: Pennie & Edmonds Llp; 1667 K Street NW; Suite 1000; Washington; DC; 20006 Patent Application Number: 20020054918 Date filed: September 17, 2001 Abstract: This application relates to a pharmaceutical composition and methods for treating inflammatory skin conditions. The compositions include hydrogen peroxide, one or more moisturizing agents, and an anti-inflammatory agent. The pharmaceutical compositions may optionally include one or more exfoliants. The compositions can be used to treat inflammatory skin conditions such as dermatitis, including, but not limited to seborrheic dermatitis, nummular dermatitis, contact dermatitis, atopic dermatitis, exfoliative dermatitis, perioral dermatitis, and stasis dermatitis; psoriasis; folliculitis; rosacea; acne; impetigo; erysipelas; paronychia, erythrasma; and eczema. Excerpt(s): This application is a continuation-in-part of application Ser. No. 09/878,231, filed Jun. 12, 2001, currently pending, of which is a continuation of application Ser. No. 09/549,202, filed Apr. 13, 2000, now allowed, which is a continuation-in-part of application Ser. No. 09/330,127, filed Jun. 11, 1999, currently U.S. Pat. No. 6,071,541, which is a continuation-in-part of provisional application Ser. No. 60/094,775, filed Jul. 31, 1998. This application relates to pharmaceutical compositions and methods to cleanse skin and facilitate the prevention, treatment, and management of skin conditions. Human skin is a composite material of the epidermis and the dermis. The topmost part of the epidermis is the stratum corneum. This layer is the stiffest layer of the skin, as well as the one most affected by the surrounding environment. Below the stratum corneum is the internal portion of the epidermis. Below the epidermis, the topmost layer of the dermis is the papillary dermis, which is made of relatively loose connective tissues that define the micro-relief of the skin. The reticular dermis, disposed beneath the papillary dermis, is tight, connective tissue that is spatially organized. The reticular dermis is also associated with coarse wrinkles. At the bottom of the dermis lies the subcutaneous layer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

9

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

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

51

CHAPTER 5. BOOKS ON IMPETIGO Overview This chapter provides bibliographic book references relating to impetigo. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on impetigo include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Atlas of Diseases of the Oral Cavity in HIV Infection Source: Copenhagen, Denmark: Munksgaard. 1995. 152 p. Contact: Available from Munksgaard. 35 Norre Sogade, P.O. Box 2148, DK-1016, Copenhagen K, Denmark. Telephone +45 33 12 70 30; Fax +45 33 12 93 87; E-mail: [email protected]; http://www.munksgaard.dk/publishers/. PRICE: DKK 400,000 plus postage; contact directly for current price in US dollars. ISBN: 8716115090. Summary: This atlas of oral diseases in HIV infection depicts and describes the oral manifestations of HIV in three sections. The authors stress that oral manifestations are often the key to an initial clinical diagnosis of HIV infection. The introductory material discusses epidemiology, the global aspects of HIV seropositivity, predictions for the future, and the classification of oral lesions associated with HIV infection. The first section covers lesions strongly associated with HIV infection including candidiasis,

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hyperplasia, angular cheilitis, hairy leukoplakia, periodontal diseases, linear gingival erythema, necrotizing gingivitis, stomatitis and periodontitis, Kaposi's sarcoma, and non-Hodgkin's lymphoma. The second section covers lesions less commonly associated with HIV infection including tuberculosis, hyperpigmentation, pigmentation of the nails, enlargement of major salivary glands, lymphoepithelial lesion, thrombocytopenia, atypical ulceration, herpes labialis, herpetic stomatitis, herpes zoster, varicella, condyloma acuminatum, focal epithelial hyperplasis, and verruca vulgaris. The third section outlines lesions seen in HIV infection, notably Klebsiella pneumonia infection, bacillar epithelioid angiomatosis, toxic epidermal necrolysis, drug-induced ulcerations, cryptococcoses, mucormycosis, penicilliosis, facial nerve paralysis, aphthous ulceration, cytomegalovirus-induced oral ulceration, and molluscum contagiosum. A final section describes other lesions, including exfoliative cheilitis, impetigo contagiosa, secondary syphilis, lichenoid lesions of buccal mucosa, and oral cancer. The atlas depicts each manifestation with a full-color photograph and provides brief descriptions. The book concludes with a list of references, coding according to the international classification of diseases, and a subject index. 111 figures. 193 references.

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 “impetigo” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “impetigo” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “impetigo” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Impetigo by Elizabeth Laskey; ISBN: 1403402744; http://www.amazon.com/exec/obidos/ASIN/1403402744/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 “impetigo” (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

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.

Books

53

•

A practical treatise on porrigo, or scalled head, and on impetigo, the humid, or running tetter. Ed. by Ashby Smith. Author: Willan, Robert,; Year: 1870; London, Cox, 1814

•

A treatise on the origin and progress of the impetigo disorder, from the earth's surface, through animated nature to man, as it displays itself in ringworms, scrofula, leprosy. Author: Hensley, J.; Year: 1814; [London] Lowe [182-?]

•

Contributions to dermatology: eczema, impetigo, scabies, ecthyma, rupia, lupus Author: Durkee, Silas.; Year: 1991; Boston: J. Campbell, 1870

•

Skin diseases: eczema, dermatitis, psoriasis, erysipelas, impetigo, alopecia, warts, rashes &c. Author: Brain, Reginald Thomas,; London, Duckworth [1955]

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

Solving Skin Problems Source: in Touchette, N. Diabetes Problem Solver. Alexandria, VA: American Diabetes Association. 1999. p. 295-311. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 for members; plus shipping and handling. ISBN: 1570400091. Summary: This chapter deals with solving skin problems in people who have diabetes. People who have diabetes may experience many skin problems, including digital sclerosis, Dupuytren's contracture, yellow skin, diabetic dermopathy, necrobiosis lipoidica diabeticorum, granuloma annulare, scleredema, bullosis diabeticorum, xanthomas, acanthus nigricans, vitiligo, pruritus, and necrolytic migratory erythema. Other skin problems include yeast infections; fungal infections; and bacterial infections such as impetigo, erythrasma, erysipelas, carbuncles and furuncles, cellulitis, necrotizing fascitis and cellulitis, and abscesses. In addition, skin problems may occur as a result of reactions to diabetes medications such as insulin and sulfonylureas. The chapter presents the symptoms of these skin conditions and explains what action people should take if they experience any of the symptoms of these conditions.

•

Acquired Mucosal Disorders Source: in Scully, C., et al. Color Atlas of Orofacial Health and Disease in Children and Adolescents. London, England: Martin Dunitz Ltd. 2002. p.123-173. Contact: Available from Martin Dunitz Ltd, The Livery House. 7-9 Pratt Street, London, England NW1 0AE. 4404074822202. Website: www.dunitz.co.uk. Email:

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[email protected]. PRICE: $125.00 plus shipping and handling. ISBN: 1841841021. Summary: This chapter on acquired mucosal disorders is from a full-color atlas that covers the presentation of the common orofacial disorders and a wide range of less common and some rare disorders. The chapter begins with an overview of common complaints associated with acquired mucosal disorders, including lumps and swellings, pigmented lesions, red lesions, ulcers, and white lesions. The chapter then covers acute candidosis (thrush, candidiasis, moniliasis), amalgam and other tattoos, angioedema, angular stomatitis (angular cheilitis), aphthae (recurrent aphthous stomatitis), Behcet's syndrome, bites, burns, carcinoma, chapped lips, check-chewing, cheilitis, choristoma, Crohn's disease, deep mycoses, erythema multiforme, exfoliative cheilitis, furred tongue, celiac disease (gluten-sensitive enteropathy), hand, foot and mouth disease, herpangina, herpes simplex infections, human papillomavirus infections, iatrogenic injury, impetigo, infectious mononucleosis, keratosis, Langerhans cell histiocytosis, lichenoid lesions, lingual papillitis, lip fissures, lupus erythematosus, lymphoepithelial cyst, lymphoma, macroglossia and microglossia, measles (rubeola), median rhomboid glossitis, melanotic macule, melanocytic nevus, molluscum contagiosum, orofacial granulomatosis, papillary hyperplasia, pemphigus vulgaris, pyostomatitis vegetans, scleroderma, self-mutilation, syphilis, traumatic ulcers, and varicella-zoster virus infections (chickenpox). Full-color photographs are accompanied by brief text entries describing each condition and noting diagnostic and management considerations for each. 107 figures. 8 tables. •

Diseases and Oral Manifestations of Systemic Disease Source: in Pinkham, J.R., et al., eds. Pediatric Dentistry: Infancy Through Adolescence. 3rd ed. Philadelphia, PA: W.B. Saunders Company. 1999. p. 54-67. Contact: Available from W.B. Saunders Company. Book Orders Fulfillment Department, Harcourt Health Sciences, 11830 Westline Industrial Drive, Saint Louis, MO 63146-9988. (800) 545-2522. Website: www.wbsaunders.com. PRICE: $69.00 plus shipping and handling. ISBN: 0721682383. Summary: This chapter on diseases and oral manifestations of systemic disease is from a textbook on pediatric dentistry. Topics include herpetic gingivostomatitis, recurrent herpes simplex (herpes labialis), herpes zoster (chicken pox), herpangina, hand, foot and mouth disease, impetigo, scarlet fever, candidiasis, diabetes mellitus, acute lymphoblastic leukemia, sickle cell anemia, histiocytoses (hystiocytosis X), hemophilia (hemophilia A; Factor VIII deficiency), and pediatric human immunodeficiency virus (HIV) infection. For each disease, the author reviews the causative agent, evaluation of the patient, diagnosis, and therapy. The chapter includes illustrative case studies for some of the diseases. The chapter is illustrated with numerous black and white photographs of the conditions under consideration. 9 figures. 3 tables. 41 references.

•

Lip Lesions Source: in Scully, C. and Cawson, R.A. Oral Disease: Colour Guide. 2nd ed. Edinburgh, Scotland: Churchill Livingstone. 1999. p. 1-22. Contact: Available from W.B. Saunders Company, A Harcourt Health Sciences Company. Book Order Fulfillment Department, 11830 Westline Industrial Drive, St Louis, MO 63146-9988. (800) 545-2522. Fax (800) 568-5136. E-mail: [email protected]. Website: www.wbsaunders.com. PRICE: $19.95 plus shipping and handling. ISBN: 044306170X.

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Summary: This chapter on lip lesions is from a book that is intended as an aid to oral medicine and the diagnosis and treatment of oral disease. The chapter includes 24 full color photographs of lip lesions, with textual information accompanying them. Conditions covered are: herpes labialis, herpes zoster (shingles), impetigo contagiosa, primary syphilis (Hunterian or hard chancre), pyogenic granuloma, carcinoma (cancer), erythema multiforme, leukemia, discoid lupus erythematosus (DLE), lichen planus, angular stomatitis, cracked lip, actinic burns, allergic angioedema, hereditary angioedema, oral Crohn's disease, sarcoidosis, nevi, Peutz-Jeghers syndrome, mucocele, and Sturge-Weber syndrome (encephalotrigeminal angiomatosis). For each condition, the text briefly covers incidence and etiology, clinical features, diagnosis and diagnostic tests, and treatment options. •

Chapter 201: Bacterial Skin Infections Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 6 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who have bacterial skin infections with information on the symptoms and treatment of impetigo, folliculitis, boils, carbuncles, erysipelas, cellulitis, paronychia, staphylococcal scalded skin syndrome, and erythrasma. Although many types of bacteria can infect the skin, the most common are Staphylococcus and Streptococcus. People at high risk of contracting skin infections include people who have diabetes or acquired immunodeficiency syndrome. Keeping the skin undamaged and clean usually prevents infections. Impetigo, which is caused by Staphylococcus or Streptococcus, is a skin infection that leads to the formation of small pus filled blisters. An oral antibiotic is used to treat impetigo. Folliculitis, which is caused by infection with Staphylococcus, causes hair follicles to become irritated and reddened. Boils, which are caused by staphylococcal infection around hair follicles, are large, tender, swollen, raised areas with a pus filled center. Carbuncles are clusters of boils. These three infections can be prevented by keeping the skin clean with a liquid soap containing an antibacterial agent. Moist heat can be used to help a boil drain spontaneously. Antibiotics are also used to treat boils and carbuncles. Erysipelas, which is caused by Streptococcus, is characterized by a shiny, red, slightly swollen, tender rash, often with small blisters. Antibiotics are used to treat this infection. Cellulitis, which is usually caused by streptococcal or staphylococcal infection, produces swelling, tenderness, warmth, and redness of the skin. Treatment involves taking penicillin or a penicillin type drug. Paronychia, which can be caused by many different bacteria or by fungi, is an infection around the edge of a fingernail or toenail. Hot compresses and warm soaks help relieve symptoms and fight infection. A doctor may need to drain the infection. Antibiotics and antifungals may also be prescribed. Staphylococcal scaled skin syndrome causes the top layer of skin to peel off as though burned. Infants, young children, and people with depressed immune systems are usually affected. Diagnosis is based on examination or culture of a skin sample. Oral or intravenous penicillin type antibiotics are used to treat this syndrome. Erythrasma, an infection of the top layers of the skin caused by Corynebacterium minutissimum, often occurs in areas where skin touches skin. An oral antibiotic can eliminate the infection.

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•

Bacterial Diseases Source: in Bork, K., et al. Diseases of the Oral Mucosa and the Lips. Orlando, FL: W.B. Saunders Company. 1993. p. 123-151. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522 (individuals) or (800) 782-4479 (schools); Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $99.00 plus shipping and handling. ISBN: 0721640397. Summary: This lengthy chapter, from a textbook on diseases of the oral mucosa and the lips, discusses the etiology, clinical features, histopathology, diagnosis, and differential diagnosis for a variety of bacterial diseases that demonstrate oral manifestations. Diseases covered include impetigo, furuncle and carbuncle (deep staphylococcal infections of the hair follicle), acute bacterial cheilitis with ectropion, chancriform pyoderma, erysipelas, periodontal disease, simple gingivitis, hyperplastic or chronic gingivitis, acute necrotizing ulcerative gingivostomatitis (ANUG), noma (cancrum oris), chronic periodontitis, juvenile periodontitis, periodontal abscess, parodontal pseudocysts, dental sinus tracts, dental infection as a cause of other diseases, nonodontogenic oral abscesses, scarlet fever, diphtheria, cat-scratch disease, gonorrhea, chancroid, syphilis, congenital syphilis, yaws, tuberculosis (including lupus vulcagis), leprosy, actinomycosis, and miscellaneous bacterial infections, including anthrax, brucellosis, listeriosis, glanders, meningococcemia, granuloma inguinale, pertussis, and tularemia. Full-color photographs illustrate the chapter; references are provided for each section. 57 figures. 100 references. (AA-M).

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APPENDICES

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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.

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

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

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

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

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

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

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

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

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

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

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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

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

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

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

•

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

•

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

•

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

•

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

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

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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.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM 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 “impetigo” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1080 23 15 4 0 1122

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 “impetigo” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

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

15

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). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

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

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

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Coffee Break: Tutorials for 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/.

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

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

•

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

The Genome Project and Impetigo In the following section, we will discuss databases and references which relate to the Genome Project and impetigo. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 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. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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

Pyogenic Sterile Arthritis, Pyoderma Gangrenosum, and Acne Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?604416 Genes and Disease (NCBI - Map)

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

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

•

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

•

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

•

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

•

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

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•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “impetigo” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “impetigo” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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

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•

Guides on impetigo Impetigo http://www.nlm.nih.gov/medlineplus/impetigo.html

•

Other guides Cellulitis http://www.nlm.nih.gov/medlineplus/cellulitis.html Immune System and Disorders http://www.nlm.nih.gov/medlineplus/immunesystemanddisorders.html Juvenile Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/juvenilerheumatoidarthritis.html Staphylococcal Infections http://www.nlm.nih.gov/medlineplus/staphylococcalinfections.html Streptococcal Infections http://www.nlm.nih.gov/medlineplus/streptococcalinfections.html Throat Disorders http://www.nlm.nih.gov/medlineplus/throatdisorders.html

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

General/Overviews Impetigo Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00464 Impetigo: What Is It? Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZYDG6G1AC &sub_cat=24

•

Diagnosis/Symptoms Skin Rashes and Other Changes: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/545.html

•

Specific Conditions/Aspects Group A Streptococcal Infections Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/factsheets/strep.htm Staphylococcus aureus Source: Nemours Foundation http://kidshealth.org/parent/infections/bacterial_viral/staphylococcus.html

Patient Resources

•

69

Children Impetigo Source: Nemours Foundation http://kidshealth.org/parent/infections/bacterial_viral/impetigo.html Impetigo: A Common Skin Infection among Children Source: American Osteopathic Association http://www.aoa-net.org/Consumers/impetigo.htm

•

Organizations National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

•

Research “Exquisite” Molecular Mechanism Found for Impetigo Infection, Spread Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.nih.gov/news/pr/nov2000/niams-06.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 Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on impetigo. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Impetigo Source: KidsHealth. October 2002. 2 p. Contact: Nemours Foundation. Website: www.kidshealth.org. Summary: This fact sheet is written for parents of children who have impetigo, a highly contagious blistering disease of the skin caused by either Group A streptococcus or Staphylococcus aureas. It usually affects preschool and school-age children and can be spread from one area of the body to another or from one child to another. If it is caused by Group A streptococcus it appears as tiny blisters. These blisters burst revealing wet red patches of skin that weep fluid. Staphylococcus aureas causes larger blisters that tend to stay intact. Impetigo may itch and can be spread by scratching. An antibiotic ointment is used to treat impetigo. The doctor may prescribe an oral antibiotic if the infection has spread to many areas of the body or if the ointment is not working. The infected skin should be cleansed daily with antiseptic soap and covered with clean

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gauze. It is not necessary to remove any layers of crust that have formed over the wet patches of skin. Healing should begin within 2 to 3 days of starting treatment, and children can return to school in about 48 hours after the treatment is started; they will no longer be contagious. Good hygiene practices, including regular hand washing and keeping the fingernails clipped, can prevent the spread of impetigo. If one family member has impetigo, towels, bed linens, and clothing should be kept separate from that of other family members and washed in hot water. 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 impetigo. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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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 “impetigo” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “impetigo”. 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 “impetigo” (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 “impetigo” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25

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

25

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

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •

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/

26

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

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•

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

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

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

•

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

•

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 impetigo: •

Basic Guidelines for Impetigo Herpes simplex Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001324.htm Impetigo Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000860.htm Pemphigus Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000882.htm Pemphigus vulgaris Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000882.htm Tinea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001439.htm

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•

Signs & Symptoms for Impetigo Blister 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 Bullae Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003239.htm Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Impetigo Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000860.htm Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Itchy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Macule Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003229.htm Papule Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003233.htm Pustules Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003234.htm Rash Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003259.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 Vesicles Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003939.htm

•

Diagnostics and Tests for Impetigo Anti-DNase B Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003537.htm Sedimentation rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003638.htm

Online Glossaries 81

Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm Urinalysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm •

Background Topics for Impetigo Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Animal bites Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000034.htm Human bites Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000035.htm Insect bites Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000033.htm Systemic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002294.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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IMPETIGO DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abducens: A striated, extrinsic muscle of the eyeball that originates from the annulus of Zinn. [NIH] Abducens Nerve: The 6th cranial nerve. The abducens nerve originates in the abducens nucleus of the pons and sends motor fibers to the lateral rectus muscles of the eye. Damage to the nerve or its nucleus disrupts horizontal eye movement control. [NIH] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Abscess: A localized, circumscribed collection of pus. [NIH] Acantholysis: Separation of the prickle cells of the stratum spinosum of the epidermis, resulting in atrophy of the prickle cell layer. It is seen in diseases such as pemphigus vulgaris (see pemphigus) and keratosis follicularis. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Actinomycosis: Infections with bacteria of the genus Actinomyces. [NIH] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH]

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Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Alopecia: Absence of hair from areas where it is normally present. [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] Amber: A yellowish fossil resin, the gum of several species of coniferous trees, found in the alluvial deposits of northeastern Germany. It is used in molecular biology in the analysis of organic matter fossilized in amber. [NIH] Ameloblastoma: An epithelial tumor of the jaw originating from the epithelial rests of Malassez or from other epithelial remnants of the developing period of the enamel. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broad-

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spectrum antibiotic. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [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] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anergy: Absence of immune response to particular substances. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anogenital: Pertaining to the anus and external genitals. [EU] Anthrax: An acute bacterial infection caused by ingestion of bacillus organisms. Carnivores may become infected from ingestion of infected carcasses. It is transmitted to humans by contact with infected animals or contaminated animal products. The most common form in humans is cutaneous anthrax. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU]

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Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antiplasmin: A member of the serpin superfamily found in human plasma that inhibits the lysis of fibrin clots which are induced by plasminogen activator. It is a glycoprotein, molecular weight approximately 70,000 that migrates in the alpha 2 region in immunoelectrophoresis. It is the principal plasmin inactivator in blood, rapidly forming a very stable complex with plasmin. [NIH] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aphthous Stomatitis: Inflammation of the mucous membrane of the mouth. [NIH] Apocrine Glands: Large, branched, specialized sweat glands that empty into the upper portion of a hair follicle instead of directly onto the skin. [NIH] Aqueous: Having to do with water. [NIH] Areola: The area of dark-colored skin on the breast that surrounds the nipple. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [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] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Augmentin: An antibiotic. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign

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and directs an immune response against them. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacterial Proteins: Proteins found in any species of bacterium. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH]

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Bladder: The organ that stores urine. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] 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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchiseptica: A small, gram-negative, motile bacillus. A normal inhabitant of the respiratory tract in man, dogs, and pigs, but is also associated with canine infectious tracheobronchitis and atrophic rhinitis in pigs. [NIH] Brucellosis: Infection caused by bacteria of the genus Brucella mainly involving the reticuloendothelial system. This condition is characterized by fever, weakness, malaise, and weight loss. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buccal mucosa: The inner lining of the cheeks and lips. [NIH] Bullous: Pertaining to or characterized by bullae. [EU] 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] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a

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systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbuncle: An infection of cutaneous and subcutaneous tissue that consists of a cluster of boils. Commonly, the causative agent is Staphylococcus aureus. Carbuncles produce fever, leukocytosis, extreme pain, and prostration. [NIH] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [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] Cat-Scratch Disease: A self-limiting bacterial infection of the regional lymph nodes caused by Afipia felis, a gram-negative bacterium recently identified by the Centers for Disease Control and Prevention and by Bartonella henselae. It usually arises one or more weeks following a feline scratch, with raised inflammatory nodules at the site of the scratch being the primary symptom. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [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 Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Adhesion Molecules: Surface ligands, usually glycoproteins, that mediate cell-to-cell adhesion. Their functions include the assembly and interconnection of various vertebrate systems, as well as maintenance of tissue integration, wound healing, morphogenic movements, cellular migrations, and metastasis. [NIH] Cell Division: The fission of a cell. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [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] Cephalexin: A semisynthetic cephalosporin antibiotic with antimicrobial activity similar to that of cephaloridine or cephalothin, but somewhat less potent. It is effective against both gram-positive and gram-negative organisms. [NIH] Cephaloridine: A cephalosporin antibiotic. [NIH]

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Cephalothin: A cephalosporin antibiotic. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chancre: The primary sore of syphilis, a painless indurated, eroded papule, occurring at the site of entry of the infection. [NIH] Chancroid: Acute, localized autoinoculable infectious disease usually acquired through sexual contact. Caused by Haemophilus ducreyi, it occurs endemically almost worldwide, especially in tropical and subtropical countries and more commonly in seaports and urban areas than in rural areas. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chickenpox: A mild, highly contagious virus characterized by itchy blisters all over the body. [NIH] Choristoma: A mass of histologically normal tissue present in an abnormal location. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] Circumcision: Excision of the prepuce or part of it. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clavulanic Acid: Clavulanic acid (C8H9O5N) and its salts and esters. The acid is a suicide inhibitor of bacterial beta-lactamase enzymes from Streptomyces clavuligerus. Administered alone, it has only weak antibacterial activity against most organisms, but given in combination with beta-lactam antibiotics prevents antibiotic inactivation by microbial lactamase. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment.

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[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] Clot Retraction: Retraction of a clot resulting from contraction of platelet pseudopods attached to fibrin strands that is dependent on the contractile protein thrombosthenin. Used as a measure of platelet function. [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] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Colloidal: Of the nature of a colloid. [EU] 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

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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] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Condyloma: C. acuminatum; a papilloma with a central core of connective tissue in a treelike structure covered with epithelium, usually occurring on the mucous membrane or skin of the external genitals or in the perianal region. [EU] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [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] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [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

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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] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Coxsackieviruses: A heterogeneous group of the genus enterovirus found in association with various diseases in man and other animals. Two groups (A and B) have been identified with a number of serotypes in each. The name is derived from a village in New York State where the virus was first identified. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the

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enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dentigerous Cyst: Most common follicular odontogenic cyst. Occurs in relation to a partially erupted or unerupted tooth with at least the crown of the tooth to which the cyst is attached protruding into the cystic cavity. May give rise to an ameloblastoma and, in rare instances, undergo malignant transformation. [NIH] Depigmentation: Removal or loss of pigment, especially melanin. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatitis, Atopic: A chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. It is manifested by lichenification, excoriation, and crusting, mainly on the flexural surfaces of the elbow and knee. In infants it is known as infantile eczema. [NIH] Dermatitis, Contact: A type of acute or chronic skin reaction in which sensitivity is manifested by reactivity to materials or substances coming in contact with the skin. It may involve allergic or non-allergic mechanisms. [NIH] Dermatologic Agents: Drugs used to treat or prevent skin disorders or for the routine care of skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Dermatomycoses: Superficial infections of the skin or its appendages by any of various fungi. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Diaper Rash: A type of irritant dermatitis localized to the area in contact with a diaper and occurring most often as a reaction to prolonged contact with urine, feces, or retained soap or detergent. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of Corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discoid: Shaped like a disk. [EU]

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Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] 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] 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] Duct: A tube through which body fluids pass. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophic: Pertaining to toxic habitats low in nutrients. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eccrine Glands: Simple sweat glands that secrete sweat directly onto the skin. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [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] Eflornithine: 2-(Difluoromethyl)-DL-ornithine. An inhibitor of ornithine decarboxylase, the rate limiting enzyme of the polyamine biosynthetic pathway. As a result of this inhibition of polyamine synthesis, the compound is effective in preventing cancer formation in many organ systems, inhibiting cancer growth, and reducing tumor size. It also has synergistic action with other antineoplastic agents. In addition, it has been found effective as a trypanocidal agent. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] 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] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a

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chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Emergency Medicine: A branch of medicine concerned with an individual's resuscitation, transportation and care from the point of injury or beginning of illness through the hospital or other emergency treatment facility. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emollients: Oleagenous substances used topically to soothe, soften or protect skin or mucous membranes. They are used also as vehicles for other dermatologic agents. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] 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] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [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] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [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] Epidermolysis Bullosa: Group of genetically determined disorders characterized by the blistering of skin and mucosae. There are four major forms: acquired, simple, junctional, and dystrophic. Each of the latter three has several varieties. [NIH] Epithelial: Refers to the cells that line the internal and external 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] Erysipelas: An acute infection of the skin caused by species of streptococcus. This disease most frequently affects infants, young children, and the elderly. Characteristics include pink-to-red lesions that spread rapidly and are warm to the touch. The commonest site of involvement is the face. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Erythrasma: A chronic bacterial infection of major folds of the skin, caused by Corynebacterium minutissimum. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Etretinate: An oral retinoid used in the treatment of keratotic genodermatosis, lichen planus, and psoriasis. Beneficial effects have also been claimed in the prophylaxis of epithelial neoplasia. The compound may be teratogenic. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotoxin: Toxic substance excreted by living bacterial cells. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU]

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Facial: Of or pertaining to the face. [EU] 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] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [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] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibroma: A benign tumor of fibrous or fully developed connective tissue. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Flexor: Muscles which flex a joint. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Follicles: Shafts through which hair grows. [NIH]

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Folliculitis: Inflammation of follicles, primarily hair follicles. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [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] Furunculosis: An infection where furuncles are present over a period of weeks to months. Species of Staphylococcus are usually the causative agents. [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] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH]

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Glanders: A contagious disease of horses that can be transmitted to humans. It is caused by Pseudomonas mallei and characterized by ulceration of the respiratory mucosa and an eruption of nodules on the skin. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glossitis: Inflammation of the tongue. [NIH] Glottis: The vocal apparatus of the larynx, consisting of the true vocal cords (plica vocalis) and the opening between them (rima glottidis). [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] 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] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] 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] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH]

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Granuloma Annulare: Benign granulomatous disease of unknown etiology characterized by a ring of localized or disseminated papules or nodules on the skin and palisading histiocytes surrounding necrobiotic tissue resulting from altered collagen structures. [NIH] Granuloma Inguinale: Anogenital ulcers caused by Calymmatobacterium granulomatis as distinguished from lymphogranuloma inguinale (see lymphogranuloma venereum) caused by Chlamydia trachomatis. Diagnosis is made by demonstration of typical intracellular Donovan bodies in crushed-tissue smears. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Hand, Foot and Mouth Disease: A mild, highly infectious viral disease of children, characterized by vesicular lesions in the mouth and on the hands and feet. It is caused by coxsackieviruses A. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Hematologic Diseases: Disorders of the blood and blood forming tissues. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatomegaly: Enlargement of the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH]

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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 virus: A member of the herpes family of viruses. [NIH] Herpes Zoster: Acute vesicular inflammation. [NIH] Herpetiformis: Duhring's disease a recurring, inflammatory disease of the skin of unknown etiology characterized by erythematous, papular, pustular, or vesicular lesions which tend to group and are accompanied by itching and burning. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Hidradenitis: The inflammation of a sweat gland (usually of the apocrine type). The condition can be idiopathic or occur as a result of or in association with another underlying condition. Neutrophilic eccrine hidradenitis is a relatively rare variant that has been reported in patients undergoing chemotherapy, usually for non-Hodgkin lymphomas or leukemic conditions. [NIH] Hidradenitis Suppurativa: A chronic suppurative and cicatricial disease of the apocrine glands occurring chiefly in the axillae in women and in the groin and anal regions in men. It is characterized by poral occlusion with secondary bacterial infection, evolving into abscesses which eventually rupture. As the disease becomes chronic, ulcers appear, sinus tracts enlarge, fistulas develop, and fibrosis and scarring become evident. Hormonal mechanisms are expected in its pathogenesis. [NIH] Histiocytosis: General term for the abnormal appearance of histiocytes in the blood. Based on the pathological features of the cells involved rather than on clinical findings, the histiocytic diseases are subdivided into three groups: Langerhans cell histiocytosis, nonLangerhans cell histiocytosis, and malignant histiocytic disorders. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH]

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Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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

effects

of

foreign

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] Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impetigo: A common superficial bacterial infection caused by staphylococcus aureus or

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group A beta-hemolytic streptococci. Characteristics include pustular lesions that rupture and discharge a thin, amber-colored fluid that dries and forms a crust. This condition is commonly located on the face, especially about the mouth and nose. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Incubation period: The period of time likely to elapse between exposure to the agent of the disease and the onset of clinical symptoms. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [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]

Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH]

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Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intertrigo: A superficial dermatitis occurring on skin surfaces in contact with each other, such as the axillae, neck creases, intergluteal fold, between the toes, etc. Obesity is a predisposing factor. The condition is caused by moisture and friction and is characterized by erythema, maceration, burning, and exudation. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratosis: Any horny growth such as a wart or callus. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Laceration: 1. The act of tearing. 2. A torn, ragged, mangled wound. [EU] Lacrimal: Pertaining to the tears. [EU]

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Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytosis: A transient increase in the number of leukocytes in a body fluid. [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Lichenification: Hypertrophy of the epidermis, resulting in thickening of the skin with exaggeration of the normal skin markings, giving the skin a leathery barklike appearance, which is caused by prolonged rubbing or scratching. It may arise on seemingly normal skin, or it may develop at the site of another pruritic cutaneous disorder. [EU] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU]

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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 site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenitis: Inflammation of the lymph nodes. [NIH] Lymphadenopathy: Disease or swelling of the lymph nodes. [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] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphogranuloma Venereum: Subacute inflammation of the inguinal lymph glands caused by certain immunotypes of Chlamydia trachomatis. It is a sexually transmitted disease in the U.S. but is more widespread in developing countries. It is distinguished from granuloma venereum (granuloma inguinale), which is caused by Calymmatobacterium granulomatis. [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] Maceration: The softening of a solid by soaking. In histology, the softening of a tissue by soaking, especially in acids, until the connective tissue fibres are so dissolved that the tissue components can be teased apart. In obstetrics, the degenerative changes with discoloration and softening of tissues, and eventual disintegration, of a fetus retained in the uterus after its death. [EU] Macrolides: A group of organic compounds that contain a macrocyclic lactone ring linked glycosidically to one or more sugar moieties. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH]

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Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [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] Miconazole: An imidazole antifungal agent that is used topically and by intravenous infusion. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [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] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA,

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can be made up of many thousands of atoms. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the drugs less effective. [NIH] Mupirocin: A topically used antibiotic from a strain of Pseudomonas fluorescens. It has shown excellent activity against gram-positive staphylococci and streptococci. The antibiotic is used primarily for the treatment of primary and secondary skin disorders, nasal infections, and wound healing. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mutilation: Injuries to the body. [NIH] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Natriuresis: The excretion of abnormal amounts of sodium in the urine. [EU] Necrobiosis Lipoidica: A degenerative disease of the dermal connective tissue characterized by the development of erythematous papules or nodules in the pretibial area. The papules form plaques covered with telangiectatic vessels. More than half of the affected patients have diabetes. [NIH] Necrolysis: Separation or exfoliation of tissue due to necrosis. [EU] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] 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] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU]

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Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neurodermatitis: An extremely variable eczematous skin disease that is presumed to be a response to prolonged vigorous scratching, rubbing, or pinching to relieve intense pruritus. It varies in intensity, severity, course, and morphologic expression in different individuals. Neurodermatitis is believed by some to be psychogenic. The circumscribed or localized form is often referred to as lichen simplex chronicus. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] 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] Neutropenia: An abnormal decrease in the number of neutrophils, a type of white blood cell. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [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] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nummular: Coin-sized and coin-shaped. [EU] Odontogenic Cysts: Cysts found in the jaws and arising from epithelium involved in tooth formation. They include follicular cysts (e.g., primordial cyst, dentigerous cyst, multilocular cyst), lateral periodontal cysts, and radicular cysts. They may become keratinized (odontogenic keratocysts). Follicular cysts may give rise to ameloblastomas and, in rare cases, undergo malignant transformation. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH]

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Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

Ornithine: An amino acid produced in the urea cycle by the splitting off of urea from arginine. [NIH] Ornithine Decarboxylase: A pyridoxal-phosphate protein, believed to be the rate-limiting compound in the biosynthesis of polyamines. It catalyzes the decarboxylation of ornithine to form putrescine, which is then linked to a propylamine moiety of decarboxylated Sadenosylmethionine to form spermidine. EC 4.1.1.17. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Oropharynx: Oral part of the pharynx. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Ovum: A female germ cell extruded from the ovary at ovulation. [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 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] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [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] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH]

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Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Paronychia: Inflammation involving the folds of tissue surrounding the nail. Called also perionychia. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Pediatric Dentistry: The practice of dentistry concerned with the dental problems of children, proper maintenance, and treatment. The dental care may include the services provided by dental specialists. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pemphigus: Group of chronic blistering diseases characterized histologically by acantholysis and blister formation within the epidermis. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penicillinase: A beta-lactamase preferentially cleaving penicillins. (Dorland, 28th ed) EC 3.5.2.-. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perianal: Located around the anus. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

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Periodontal Abscess: Localized circumscribed purulent area of inflammation in the periodontal tissue. It is a derivative of marginal periodontitis and commonly associated with suprabony and infrabony pockets and interradicular involvements, in contrast to periapical abscess which is attributable to pulp necrosis. [NIH] Periodontal Cyst: An epithelium-lined sac containing fluid; usually found at the apex of a pulp-involved tooth. The lateral type occurs less frequently along the side of the root. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Perioral: Situated or occurring around the mouth. [EU] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [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] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Pertussis: An acute, highly contagious infection of the respiratory tract, most frequently affecting young children, usually caused by Bordetella pertussis; a similar illness has been associated with infection by B. parapertussis and B. bronchiseptica. It is characterized by a catarrhal stage, beginning after an incubation period of about two weeks, with slight fever, sneezing, running at the nose, and a dry cough. In a week or two the paroxysmal stage begins, with the characteristic paroxysmal cough, consisting of a deep inspiration, followed by a series of quick, short coughs, continuing until the air is expelled from the lungs; the close of the paroxysm is marked by a long-drawn, shrill, whooping inspiration, due to spasmodic closure of the glottis. This stage lasts three to four weeks, after which the convalescent stage begins, in which paroxysms grow less frequent and less violent, and finally cease. Called also whooping cough. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharyngitis: Inflammation of the throat. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Photochemotherapy: Therapy using oral or topical photosensitizing agents with subsequent exposure to light. [NIH] Photosensitizing Agents: Drugs that are pharmacologically inactive but when exposed to

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ultraviolet radiation or sunlight are converted to their active metabolite to produce a beneficial reaction affecting the diseased tissue. These compounds can be administered topically or systemically and have been used therapeutically to treat psoriasis and various types of neoplasms. [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]

Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working

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kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] 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] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] 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] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Prepuce: A covering fold of skin; often used alone to designate the preputium penis. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prickle: Several layers of the epidermis where the individual cells are connected by cell bridges. [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] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU]

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Protease Inhibitors: Compounds which inhibit or antagonize biosynthesis or actions of proteases (endopeptidases). [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] 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] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Pseudocysts: A collection of enzyme-rich pancreatic fluid and tissue debris arising within areas of necrosis or an obstructed smaller duct. [NIH] 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] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by

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pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyoderma: Any purulent skin disease (Dorland, 27th ed). [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quiescent: Marked by a state of inactivity or repose. [EU] Rabies: A highly fatal viral infection of the nervous system which affects all warm-blooded animal species. It is one of the most important of the zoonoses because of the inevitably fatal outcome for the infected human. [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] Radicular: Having the character of or relating to a radicle or root. [NIH] Radicular Cyst: Slow-growing fluid-filled epithelial sac at the apex of a tooth with a nonvital pulp or defective root canal filling. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [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] Reagin: The antibody-like substances responsible for allergic phenomena; part of the gamma globulin fraction of serum. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regional lymph node: In oncology, a lymph node that drains lymph from the region around a tumor. [NIH] Respiratory Mucosa: The mucous membrane lining the respiratory tract. [NIH]

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Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Reticular: Coarse-fibered, netlike dermis layer. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scabies: A contagious cutaneous inflammation caused by the bite of the mite Sarcoptes scabiei. It is characterized by pruritic papular eruptions and burrows and affects primarily the axillae, elbows, wrists, and genitalia, although it can spread to cover the entire body. [NIH]

Scarlet Fever: Infection with group A streptococci that is characterized by tonsillitis and pharyngitis. An erythematous rash is commonly present. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH]

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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] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skin Manifestations: Dermatologic disorders attendant upon non-dermatologic disease or injury. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Spasmodic: Of the nature of a spasm. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In

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taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Species Specificity: Restriction of a characteristic or response to the members of one species; it usually refers to that property of the immune response which differentiates one species from another on the basis of antigen recognition, but the concept is not limited to immunology and is used loosely at levels higher than the species. [NIH] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spirochete: Lyme disease. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sporotrichosis: The commonest and least serious of the deep mycoses, characterized by nodular lesions of the cutaneous and subcutaneous tissues. It is caused by inhalation of contaminated dust or by infection of a wound. [NIH] Staphylococcal Infections: Infections with bacteria of the genus Staphylococcus. [NIH] Staphylococcal Scalded Skin Syndrome: A disease of infants due to group 2 phage type 17 staphylococci that produce an epidermolytic exotoxin. Superficial fine vesicles and bullae form and rupture easily, resulting in loss of large sheets of epidermis. [NIH] Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Staphylococcus aureus: Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Streptococcal: Caused by infection due to any species of streptococcus. [NIH]

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Streptococcal Infections: Infections with bacteria of the genus Streptococcus. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Streptokinase: Streptococcal fibrinolysin . An enzyme produced by hemolytic streptococci. It hydrolyzes amide linkages and serves as an activator of plasminogen. It is used in thrombolytic therapy and is used also in mixtures with streptodornase (streptodornase and streptokinase). EC 3.4.-. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Syphilis, Congenital: Syphilis acquired in utero and manifested by any of several characteristic tooth (Hutchinson's teeth) or bone malformations and by active mucocutaneous syphilis at birth or shortly thereafter. Ocular and neurologic changes may also occur. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH]

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Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Teichoic Acids: Bacterial polysaccharides that are rich in phosphodiester linkages. They are the major components of the cell walls and membranes of many bacteria. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Tetani: Causal agent of tetanus. [NIH] Tetanic: Having the characteristics of, or relating to tetanus. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombolytic Therapy: Use of infusions of fibrinolytic agents to destroy or dissolve thrombi in blood vessels or bypass grafts. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tinea Pedis: Dermatological pruritic lesion in the feet, caused by Trichophyton rubrum, T. mentagrophytes, or Epidermophyton floccosum. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH]

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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] Tonsillitis: Inflammation of the tonsils, especially the palatine tonsils. It is often caused by a bacterium. Tonsillitis may be acute, chronic, or recurrent. [NIH] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Traction: The act of pulling. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triamcinolone Acetonide: An esterified form of triamcinolone. It is an anti-inflammatory glucocorticoid used topically in the treatment of various skin disorders. Intralesional, intramuscular, and intra-articular injections are also administered under certain conditions. [NIH]

Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tularemia: A plague-like disease of rodents, transmissible to man. It is caused by Francisella tularensis and is characterized by fever, chills, headache, backache, and weakness. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder.

124 Impetigo

[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] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Varicella: Chicken pox. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Verruca: A circumscribed, cutaneous excrescence having a papilliferous surface; a small, circumscribed, epidermal tumor. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [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] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the

Dictionary 125

opening to the vagina. [NIH] Wart: A raised growth on the surface of the skin or other organ. [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]

Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Yaws: A systemic non-venereal infection of the tropics caused by Treponema pallidum subspecies pertenue. [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] Zoonoses: Diseases of non-human animals that may be transmitted to man or may be transmitted from man to non-human animals. [NIH] Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH]

127

INDEX A Abdomen, 46, 83, 101, 105, 107, 111, 113, 120, 122 Abducens, 15, 83 Abducens Nerve, 15, 83 Abrasion, 48, 83 Abscess, 83, 98, 113 Acantholysis, 83, 112 Acne, 5, 48, 49, 64, 83 Acne Vulgaris, 5, 48, 83 Acquired Immunodeficiency Syndrome, 55, 83 Actinomycosis, 56, 83 Acute lymphoblastic leukemia, 54, 83 Acute lymphocytic leukemia, 83 Acute renal, 83, 101 Adrenal Cortex, 83, 92, 102 Adverse Effect, 83, 119 Aetiology, 33, 83 Afferent, 83, 98 Affinity, 10, 30, 84, 119 Algorithms, 84, 87 Alkaline, 84, 88 Alleles, 9, 84, 106 Allergic Rhinitis, 84, 94 Alopecia, 53, 84 Alpha Particles, 84, 117 Alternative medicine, 84 Amber, 84, 104 Ameloblastoma, 84, 94, 110 Amino Acid Sequence, 84, 85 Amino Acids, 9, 84, 97, 112, 115, 116, 119, 123 Ammonia, 46, 84, 121, 123 Amoxicillin, 15, 84 Ampicillin, 30, 84 Anaerobic, 85, 120 Anal, 85, 102 Anatomical, 85, 106, 118 Androgens, 83, 85, 93 Anemia, 54, 65, 85 Anergy, 32, 85 Animal model, 6, 8, 85 Anions, 85, 105, 119 Anogenital, 46, 85, 101 Anthrax, 56, 85 Antiallergic, 85, 93 Antibacterial, 33, 39, 42, 55, 85, 90, 120

Antibiotic, 4, 12, 21, 26, 34, 48, 55, 69, 84, 85, 86, 88, 89, 90, 97, 109, 112, 120 Antibodies, 13, 85, 86, 101, 103, 107, 114 Antibody, 8, 84, 85, 91, 101, 102, 104, 117, 119, 120 Antifungal, 85, 108 Antigen, 84, 85, 91, 99, 102, 104, 119, 120 Anti-infective, 85, 103 Anti-inflammatory, 49, 86, 93, 100, 115, 123 Anti-Inflammatory Agents, 86, 93 Antimicrobial, 12, 13, 17, 29, 42, 46, 86, 89 Antineoplastic, 86, 93, 95 Antineoplastic Agents, 86, 95 Antiplasmin, 6, 86 Antiseptic, 69, 86 Anus, 85, 86, 112 Aphthous Stomatitis, 54, 86 Apocrine Glands, 46, 86, 102 Aqueous, 48, 86, 87, 103, 106 Areola, 24, 86 Arterial, 86, 116 Arteries, 86, 88, 92, 108 Articular, 86, 123 Assay, 6, 86 Ataxia, 64, 65, 86, 122 Atopic, 16, 26, 32, 86 Atrophy, 64, 83, 86 Attenuated, 86, 124 Atypical, 52, 86, 104 Augmentin, 15, 86 Autoantibodies, 8, 86 Autoantigens, 86 Autoimmune disease, 8, 86 Autosuggestion, 87, 103 Axillary, 46, 87 B Bacillus, 85, 87, 88 Bacteremia, 6, 87 Bacteria, 4, 7, 9, 55, 83, 85, 87, 88, 94, 98, 100, 108, 114, 118, 120, 121, 122, 124 Bacterial Infections, 42, 48, 53, 56, 87 Bacterial Proteins, 6, 87 Bacteriostatic, 87, 97 Bacterium, 7, 87, 89, 101, 123 Basal Ganglia, 86, 87, 99 Basal Ganglia Diseases, 86, 87 Base, 87, 105

128 Impetigo

Benign, 3, 15, 87, 98, 99, 101, 109, 110, 111 Benign tumor, 3, 87, 98 Biochemical, 84, 87 Biopsy, 87, 112 Biosynthesis, 87, 111, 116, 119 Biotechnology, 10, 52, 61, 63, 64, 65, 87 Bladder, 88, 115, 123, 124 Blister, 8, 10, 27, 33, 80, 88, 112 Blood Platelets, 88, 122 Blood pressure, 88, 119 Blood vessel, 88, 100, 101, 105, 119, 122, 124 Body Fluids, 88, 95, 119 Bone Marrow, 83, 88, 93, 107 Branch, 77, 88, 96, 112, 119 Broad-spectrum, 84, 85, 88 Bronchiseptica, 88, 113 Brucellosis, 56, 88 Buccal, 52, 88, 107, 120 Buccal mucosa, 52, 88 Bullous, 4, 8, 10, 12, 14, 15, 16, 17, 18, 27, 30, 31, 33, 34, 35, 36, 39, 88 Burns, 48, 54, 55, 88 Burns, Electric, 88 C Calcium, 88, 91, 112 Callus, 88, 105 Candidiasis, 3, 51, 54, 88 Candidosis, 54, 89 Carbohydrate, 89, 93 Carbuncle, 4, 56, 89 Carcinogens, 89, 110 Carcinoma, 54, 55, 89 Case report, 14, 15, 22, 23, 29, 39, 89, 90, 98 Cat-Scratch Disease, 56, 89 Celiac Disease, 54, 89 Cell Adhesion, 8, 89 Cell Adhesion Molecules, 8, 89 Cell Division, 64, 87, 89, 114 Cellulitis, 4, 6, 53, 55, 68, 89 Cellulose, 89, 99, 114 Cephalexin, 16, 25, 38, 89 Cephaloridine, 89 Cephalothin, 89, 90 Cerebellar, 86, 90, 117 Cerebral, 86, 87, 90 Cerebrum, 90, 123 Chancre, 55, 90 Chancroid, 56, 90 Character, 90, 93, 100, 117 Cheilitis, 52, 54, 56, 90 Chemotherapy, 12, 17, 18, 29, 42, 90, 102

Chickenpox, 54, 90 Choristoma, 54, 90 Chromosomal, 90, 114 Chromosome, 90, 106 Chronic renal, 90, 115 Cicatricial, 90, 102 Circumcision, 24, 90 Clamp, 24, 90 Clavulanic Acid, 15, 90 Clinical study, 90, 92 Clinical trial, 5, 11, 29, 39, 61, 90, 92, 93, 117 Clone, 12, 90 Cloning, 87, 91 Clot Retraction, 91, 114 Cofactor, 91, 116 Collagen, 91, 98, 101, 102 Collagen disease, 91, 102 Colloidal, 91, 96, 119 Complement, 91, 92, 114 Complementary and alternative medicine, 41, 44, 91 Complementary medicine, 41, 91 Computational Biology, 61, 63, 92 Conception, 92, 98 Condyloma, 52, 92 Congenita, 27, 92 Congestion, 92, 97 Connective Tissue, 49, 88, 89, 91, 92, 98, 107, 109, 113, 118, 122 Connective Tissue Cells, 92 Contracture, 53, 92 Contraindications, ii, 92 Controlled clinical trial, 42, 92 Controlled study, 12, 92 Cornea, 92, 125 Corneum, 4, 49, 92, 97 Coronary, 92, 108 Coronary Thrombosis, 92, 108 Corpus, 92, 112 Cortex, 86, 92, 111, 117 Corticosteroid, 47, 92, 115 Cortisone, 93, 115 Coxsackieviruses, 93, 101 Cranial, 83, 93, 98, 101, 113 Curative, 5, 93, 118 Cutaneous, 22, 25, 28, 31, 35, 39, 85, 88, 89, 93, 106, 107, 118, 120, 124 Cyclosporine, 33, 93 Cyst, 3, 54, 93, 94, 110 Cysteine, 9, 93, 96 Cystine, 93

Index 129

Cytomegalovirus, 52, 93 D Databases, Bibliographic, 61, 93 Deamination, 93, 123 Decubitus, 48, 93 Degenerative, 93, 101, 107, 109 Dementia, 83, 93 Dental Care, 93, 112 Dental Caries, 93, 98 Dentigerous Cyst, 94, 110 Depigmentation, 94, 124 Dermal, 94, 106, 109 Dermatitis, 16, 26, 32, 46, 48, 49, 53, 94, 95, 105 Dermatitis, Atopic, 49, 94 Dermatitis, Contact, 49, 94 Dermatologic Agents, 94, 96 Dermatomycoses, 4, 94 Dermatosis, 47, 48, 94 Deuterium, 94, 103 Diabetes Mellitus, 54, 94, 100, 101 Diagnostic procedure, 45, 94 Dialysate, 48, 94 Diaper Rash, 15, 47, 48, 94 Dihydroxy, 47, 94 Diphtheria, 56, 94 Direct, iii, 6, 18, 94, 117 Discoid, 55, 94 Disposition, 94, 95 Dissociation, 84, 95 Distal, 8, 95, 116 Dorsal, 95, 97, 115 Drug Tolerance, 95, 123 Duct, 46, 95, 116, 118, 121 Dura mater, 95, 108, 111 Dysplasia, 65, 95 Dystrophic, 95, 97 Dystrophy, 64, 95 E Eccrine Glands, 46, 95 Eczema, 11, 47, 48, 49, 53, 94, 95 Efficacy, 11, 15, 18, 21, 38, 47, 95 Eflornithine, 5, 95 Elective, 10, 30, 95 Electrode, 95 Electrodesiccation, 28, 95 Electrolysis, 5, 85, 95 Electrolyte, 93, 96, 108, 115, 119 Electrons, 87, 96, 105, 117 Electrophoresis, 16, 96, 103 Emaciation, 83, 96 Emergency Medicine, 34, 96

Emergency Treatment, 96 Emollients, 5, 96 Endocarditis, 89, 96 Endopeptidases, 96, 116 End-stage renal, 90, 96, 115 Environmental Exposure, 96, 110 Environmental Health, 60, 62, 96 Enzymatic, 6, 88, 91, 94, 96 Enzyme, 20, 95, 96, 108, 114, 115, 116, 121, 122, 124 Eosinophilia, 96, 98 Epidemic, 12, 14, 17, 96, 120 Epidermal, 18, 20, 52, 96, 105, 106, 108, 124 Epidermis, 8, 9, 35, 49, 83, 88, 92, 96, 97, 102, 103, 105, 106, 112, 115, 117, 120 Epidermolysis Bullosa, 47, 48, 97 Epithelial, 52, 84, 97, 111, 117 Epithelium, 92, 97, 110, 111, 113, 125 Erectile, 97, 112 Erysipelas, 4, 49, 53, 55, 56, 97 Erythema, 47, 48, 52, 53, 54, 55, 80, 97, 105 Erythema Multiforme, 54, 55, 97 Erythrasma, 4, 46, 49, 53, 55, 97 Erythrocytes, 85, 88, 97, 117 Erythromycin, 11, 15, 16, 17, 18, 21, 25, 29, 34, 38, 39, 97 Essential Tremor, 64, 97 Etretinate, 24, 97 Exfoliation, 8, 97, 109 Exogenous, 95, 97 Exotoxin, 97, 120 Extensor, 97, 116, 124 Extracellular, 92, 97, 98, 119 Extracellular Matrix, 92, 97, 98 Extravasation, 97, 101 F Facial, 52, 98, 112 Facial Nerve, 52, 98, 112 Family Planning, 61, 98 Fasciitis, 6, 98 Fat, 88, 93, 98, 106, 109, 118, 119 Fatal Outcome, 98, 109, 117 Feces, 94, 98 Fetus, 42, 98, 107, 114 Fibrin, 13, 86, 91, 98, 114, 122 Fibrinogen, 6, 13, 98, 114, 122 Fibroblasts, 92, 98 Fibroma, 3, 98 Fibrosarcoma, 98 Fibrosis, 65, 92, 98, 102, 118 Fistulas, 98, 102 Flexor, 97, 98, 106

130 Impetigo

Fluorine, 47, 98 Fold, 98, 105, 115 Follicles, 4, 55, 98, 99 Folliculitis, 4, 5, 46, 48, 49, 55, 99 Forearm, 88, 98, 99 Friction, 99, 105 Fungi, 4, 55, 85, 94, 99, 108, 124, 125 Fungus, 88, 99 Furunculosis, 34, 35, 99 G Ganglion, 99, 125 Gas, 84, 98, 99, 103, 110 Gastric, 84, 99 Gastric Acid, 84, 99 Gene, 6, 7, 9, 52, 65, 66, 84, 87, 99, 110 Gene Expression, 6, 9, 65, 99 Genetic Markers, 31, 99 Genetics, 7, 99 Genital, 99, 124 Genotype, 99, 113 Gestation, 22, 99, 114 Giant Cells, 99, 118 Gland, 83, 93, 99, 102, 107, 111, 112, 114, 115, 118, 119, 121 Glanders, 56, 100 Glomerular, 100 Glomeruli, 100 Glomerulonephritis, 13, 17, 26, 32, 33, 38, 42, 100 Glomerulus, 100, 110 Glossitis, 54, 100 Glottis, 100, 113 Glucocorticoid, 47, 100, 102, 115, 123 Glucose, 64, 89, 94, 100, 101, 104, 105 Glucose Intolerance, 94, 100 Gluten, 54, 89, 100 Glycine, 100, 119 Glycoprotein, 86, 98, 99, 100 Gonorrhea, 56, 100 Governing Board, 100, 115 Graft, 100, 102 Gram-negative, 4, 88, 89, 100 Gram-positive, 4, 7, 46, 89, 100, 109, 120, 121 Gram-Positive Bacteria, 46, 100 Granuloma, 53, 55, 56, 100, 101, 107 Granuloma Annulare, 53, 101 Granuloma Inguinale, 56, 101, 107 Groin, 101, 102 Growth, 5, 9, 42, 43, 48, 64, 85, 86, 87, 95, 98, 101, 102, 105, 107, 109, 110, 114, 125

H Hair follicles, 4, 55, 99, 101, 120, 124 Hand, Foot and Mouth Disease, 54, 101 Haptens, 84, 101 Headache, 101, 123 Hematologic Diseases, 3, 101 Hematoma, 3, 101 Hemodialysis, 94, 101 Hemoglobin, 85, 97, 101 Hemoglobinuria, 64, 101 Hemolytic, 27, 98, 101, 104, 121 Hepatitis, 101, 104 Hepatomegaly, 101, 104 Hereditary, 55, 94, 101, 118 Heredity, 83, 99, 102 Herpes, 3, 31, 52, 54, 55, 79, 102 Herpes virus, 3, 102 Herpes Zoster, 52, 54, 55, 102 Herpetiformis, 11, 18, 19, 20, 22, 23, 24, 29, 30, 31, 33, 35, 38, 39, 102 Heterogeneity, 16, 84, 102 Heterotrophic, 99, 102 Hidradenitis, 47, 48, 102 Hidradenitis Suppurativa, 47, 48, 102 Histiocytosis, 3, 54, 102 Homologous, 84, 102 Hormonal, 20, 86, 93, 102 Hormone, 92, 93, 102, 104, 112 Horny layer, 97, 102 Host, 6, 7, 42, 89, 102, 124 Human papillomavirus, 4, 54, 102 Hybrid, 90, 102 Hydrocortisone, 5, 11, 47, 102 Hydrogen, 20, 46, 49, 87, 89, 94, 103, 108, 110, 116 Hydrogen Peroxide, 49, 103 Hydrolysis, 103, 106, 115, 116 Hyperpigmentation, 52, 103 Hyperplasia, 52, 54, 103, 106 Hypertrophy, 103, 106 Hypothermia, 103, 109 I Iatrogenic, 54, 103 Id, 40, 43, 68, 70, 76, 78, 103 Idiopathic, 102, 103, 118 Imidazole, 15, 103, 108 Immune response, 8, 85, 86, 87, 93, 101, 103, 120, 121, 124 Immune system, 55, 103, 107, 125 Immunity, 20, 28, 30, 83, 103 Immunocompromised, 8, 103 Immunodeficiency, 54, 64, 83, 103

Index 131

Immunoelectrophoresis, 86, 103 Immunology, 6, 9, 84, 103, 120 Immunosuppressive, 100, 103 In vitro, 6, 18, 33, 39, 42, 104, 119 In vivo, 6, 9, 20, 33, 39, 42, 104 Incision, 4, 104, 105 Incubation, 104, 113 Incubation period, 104, 113 Indicative, 52, 104, 112, 124 Infancy, 54, 104, 118 Infantile, 94, 104 Infarction, 92, 104, 108 Infectious Mononucleosis, 54, 104 Infiltration, 100, 104, 125 Infusion, 104, 108 Ingestion, 85, 104 Inhalation, 104, 120 Innervation, 98, 104 Insight, 7, 8, 9, 104 Insulin, 53, 104, 105 Insulin-dependent diabetes mellitus, 104, 105 Interstitial, 105, 110 Intertrigo, 48, 105 Intestinal, 23, 89, 105, 107, 109 Intestine, 102, 105, 117, 121 Intracellular, 101, 104, 105, 115, 118 Intramuscular, 105, 123 Intravenous, 55, 104, 105, 108 Intrinsic, 84, 105 Invasive, 6, 9, 103, 105 Involuntary, 87, 97, 105, 109, 119 Ions, 87, 95, 96, 103, 105 Ischemia, 86, 105 J Joint, 86, 98, 105, 121, 122 K Kb, 60, 105 Keratin, 105, 118 Keratinocytes, 7, 105 Keratosis, 54, 83, 105 Kidney Disease, 60, 65, 105 Kinetics, 8, 105 L Laceration, 105, 122 Lacrimal, 98, 105 Lens, 92, 106 Leprosy, 53, 56, 106 Lesion, 29, 52, 80, 100, 106, 107, 122, 123 Leukemia, 55, 64, 106 Leukocytosis, 89, 106 Leukoplakia, 52, 106

Library Services, 76, 106 Lichen Planus, 55, 97, 106 Lichenification, 94, 106 Life cycle, 99, 106 Ligament, 106, 115 Ligands, 89, 106 Linkage, 9, 99, 106 Linkage Disequilibrium, 9, 106 Lip, 54, 55, 106 Lipid, 104, 106 Lipolysis, 35, 106 Lipopolysaccharide, 100, 106 Lipoprotein, 100, 106 Liquor, 106, 117 Liver, 93, 98, 101, 107, 115, 118, 123 Localization, 8, 9, 107 Localized, 8, 14, 83, 90, 93, 94, 101, 104, 106, 107, 110, 111, 113, 114, 118, 122, 123 Lupus, 53, 54, 55, 56, 107, 122 Lymph, 87, 104, 107, 117, 118 Lymph node, 87, 107, 117, 118 Lymphadenitis, 22, 107 Lymphadenopathy, 104, 107 Lymphatic, 104, 107, 120 Lymphoblastic, 107 Lymphoblasts, 83, 107 Lymphocyte, 83, 85, 107 Lymphocyte Count, 83, 107 Lymphogranuloma Venereum, 101, 107 Lymphoid, 85, 107 Lymphoma, 52, 54, 64, 107 M Maceration, 105, 107 Macrolides, 4, 107 Malabsorption, 64, 89, 107 Malaise, 88, 107 Malignancy, 107, 111 Malignant, 64, 83, 86, 94, 98, 102, 107, 109, 110, 118 Malnutrition, 86, 108, 109 Mammary, 46, 108 Mediate, 89, 108 MEDLINE, 61, 63, 65, 108 Melanocytes, 103, 108, 110 Melanoma, 64, 108 Membrane, 7, 83, 84, 86, 91, 92, 97, 100, 108, 109, 111, 113, 117 Meninges, 95, 108 Meningitis, 24, 108 Meta-Analysis, 12, 108 Metabolic disorder, 3, 108 Metastasis, 89, 108

132 Impetigo

MI, 26, 29, 31, 81, 108 Miconazole, 34, 108 Microbiology, 6, 9, 16, 20, 27, 30, 31, 42, 86, 108 Microorganism, 91, 108, 112, 124 Millimeter, 5, 108 Mineralocorticoids, 83, 93, 108 Molecular, 7, 8, 9, 10, 27, 41, 42, 61, 63, 69, 84, 85, 86, 87, 92, 98, 108, 114 Molecule, 85, 87, 91, 95, 103, 108, 114, 117 Monocyte, 43, 109 Mononuclear, 98, 100, 104, 109 Mucocutaneous, 109, 121 Mucosa, 56, 89, 107, 109, 120 Multidrug resistance, 31, 109 Mupirocin, 11, 15, 16, 17, 21, 27, 28, 29, 30, 34, 38, 39, 109 Muscle Fibers, 109 Muscular Atrophy, 64, 109 Muscular Dystrophies, 95, 109 Mutilation, 54, 109 Myocarditis, 94, 109 Myocardium, 108, 109 Myotonic Dystrophy, 64, 109 N Natriuresis, 47, 109 Necrobiosis Lipoidica, 53, 109 Necrolysis, 20, 52, 109 Necrosis, 98, 104, 108, 109, 113, 116, 118 Need, 3, 51, 53, 55, 71, 90, 109, 123 Neonatorum, 24, 27, 109 Neoplasia, 64, 97, 109 Neoplasm, 109, 111, 118 Neoplastic, 102, 107, 109 Nephritis, 13, 110 Nephropathy, 105, 110 Nerve, 83, 86, 98, 99, 104, 110, 111, 118, 125 Nervous System, 64, 83, 99, 101, 110, 113, 115, 117 Networks, 7, 110 Neurodermatitis, 47, 48, 110 Neurologic, 110, 121 Neutrons, 84, 110, 117 Neutropenia, 3, 110 Neutrophils, 110 Nevus, 54, 110 Nitrogen, 5, 85, 110 Nucleic acid, 110, 116 Nucleus, 83, 87, 94, 109, 110, 116, 122 Nummular, 49, 110

O Odontogenic Cysts, 3, 110 Oncogene, 64, 110 Opportunistic Infections, 83, 111 Oral Manifestations, 51, 54, 56, 111 Ornithine, 95, 111 Ornithine Decarboxylase, 95, 111 Orofacial, 53, 54, 111 Oropharynx, 9, 111 Osmotic, 111, 119 Ossification, 111, 118 Osteomyelitis, 35, 111 Ovum, 99, 106, 111 P Pachymeningitis, 108, 111 Palate, 111, 120 Palsy, 15, 111 Pancreas, 104, 111 Pancreatic, 64, 111, 116 Pancreatic cancer, 64, 111 Papilla, 111 Papillary, 49, 54, 111 Papilloma, 92, 111 Papillomavirus, 111 Papule, 80, 90, 111 Paralysis, 52, 111 Parasite, 111, 112 Parasitic, 42, 112, 118 Parathyroid, 112, 118 Parathyroid Glands, 112, 118 Paronychia, 49, 55, 112 Parotid, 112, 118 Paroxysmal, 64, 112, 113, 125 Patch, 106, 112 Pathogen, 6, 104, 112 Pathogenesis, 5, 9, 102, 112 Pathologic, 87, 89, 92, 112, 116 Pathophysiology, 8, 112 Patient Education, 69, 74, 76, 81, 112 Pediatric Dentistry, 54, 112 Pelvic, 112, 115 Pemphigus, 8, 15, 16, 35, 36, 54, 79, 83, 112 Penicillin, 12, 25, 27, 33, 39, 42, 55, 84, 112 Penicillinase, 4, 112 Penis, 4, 112, 115 Peptide, 96, 105, 112, 115, 116 Percutaneous, 47, 112 Perianal, 92, 112 Pericardium, 112, 122 Periodontal Abscess, 56, 113 Periodontal Cyst, 110, 113 Periodontal disease, 52, 56, 113

Index 133

Periodontitis, 3, 52, 56, 113 Perioral, 49, 113 Peripheral Nerves, 106, 113 Peripheral Nervous System, 111, 113, 121 Peritoneal, 94, 113 Peritoneal Dialysis, 94, 113 Peroxide, 20, 113 Pertussis, 56, 113, 125 Pharmacologic, 113, 123 Pharyngitis, 6, 19, 113, 118 Pharynx, 111, 113 Phenotype, 6, 113 Photochemotherapy, 23, 113 Photosensitizing Agents, 113 Physiologic, 87, 114, 117 Pigment, 94, 108, 114 Pigmentation, 52, 103, 114 Pituitary Gland, 92, 114 Placenta, 114, 116 Plague, 114, 123 Plants, 100, 114, 123 Plasma, 85, 86, 98, 100, 101, 108, 114, 119 Plasma cells, 85, 114 Plasma protein, 114, 119 Plasmid, 31, 114 Plasmin, 6, 86, 114 Plasminogen, 6, 9, 10, 30, 86, 114, 121 Plasminogen Activators, 114 Polycystic, 65, 114 Polypeptide, 84, 91, 98, 114, 115 Pons, 83, 115 Posterior, 85, 86, 95, 111, 115 Potassium, 11, 46, 108, 115 Practice Guidelines, 62, 115 Precursor, 96, 114, 115 Prednisolone, 115 Prednisone, 47, 115 Prepuce, 90, 115 Prevalence, 17, 27, 38, 115 Prickle, 83, 105, 115 Progression, 85, 115 Progressive, 90, 93, 95, 101, 109, 115 Prophylaxis, 4, 12, 97, 115 Prospective study, 13, 115 Prostate, 64, 115 Protease, 6, 8, 9, 115, 116 Protease Inhibitors, 6, 116 Protein C, 84, 105, 106, 116, 123 Protein S, 52, 65, 87, 97, 116 Proteins, 6, 7, 46, 84, 85, 87, 91, 97, 103, 105, 108, 110, 112, 114, 116, 119, 122, 123, 124

Proteolytic, 6, 91, 98, 114, 116 Protons, 84, 103, 116, 117 Protozoa, 108, 116, 124 Proximal, 95, 116 Pruritic, 5, 95, 106, 116, 118, 122 Pruritus, 53, 94, 110, 116 Pseudocysts, 56, 116 Psoriasis, 19, 22, 23, 24, 47, 48, 49, 53, 97, 114, 116 Psychogenic, 110, 116 Public Policy, 61, 116 Publishing, 10, 116 Puerperium, 23, 116 Purines, 116, 119 Purulent, 113, 116, 117, 124 Pustular, 15, 19, 22, 23, 24, 83, 102, 104, 117 Pyoderma, 29, 39, 56, 64, 117 Pyogenic, 55, 64, 111, 117 Q Quiescent, 117, 124 R Rabies, 4, 117 Radiation, 48, 96, 114, 117 Radicular, 110, 117 Radicular Cyst, 110, 117 Radioactive, 103, 117 Radiological, 112, 117 Randomized, 11, 29, 38, 39, 95, 117 Reagin, 94, 117 Receptor, 6, 8, 85, 117 Recombination, 99, 117 Rectum, 86, 99, 115, 117 Red blood cells, 97, 101, 117 Red Nucleus, 86, 117 Refer, 1, 88, 91, 99, 102, 107, 110, 117 Refraction, 117, 120 Regeneration, 48, 117 Regimen, 95, 117 Regional lymph node, 89, 117 Respiratory Mucosa, 100, 117 Resuscitation, 96, 118 Reticular, 49, 118 Retinoblastoma, 64, 118 Retinoid, 97, 118 Retrospective, 10, 31, 118 Rickets, 22, 38, 118 Rickettsiae, 118, 124 Risk factor, 115, 118 Rod, 87, 90, 118 S Saliva, 118

134 Impetigo

Salivary, 52, 93, 98, 111, 118 Salivary glands, 52, 93, 98, 118 Sarcoidosis, 55, 118 Sarcoma, 52, 98, 118 Scabies, 53, 118 Scarlet Fever, 54, 56, 118 Scleroderma, 54, 98, 118 Sclerosis, 53, 64, 91, 118 Screening, 90, 118 Sebaceous, 46, 118, 124 Sebaceous gland, 46, 118, 124 Sebum, 83, 118 Secretion, 83, 93, 105, 108, 119 Seizures, 112, 119 Semen, 115, 119 Semisynthetic, 84, 89, 119 Serine, 8, 96, 119 Serology, 32, 119 Serum, 17, 23, 84, 91, 108, 117, 119 Serum Albumin, 17, 119 Sex Determination, 65, 119 Shock, 102, 119, 123 Side effect, 26, 38, 47, 83, 119, 123 Skeletal, 85, 90, 109, 119 Skin Manifestations, 8, 119 Sneezing, 113, 119 Sodium, 46, 47, 48, 108, 109, 119, 121 Soft tissue, 88, 98, 119 Spasmodic, 113, 119 Specialist, 71, 119 Species, 4, 8, 9, 17, 84, 87, 97, 99, 102, 111, 112, 117, 119, 120, 121, 123, 124, 125 Species Specificity, 9, 120 Specificity, 9, 84, 96, 120 Spectrum, 26, 120 Spinous, 97, 105, 120 Spirochete, 120, 121 Spleen, 93, 107, 118, 120 Splenomegaly, 104, 120 Sporadic, 118, 120 Sporotrichosis, 4, 120 Staphylococcal Infections, 56, 68, 120 Staphylococcal Scalded Skin Syndrome, 8, 10, 27, 55, 120 Staphylococcus aureus, 8, 10, 12, 13, 14, 15, 16, 17, 18, 22, 31, 33, 35, 38, 41, 68, 89, 103, 120 Stasis, 49, 120 Steel, 90, 120 Steroids, 24, 92, 100, 120 Stomatitis, 52, 54, 55, 120

Streptococcal, 4, 6, 7, 10, 12, 13, 17, 19, 20, 24, 26, 30, 32, 38, 42, 55, 68, 120, 121 Streptococcal Infections, 7, 42, 68, 121 Streptococci, 6, 7, 9, 10, 14, 27, 28, 30, 33, 41, 104, 109, 118, 121 Streptococcus, 4, 6, 7, 14, 27, 55, 69, 97, 98, 120, 121 Streptokinase, 6, 9, 30, 121 Stress, 51, 121 Subacute, 104, 107, 121 Subclinical, 104, 119, 121 Subcutaneous, 4, 49, 89, 109, 120, 121 Subspecies, 119, 121, 125 Substance P, 97, 119, 121 Supplementation, 42, 43, 121 Suppression, 93, 121 Suppurative, 21, 89, 102, 121 Sweat, 46, 86, 95, 102, 121 Sweat Glands, 46, 86, 95, 121 Symphysis, 115, 121 Synergistic, 95, 121 Syphilis, 52, 54, 55, 56, 90, 121 Syphilis, Congenital, 56, 121 Systemic, 6, 18, 39, 54, 81, 88, 89, 91, 94, 104, 115, 118, 120, 121, 122, 125 Systemic disease, 54, 121 Systemic lupus erythematosus, 18, 91, 122 T Tachycardia, 87, 122 Tachypnea, 87, 122 Teichoic Acids, 100, 122 Telangiectasia, 65, 122 Teratogenic, 97, 122 Tetani, 122 Tetanic, 122 Tetanus, 4, 122 Thalamic, 86, 122 Thalamic Diseases, 86, 122 Thorax, 83, 122 Threonine, 119, 122 Threshold, 94, 122 Thrombin, 98, 116, 122 Thrombocytopenia, 52, 122 Thrombolytic, 114, 121, 122 Thrombolytic Therapy, 121, 122 Thrombosis, 116, 122 Tinea Pedis, 4, 122 Tolerance, 15, 100, 123 Tonsillitis, 118, 123 Tooth Loss, 3, 123 Topical, 5, 16, 20, 21, 28, 29, 34, 38, 39, 46, 47, 48, 103, 113, 123

Index 135

Toxic, iv, 20, 52, 94, 95, 96, 97, 103, 123 Toxicology, 62, 123 Toxins, 8, 85, 104, 123 Trace element, 98, 123 Traction, 90, 123 Transfection, 87, 123 Translation, 97, 123 Translocation, 97, 123 Trauma, 87, 101, 109, 122, 123, 125 Triamcinolone Acetonide, 47, 48, 123 Tuberculosis, 52, 56, 107, 123 Tuberous Sclerosis, 65, 123 Tularemia, 56, 123 U Ulcer, 48, 89, 123 Ulceration, 3, 52, 100, 123 Unconscious, 103, 123 Urea, 5, 46, 111, 121, 123 Urethra, 112, 115, 123, 124 Urinary, 13, 123, 124 Urine, 88, 94, 101, 109, 123, 124 Urogenital, 100, 124 V Vaccines, 9, 124 Vagina, 88, 124, 125 Vaginal, 124 Vaginitis, 88, 124 Varicella, 36, 52, 54, 124 Vascular, 104, 114, 124 Vein, 105, 112, 124

Venereal, 121, 124, 125 Venous, 116, 124 Verruca, 52, 124 Vesicular, 101, 102, 124 Veterinary Medicine, 61, 124 Villous, 89, 124 Viral, 68, 69, 99, 101, 117, 124 Virulence, 6, 9, 86, 124 Virus, 3, 31, 54, 83, 90, 93, 99, 102, 104, 124, 125 Vitiligo, 53, 124 Vitro, 124 Vivo, 6, 10, 124 Vulgaris, 52, 54, 79, 83, 124 Vulva, 4, 124 W Wart, 105, 125 White blood cell, 83, 85, 104, 107, 109, 110, 114, 125 Whooping Cough, 113, 125 Wound Healing, 89, 109, 125 Wound Infection, 4, 125 X Xenograft, 85, 125 Y Yaws, 56, 125 Yeasts, 89, 99, 113, 125 Z Zoonoses, 117, 125 Zoster, 54, 125

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