MENINGITIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Meningitis: 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: 0-597-83628-0 1. Meningitis-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.
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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 meningitis. 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 MENINGITIS .............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Meningitis..................................................................................... 5 E-Journals: PubMed Central ....................................................................................................... 71 The National Library of Medicine: PubMed ................................................................................ 86 CHAPTER 2. NUTRITION AND MENINGITIS .................................................................................. 219 Overview.................................................................................................................................... 219 Finding Nutrition Studies on Meningitis ................................................................................. 219 Federal Resources on Nutrition ................................................................................................. 226 Additional Web Resources ......................................................................................................... 226 CHAPTER 3. ALTERNATIVE MEDICINE AND MENINGITIS ............................................................ 229 Overview.................................................................................................................................... 229 National Center for Complementary and Alternative Medicine................................................ 229 Additional Web Resources ......................................................................................................... 237 General References ..................................................................................................................... 238 CHAPTER 4. DISSERTATIONS ON MENINGITIS .............................................................................. 239 Overview.................................................................................................................................... 239 Dissertations on Meningitis ...................................................................................................... 239 Keeping Current ........................................................................................................................ 240 CHAPTER 5. CLINICAL TRIALS AND MENINGITIS ......................................................................... 241 Overview.................................................................................................................................... 241 Recent Trials on Meningitis ...................................................................................................... 241 Keeping Current on Clinical Trials ........................................................................................... 249 CHAPTER 6. PATENTS ON MENINGITIS ......................................................................................... 251 Overview.................................................................................................................................... 251 Patents on Meningitis................................................................................................................ 251 Patent Applications on Meningitis............................................................................................ 257 Keeping Current ........................................................................................................................ 258 CHAPTER 7. BOOKS ON MENINGITIS............................................................................................. 259 Overview.................................................................................................................................... 259 Book Summaries: Federal Agencies............................................................................................ 259 Book Summaries: Online Booksellers......................................................................................... 261 The National Library of Medicine Book Index ........................................................................... 263 Chapters on Meningitis ............................................................................................................. 264 CHAPTER 8. MULTIMEDIA ON MENINGITIS .................................................................................. 273 Overview.................................................................................................................................... 273 Video Recordings ....................................................................................................................... 273 Audio Recordings....................................................................................................................... 274 Bibliography: Multimedia on Meningitis .................................................................................. 275 CHAPTER 9. PERIODICALS AND NEWS ON MENINGITIS ............................................................... 277 Overview.................................................................................................................................... 277 News Services and Press Releases.............................................................................................. 277 Newsletter Articles .................................................................................................................... 283 Academic Periodicals covering Meningitis................................................................................ 285 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 287 Overview.................................................................................................................................... 287 U.S. Pharmacopeia..................................................................................................................... 287 Commercial Databases ............................................................................................................... 288 Researching Orphan Drugs ....................................................................................................... 289
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APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 293 Overview.................................................................................................................................... 293 NIH Guidelines.......................................................................................................................... 293 NIH Databases........................................................................................................................... 295 Other Commercial Databases..................................................................................................... 298 APPENDIX B. PATIENT RESOURCES ............................................................................................... 299 Overview.................................................................................................................................... 299 Patient Guideline Sources.......................................................................................................... 299 Associations and Meningitis...................................................................................................... 305 Finding Associations.................................................................................................................. 307 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 309 Overview.................................................................................................................................... 309 Preparation................................................................................................................................. 309 Finding a Local Medical Library................................................................................................ 309 Medical Libraries in the U.S. and Canada ................................................................................. 309 ONLINE GLOSSARIES................................................................................................................ 315 Online Dictionary Directories ................................................................................................... 319 MENINGITIS DICTIONARY ..................................................................................................... 321 INDEX .............................................................................................................................................. 419
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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 meningitis 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 meningitis, 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 meningitis, 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 meningitis. 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 meningitis, 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 meningitis. 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 MENINGITIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on meningitis.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and meningitis, 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 “meningitis” (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: •
Performance After Cochlear Implantation: A Comparison of Children Deafened by Meningitis and Congenitally Deaf Children Source: Journal of Laryngology and Otology. 114(1): 33-37. January 2000. Contact: Available from Royal Society of Medicine Press Limited. Publications Subscription Department, P.O. Box 9002, London W1A 0ZA, United Kingdom. E-mail:
[email protected]. Summary: This article reports on a study in which the speech perception and speech production performance following cochlear implantation of congenitally deaf children and children deafened by meningitis were analyzed. Three groups consisting of 70 congenitally deaf children, 22 children deafened by meningitis before two years of age, and 14 children deafened by meningitis after two years of age were compared. The
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group deafened by meningitis after two years of age demonstrated significantly better speech perception than the other two groups. Their speech production appeared better, but did not achieve statistical significance compared with the other two groups. There were no significant differences in speech perception or production between the congenitally deaf group and the group deafened by meningitis before two years of age. Further research is required to determine whether this is a consequence of meningitis, whether they have failed to derive benefit from their previous auditory experience, or whether any benefit they may have derived has been lost during their period of deafness. 2 figures. 9 tables. 15 references. •
Risk Factors for Hearing Loss from Meningitis in Children Source: Archives of Otolaryngology-Head and Neck Surgery. 125(5): 509-514. May 1999. Contact: Available from American Medical Association. Subscriber Services, P.O. Box 10946, Chicago, IL 60610-0946. (800) 262-3250 or (312) 670-7827. Fax (312) 464-5831. Email:
[email protected]. Website: www.ama-assn.org/oto. Summary: This article reports on a study undertaken to identify statistically significant risk factors for hearing loss in children with meningitis, determine the overall incidence of hearing loss in a large group of children with confirmed meningitis, and quantify the percentage of children with progressive or fluctuating hearing loss after meningitis. The study included 432 children admitted to the Children's Hospital, Birmingham, Alabama, from 1985 to 1995. Of 432 children with meningitis, 59 (13.7 percent) developed hearing loss. Of these 59 children, 46 (78.0 percent) had stable sensorineural hearing loss and 13 (22. 0 percent) had either progressive or fluctuating hearing loss. Of the variables examined, only 5 appeared to be significantly associated with the development of hearing loss: CT scan evidence of increased intracranial pressure, male sex, the common logarithm of glucose levels in the cerebrospinal fluid, Streptococcus pneumoniae as the causative organism, and the presence of neck rigidity. In the children with progressive hearing loss, the time for progression varied from 3 months to 4 years before hearing stabilized. 1 figure. 4 tables. 12 references. (AA-M).
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Prevention of Hearing Loss From Meningitis Source: Lancet. 350(9072): 158-159. July 19, 1997. Summary: This brief commentary presents information on the prevention of hearing loss due to meningitis. Before the introduction of the Haemophilus influenzae type b conjugate vaccines, bacterial meningitis accounted for close to 10 percent of acquired deafness in children in the United States. In hearing loss due to bacterial meningitis, suppurative labyrinthitis precedes the destruction of cochlear structures. Bacteria may reach the cochlea by various routes. Exactly how suppurative labyrinthitis leads to deafness is not totally clear. Hearing loss caused by bacterial meningitis occurs quite early in the course of the infection. Differences in the ability of various microorganisms to reach the cochlea and cause damage and in host response to infection are possible reasons why some children develop hearing loss after bacterial meningitis and some do not. In order to prevent or diminish the likelihood of hearing loss due to bacterial meningitis, the author recommends optimum antimicrobial therapy, surveillance and careful monitoring of recommended treatment regimens, dexamethasone as an adjunctive measure, and other, newer adjunctive drug therapies that may reduce the incidence of hearing loss. The author concludes that in developed countries, deafness due to H. influenzae type b meningitis has been all but eliminated by protein conjugate vaccines that prevent invasive infections effectively. The hope is that protein conjugate
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vaccines under development will eventually prevent pneumococcal and meningococcal infections, including meningitis. 1 figure. 7 references. •
Vestibular Dysfunction Due to Cryptococcal Meningitis Source: Otolaryngology-Head and Neck Surgery. 116(4): 536-540. April 1997. Contact: Available from Mosby-Year Book, Inc. Subscription Services, 11830 Westline Industrial Drive, St. Louis, MO 63146-3318. (800) 453-4351 or (314) 453-4351. Fax (314) 432-1158. E-mail:
[email protected]. Summary: Cryptococcus neoformans is an encapsulated, opportunistic, fungal organism found primarily in soil and pigeon feces. Human beings presumably are infected through inhalation of the organism, which causes pulmonary (lung) cryptococcus that can then spread hematogenously (through the blood) to the central nervous system, bone, and kidneys. This article presents the case of a nonimmunosuppressed and previously healthy woman with subacute onset of severe ataxia (impaired ability to coordinate movement) in whom cryptococcal meningitis was subsequently diagnosed. This case is unique in that the patient had bilateral vestibular hypofunction and only a moderate unilateral sensorineural hearing loss (SNHL). The other unique aspect was the reversal of the vestibular symptoms after appropriate treatment, which included decompression of obstructive hydrocephalus (fluid on the brain) and long term antifungal therapy. This is the first case reported in the recent otolaryngologic literature in which a reversal rather than merely a stabilization of vestibular symptoms occurred in cryptococcal meningitis. The authors remind readers that the diagnosis of cryptococcal meningitis can be difficult because of the subacute nature of the infection and the initially mild symptoms. Audiovestibular damage is the result of direct invasion of the neural tissue and sensory end organs by the organism. 3 figures. 13 references.
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Hearing Impairment After Bacterial Meningitis: A Review Source: Archives of Disease in Childhood. 67(9): 1128-1133. 1992. Summary: This journal article, intended for health professionals, reviews the recent literature on the incidence of hearing impairment following bacterial meningitis. The article discusses the rate of hearing impairment following bacterial meningitis, possible predictive factors, the permanence of hearing loss following bacterial meningitis, and possible means of reducing the risks of postmeningitic sensorineural hearing loss. It recommends that all children recovering from bacterial meningitis be referred for audiological assessment before discharge from the hospital. Bibliographic references are included.
Federally Funded Research on Meningitis The U.S. Government supports a variety of research studies relating to meningitis. 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. 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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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 meningitis. 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 meningitis. The following is typical of the type of information found when searching the CRISP database for meningitis: •
Project Title: 26TH INTL HERPESVIRUS WORKSHOP, REGENSBURG, GERMANY Principal Investigator & Institution: Nelson, Jay A. Director & Professor; Molecular Microbiol and Immun; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 01-AUG-2002 Summary: (provided by applicant) This proposal requests funds to enable young investigators to attend the 26th International Herpesvirus Workshop at the University of Regensburg in Germany, July 28-August 3, 2001. The International Herpesvirus Workshop is the premier scientific meeting for herpesvirus researchers, and the only meeting with an interdisciplinary focus on all the major subfamilies of herpesviruses and all aspects of research from molecular biology to clinical studies. The strength of the Workshop rests on the cross-fertilization that results from comparison of different herpesviruses, different approaches to key questions and on the support and participation of leading researchers in the field, most significantly including promising young investigators and students in training. Moreover, the forum is truly international, with broad-based world-wide attendance. The medical importance of this meeting is clearly indicated from the wide variety of diseases caused by the now recognized eight human herpesviruses. These include skin and eye ulcerations (HSV-1), genital lesions (HSV-2), meningitis and encephalitis (HSV-1 and HSV-2), infectious mononucleosis (EBV) chicken pox and shingles (VZV). CMV is a major cause of birth defects including mental retardation, blindness and deafness due to congenital transmission but also a significant opportunistic pathogen in AIDS patients and organ transplant recipients. More recently, CMV and HSV have been implicated as pathogenic contributors in the development of atherosclerosis. Cancer has also been associated with herpesvirus infections. EBV is associated with Burkitt's lymphoma, other B cell neoplasias and nasopharyngeal carcinoma. The most recent human herpesvirus discovered (HHV-8 or KSHV) is associated with Kaposi's sarcoma in AIDS patients and other immunosupressed persons and in other groups. All of the herpesviruses persist for life and therefore pose significant problems in the treatment of immunologically compromised persons. Disease due to reactivation of most human herpesviruses are a significant cause of morbidity and mortality in various immune patient populations. Shingles and post-herpetic neuralgia are problems in the elderly. Animal herpes significant economic importance to the poultry (Marek's and others), swine (pseudorabies virus), cattle (several bovine herpesviruses) and horses (several equine herpesviruses). In addition, these animal herpes serve as important model systems for studying herpesvirus pathogenesis. Finally, recombinant DNA technology permits the design of novel vaccines for controlling the spread of animal herpesvirus infection and the design of herpesvirus vectors for gene therapy. Workshop sessions will take an interdisciplinary approach to the following topics: virus structure, mechanism of virus entry and cell-cell spread, membrane proteins, pathogenesis and latency, DNA replication, vaccination and the immune response, transcriptional control, regulation of gene expression, chemotherapeutic targets, and virus gene therapy,
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: A MENINGOCOCCAL LOS VACCINE Principal Investigator & Institution: Griffiss, John M. Associate Professor; Northern California Institute Res & Educ San Francisco, CA 941211545 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 30-NOV-2005 Summary: (provided by applicant): Meningococcal disease primarily affects infants and very young children. The group B capsule is not immunogenic, and outer membrane protein vaccines provide only short-lived protection, in older children, that is restricted to serotypes in the vaccine. Protection is mediated by bactericidal antibodies that are induced by asymptomatic colonization by organisms that share lipooligosaccharides (LOS). By adolescence most children have LOS IgG that are bactericidal for most meningococcal strains. These antibodies prevent meningococcal disease, regardless of protein serotype. LOS are immunogenic at birth, and LOS antibodies can be induced by vaccination. During disease, infants make bactericidal antibodies against their infecting strains. These antibodies bind to a conserved LOS structure that is expressed well by 126E (L1,8), other L1 strains, and by L3,7 and L4,6 strains. This structure has not been definitively identified. LOS antibodies induced during infancy can prevent the monoclonal antibody (mAb), D6A, from binding to 126E LOS, and we have used this mAb, which binds to meningococci of all groups and types, as a surrogate for the LOS structure. MAb D6A binds the deeply truncated LOS of deltagalE mutants that have only a conserved basal structure, but it is not clear that this truncated LOS is the optimal immunogen. We now propose to affinity purify human IgG that binds the conserved LOS structure by 1) passage of IVIG over deltagalE LOS, and 2) by sequential passage of IVIG over L1, L1,8, L3,7 and L4,6 LOS, each coupled to Sepharose. We will assess how well each IgG kills 34 consecutive and unique endemic meningococcal case strains, and whether they can opsonize these meningococci for PMN killing. We will compare the binding of this pauciclonal IgG (pclgG) to that of mAb D6A and use Mass Spectrometry combined with chemical and enzymatic degradations to confirm the LOS structure recognized by mAb D6A and pclgG. We will immunize transgenic mice that have human immmunoglobulin loci (XenoMouse) with a deltagalE mutant to insure that this LOS structure is immunogenic for the human immune system, and characterize the functional activity of the induced IgG, as for the IVIG IgG. We will use enrichment of a coliphage display library with mAb D6A to identify a peptide mimic of the mAb D6A LOS antigen, use this peptide to immunize XenoMouse mice and functionally charaterize the induced IgG. We also will try to identify a peptide mimic that binds the human pclgG. The resulting data should confirm the suitability of a conserved LOS structure as a vaccine for the prevention of endemic group B disease in infants and young children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AMBISOME VS APHOTERICIN B IN AIDS PATIENTS WITH CRYPTOCOCCAL MENINGITIS Principal Investigator & Institution: Javaly, Kedernath; New York University School of Medicine 550 1St Ave New York, NY 10016 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANALYSIS OF M. CATARRHALIS LOS: ROLE IN IMMUNITY Principal Investigator & Institution: Campagnari, Anthony A. Professor; State University of New York at Buffalo 402 Crofts Hall Buffalo, NY 14260 Timing: Fiscal Year 2001; Project Start 01-MAR-2001; Project End 28-FEB-2006 Summary: Moraxella catarrhalis, a human mucosal pathogen, is a prominent cause of otitis media in young children and lower respiratory tract infections in adults with COPD. The significant financial burden on the health care system in this country, has stimulated research studies aimed at identifying possible vaccine components expressed on the bacterial surface. Recent studies have focused on components of the bacterial outer membrane, as these structures would most likely be available for interaction with the host immune response. However, it is clear that little is known about the virulence factors and the host immune response to M. catarrhalis. One prominent bacterial surface component, implicated as a potential virulence factor, is the lipooligosaccharide (LOS). Structural studies have shown that this major glycolipid is relatively conserved among clinical isolates obtained from adults. There have been three LOS serotypes reported using polyclonal rabbit sera for detection. In addition, a comparison of M. catarrhalis LOS has shown that this structure has oligosaccharide epitopes which share homology with the LOS of 9other important Gram-negative human pathogens, including Neisseria meningitis, Neisseria gonorrhea and Haemophilus influenzae. The LOPS epitopes shared by M. catarrhalis and these other important pathogens have been implicated as potential virulence factors involved in various mechanisms of pathogenesis including adherence and invasion of mucosal cells, serum resistance and resistance to opsonophagocytosis. In addition, recent studies have shown that antibodies to M. catarrhalis LOS elicit bactericidal activity, suggesting that this molecule may be an important component of a multifactorial vaccine. Despite these data, there is very little known about the role of M. catarrhalis LOS in colonization of infection, and there are no studies reported which characterize the genes and gene products of this important bacterial component. In this proposal, we will clone and sequence genes involved in the biosynthesis and assembly of LOS and we will construct specific isogenic mutants in these genes. These LOS mutants will be evaluated in various biologic assays to begin to understand the role of this molecule in pathogenesis. Also, we will perform a detailed analysis of the human antibody response to LOS in both children and adults which will provide insight into the host-pathogen relationship. The data obtained from these studies will provide critical information to our understanding of the steps involved in the pathogenesis of M. catarrhalis infections which will lead to new insight into strategies designed to prevent disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANTIGEN SPECIFIC T CELL ACCUMULATION IN THE CNS Principal Investigator & Institution: Fabry, Zsuzsanna; Professor; Pathology and Lab Medicine; University of Wisconsin Madison 750 University Ave Madison, WI 53706 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2004 Summary: The influx of T lymphocytes into the Central Nervous System (CNS) is an important part of the pathology of various autoimmune and infectious diseases, which are associated with inflammation in the brain, including viral encephalitis, chronic meningitis and Multiple Sclerosis (MS). Typically, inflammatory reactions involve the following phases: 1.) the initial entry phase of activated T cells; 2.) the preferential accumulation and site-specific survival of a small number of activated, antigen specific T cells; 3.) recruitment phase, in which, inflammatory mediators produced by these
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antigen specific T cells contribute to the influx of non-antigen specific leukocytes resulting in an amplification of the inflammatory response. The primary goal of this application is to achieve progress toward understanding the mechanism of entry and accumulation of antigen specific T cells in the early initiation phase of CNS inflammatory reactions. The first part of our work (Specific Aims 1 and 2) will focus on understanding how antigen specific T cell responses are initiated by systemic or CNS introduction of antigens. We will compare different routes of antigenic stimulation and determine which one results in the most exacerbated T cell response in the brain parenchyma and Cerebral Spinal Fluid (CSF). Because of the difficulties in monitoring the very small numbers of antigen specific T cells found in a normal animal, we will use a novel technology already available in our laboratory, involving T cell receptor transgenic animals and their respective antigens. In this way we will be able to follow the accumulation of a monospecific T cell population in the CNS. The goal of Specific Aim 3 will be to interfere with the initial entry (phase 1) of antigen specific and nonspecific T cells into the CNS. Molecules governing this initial entry phase of T cells will be defined. Characterization of this process will be crucial to understanding the pathogenesis of disease, and developing effective immunotherapies. We believe that the successful completion of this research project will lead to an improved understanding of the role of T cells in CNS inflammatory diseases and will provide the foundation for new therapeutic methodologies for controlling CNS inflammatory diseases, such as MS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BACTERIAL PHOSPHORYLCHOLINE AND PATHOGENESIS Principal Investigator & Institution: Weiser, Jeffrey N. Associate Professor; Microbiology; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: Description (Adapted from Applicant's Abstract): The bacterial cell surface is generally considered to be highly divergent from species to species. An exception to this rule is the expression of phosphorylcholine (ChoP). This unusual prokaryotic structure is now known to be exposed on the surface of the most common pathogens infecting the human respiratory tract; Haemophilus influenzae, mycoplasma, and Streptococcus pneumoniae. In addition, based on cross-reactivity to a MAb recognizing this structure, ChoP may be present on diverse phase-variable structures on N. meningitidis, N. gonorrhoeae, P. aeruginosa, and A. actinomycetemcomitans. We have defined the genetic basis of ChoP expression and the molecular mechanism controlling its phase variation in H. influenzae. This has allowed direct genetic analysis of clinical samples to show that the ChoP+ phase variants predominate on the mucosal surface of humans. The structure, however, is the target of innate immunity mediated by binding of C-reactive protein (CRP), which is bactericidal in the presence of complement. The focus of this proposal is to define the biological role of variants both with and without ChoP using H. influenzae as a prototype human respiratory tract pathogen. In Aim 1, we will determine whether switching to the ChoP- phenotype is required in natural H. influenzae infection (otitis media, pneumonia, bacteremia, and meningitis) to evade clearance by CRP and bactericidal anti-ChoP IgG. The ChoP phenotype in vivo will be determined by direct genetic analysis and compared to the local concentration of CRP and anti-ChoP antibody during infection. The local expression and concentration of CRP in the upper respiratory tract will be investigated. In Aim 2, we will determine how ChoP contributes to persistence on the mucosal surface. Genetically defined H. influenzae mutants with constitutive ChoP-on and ChoP-off phenotypes will be used to determine whether this host membrane-like
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structure contributes to (a) resistance to respiratory tract antibacterial peptides including LL-37 and tracheal antimicrobial peptide (TAP), and (b) colonization by functioning as a bacterial adhesin to host epithelial cells via putative ChoP ligands including GalNAcb 14Gal on the asialo-GM1 glycolipid and the platelet activating factor receptor. The blocking of complement mediated killing by naturally acquired secretory IgA recognizing ChoP will be explored as an explanation for the selection of the ChoP+ phenotype on the mucosal surface, despite the increased susceptibility of this phenotype to CRP and complement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BACTERIAL VACCINE ANTIGEN DISCOVERY Principal Investigator & Institution: Paoletti, Lawrence C.; Brigham and Women's Hospital 75 Francis Street Boston, MA 02115 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): New directions in bacterial vaccine discovery may arise from studies of host-microbe interactions, particularly through the use of a newly described technology: the dynamic in vitro attachment and invasion system (DIVAS). DIVAS was developed to study bacterial attachment and invasion with cells held at specific and controlled conditions of growth, metabolism, and nutrient levels. Results from experiments performed with DIVAS and group B Streptococcus (GBS) type III strains substantiated earlier findings that capsular polysaccharide is not critical for invasion of respiratory epithelial cells. Moreover, GBS invaded these cells only when held at a fast as opposed to a relatively slower rate of growth and they expressed several proteins solely under growth conditions conducive for invasion. In this proposal, we seek to test the hypothesis that GBS proteins involved with invasion of eukaryotic cells are new and important targets of protective immunity. GBS is a major cause of neonatal sepsis and meningitis, and is increasingly prevalent among nonpregnant adults and the elderly with underlying illnesses. Preclinical and clinical trials have been successfully performed with protein conjugate vaccines prepared with polysaccharides from most of the nine currently known GBS serotypes. GBS protein antigens with virulence properties have been described and some with vaccine potential have been tested preclinically. In this proposal, we seek to use DIVAS to identify physiological conditions conducive for bacterial attachment/invasion of eukaryotic cells using GBS as a model pathogen. We plan to isolate and identify GBS membrane proteins expressed solely under invasive conditions (Specific Aim 1). Several of these newly expressed proteins will be purified directly from GBS, or cloned and recombinantly expressed, and tested as vaccine candidates in mice (Specific Aim 2). Findings from these studies utilizing this unique approach to vaccine antigen discovery could be directly applied to other bacterial pathogens including those on the category A bioterrorism list. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENINGITIS
BIOACTIVITIES
OF
PNEUMOCOCCAL
CELL
WALL
IN
Principal Investigator & Institution: Tuomanen, Elaine I. Chair, Professor; St. Jude Children's Research Hospital Memphis, TN 381052794 Timing: Fiscal Year 2001; Project Start 01-JUN-1989; Project End 31-JAN-2005 Summary: The pneumococcus remains the cause of meningitis with the greatest morbidity and mortality in children and older adults. This pattern persists despite the use of antibiotics of exceptionally rapid bactericidal activity. Over the past 10 years of
Studies 11
this proposal we have sought to understand the biochemical basis of the inflammatory response to pneumococci in the subarachnoid space. We established that the pneumococcal cell wall is a library of inflammatory components which incites the cytokine, coagulation and arachidonate cascades and directly injures endothelial cells of the blood brain barrier. Further, we established that the release of cell wall during antibiotic-induced death engenders a dramatic host response that is responsible for serious injury to host tissues. This provided a rationale for use of agents like dexamethasone that can act as partner drugs with antibiotics to selectively control the injurious components of the host defense response. The current proposal seeks to determine the molecular details of the mechanism of pneumococcal invasion into brain and how neuronal cells are killed during meningitis. Blocking information decreases some sequelae of infection but does not appear to be sufficient in controlling neuronal loss, particularly for pneumococcal disease. Over half of the current survivors of this injection still have major permanent sequelae. Understanding this process will allow design of agents to specifically attenuate these ongoing losses. We propose to apply our expertise in the identification and characterization of pneumococcal surface components, to map the process of transcytosis across the blood brain barrier. We will identify the pneumococcal components involved, specifically focusing on CbpA. This protein is required for pneumococcal invasion. Secondly, we will characterize the process of pneumococcal translocation in terms of the intracellular vesicle and the signaling process. Involvement of the PAF receptor that binds pneumococci and sIgA that ligates CbpA in actual translocation will be determined. Finally, we will investigate preliminary evidence that upon inhibition of apoptosis suggest this is an important contributor to sequelae. The detailed mechanism appears to be novel and will potentially instruct cell biology as well as pathogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOLOGY OF H INFLUENZAE HIA AND HSF ADHESINS Principal Investigator & Institution: St Geme, Joseph W. Associate Professor; Pediatrics; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 15-DEC-1998; Project End 30-NOV-2003 Summary: Haemophilus influenzae is common cause of localized respiratory tract disease, including otitis media, sinusitis, bronchitis, and pneumonia. Less commonly, this organism causes serious systemic disease, such as meningitis, endocarditis, and septicemia. The initial step in the pathogenesis of H. influenzae disease involves colonization of the upper respiratory mucosa. We have identified a high-molecularweight protein called Hia, which is present in nontypable (nonencapsulated) H. influenzae and promotes attachment to human epithelium. In addition, we have identified a homolog of Hia called Hsf, which is univerally present among encapsulated H. influenzae and also mediates in vitro adherence. Interestingly, Hia has a predicted molecular mass of approximately 114 kDa and is not detectable by coventional transmission electron microscopy, while Hsf has a predicted molecular mass of approximately 245 kDa and is associated with the presence of short, thin surface fibrils visible by negative staining electron microscopy. Based on our in vitro results, we speculate that Hia and Hsf are important colonization factors. In the present proposal, we plan to characterize the pathway by which Hia and Hsf are localized on the surface of the organism. In particular, we will define the structural features of these proteins that direct them to the periplasm and facilitate their translocation across the outer membrane. We will dissect the influence of an unusual N-terminal extremity, a Cterminal domain predicted to form a beta-barrel, and a putative ATP-binding motif. In
12 Meningitis
additional studies, we will examine the architecture of Hia and will investigate the relationship between structure and adhesive activity, focusing in particular on the role of a predicted coiled coil motif. We will also determine whether Hia and Hsf function interchangeably in an encapsulated strain. From a practical perspective, the results of these experiments may facilitate efforts to develop a vaccine protective against non-type b H. influenzae and suggest targets for novel antimicrobials with activity against a broad range of gram-negative bacteria. More generally, they may provide fundamental insights into the biogenesis of non-pilus adhesins and the nature of the host-microbial relationship. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOMARKER OF NEUROPROTECTANT EFFICACY IN ALS Principal Investigator & Institution: Gabbita, Somasundar P.; Phase 2 Discovery, Inc. 3130 Highland Ave, 3Rd Fl Cincinnati, OH 45219 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): The objective of this Phase I feasibility study is to develop a reliable biomarker of neuronal damage in a validated mouse model of amyotrophic lateral sclerosis (ALS). Currently, there is no widely accepted biomarker to quantify ALS-induced motor neuron injury. Previously, we have shown that neuronal degeneration in rodents and humans results in cleavage of the cytoskeletal protein MAP-tau. Our laboratory has developed a sensitive ELISA that specifically measures cleaved MAP-tau (C-tau) in rodent models of traumatic brain injury and bacterial meningitis. Using this C-tau ELISA assay, our preliminary studies demonstrate that spinal cord C-tau levels are tenfold higher in late stage symptomatic ALS (G93A-SOD1 mutation) mice as compared to control mice. Using a rotorod motor performance assay, Hensley et al. have recently demonstrated that administration of Nor-dihydroguaiaretic acid (NDGA) to ALS mice delays onset of neurologic deficits. We hypothesize that 1) Ctau is a reliable biomarker of motor neuron injury in ALS mice and 2) C-tau can serve as a screening tool to identify neuroprotectant drags for treating ALS. We will test these hypotheses by determining the relationship between C-tau levels and progression of neurologic deficits in ALS mice. Furthermore, we will test whether the demonstrated neuroprotectant effect of NDGA that delays onset of neurologic deficits in ALS mice also exerts expected effects on C-tau levels. Our Specific Aims are: Specific Aim 1: Compare spinal cord C-tau levels in ALS mice and control mice at 120 days. Specific Aim 2: Determine the relationship between C-tau levels and neurologic deficits in ALS mice as compared to controls. Neurologic deficits and spinal cord C-tau levels will be determined in ALS and age-matched control mice and statistically compared from the presymptomatic stages to late symptomatic stages of disease progression. Specific Aim 3: Determine if C-tau levels reliably quantify the effect of a demonstrated neuroprotectant drag intervention in ALS mice. C-tau levels and rotorod performance will be determined and compared as a function of NDGA treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BIOMARKER OF NEUROTOXICITY IN MENINGITIS Principal Investigator & Institution: Mulchahey, James J. Assistant Professor; Phase 2 Discovery, Inc. 3130 Highland Ave, 3Rd Fl Cincinnati, OH 45219 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2003 Summary: (provided by applicant): The objective of this Phase I application is to develop a sensitive biomarker for quantifying neurotoxicity and neuroprotectant
Studies 13
efficacy in meningitis. Previous research documents that brain injury caused by meningitis affects multiple brain areas with a heterogeneous distribution. We have previously shown that the cytoskeletal protein MAP-tau is cleavedin brain during axonal degeneration. We developed a sensitive ELISA that specifically quantifies this biomarker of neuronal degeneration, cleaved-tau (C-tau). Our preliminary studies demonstrate that levels of C-tau are increased over 300-fold in an animal model of group B streptococcus meningitis (GBM). We will use the well-documented neurotoxicity of GBM to validate the C-tau as a biomarker of neurotoxicity and a measure of neuroprotectant efficacy. Our Specific Aims are: Specific Aim 1: Determine whether GBM results in a time-dependent elevation in brain, plasma and CSF concentrations of C-tau. Specific Aim 2: Determine it C-tau levels in brain, CSF and plasma correlate with traditional measures of neuronal damage in GBM. Specific Aim 3: Determine whether perihperal tissues such as liver, kidney or spleen are potential sources of C-tau measured in GBM. Specific Aim 4: Determine whether a neuroprotectant intervention known to be effective in GBM has predictable effects on Ctau levels. PROPOSED COMMERCIAL APPLICATIONS: The C-tau ELISA may be used to quantify the severity of brain injury in meningitis and to quantify the effects of neuroprotectant interventions in basic science, preclinical and clinical research settings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL TRIALS WITH SOLID INTRACRANIAL TUMORS & NEOPLASTIC MENINGITIS Principal Investigator & Institution: Bigner, Darell D. Jones Cancer Research Professor; Duke University Durham, NC 27706 Timing: Fiscal Year 2002 Summary: Given the toxicity and poor survival results after current treatment modalities, regional therapy using monoclonal antibody-based strategies and alkylators may have clinical potential. The PI proposes to define the MTD and therapeutic benefits of 9 different approaches, 6 for solid intracranial tumors and 3 for neoplastic meningitis. For solid tumors, 4 approaches involved intratumoral or intracystic infusions: (1) 131-I81C6, (2) 211-Att-ch81C6, (3) ch81C6-streptavidin followed by 211-At-biotin or 131-Ibiotin, (4) 211-At or I-131 conjugated alpha-EGFRvIII/ fragments; and 2 approaches only intratumoral infusions: (1) MRI (a-EGFRvIII-scFv-pseudomonas toxin), and (2) TP38 (TGFa-pseudomonas toxin). For neoplastic meningitis, two treatment studies were chemotherapy based: melphalan and camptothecin analogues and the rest utilized 131-IMel-14, 131-I-81C6, and other anti-medullobastoma antibodies and genetic variants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANTIGENICITY
COMPUTATIONAL
ANALYSIS
OF
CARBOHYDRATE
Principal Investigator & Institution: Woods, Robert J. None; University of Georgia 617 Boyd, Gsrc Athens, GA 306027411 Timing: Fiscal Year 2003; Project Start 01-MAR-1997; Project End 30-APR-2007 Summary: (provided by applicant): Group Beta Streptococcus and Neisseria meningitidis are leading causes of neonatal sepsis and meningitis. The increasing use of carbohydrate-based conjugate vaccines is founded on the observation that antibodies against the type-specific bacterial capsular polysaccharides (CPS) are often protective, and-is driven by the increasing prevalence of antibiotic resistant strains. However, the relationships between the carbohydrate sequence in the CPS and antigenicity are poorly
14 Meningitis
understood. Similarly, the immune response to the CPS is structure-sensitive; some are poor immunogens and others good. The goal of this proposal is to provide an understanding of the structural features of antigenic oligosaccharides that are responsible for mediating the affinity and specificity of their interactions with antibodies. Ultimately, this information would form a basis for the rational development of more effective antibacterial vaccines. We have selected three systems (Aims 1-3) for study that display complementary levels of complexity. In Aims 1 and 2, we will use computational and experimental methods to determine the conformational properties of the bacterial CPSs from iV. meningitides and Group B Streptococcus, both free and bound to monoclonal antibody fragments. This information will provide a structural basis for interpreting the antigenicities and antibody specificities for these systems, as well as assist in the determination of the conformation of the immunodominant regions. To aid in the development and validation of the computational methods, in Aim 3, we will examine the properties of the related anionic sugars in glycosaminoglycans (GAGs), for which considerable experimental data exist. Computational methods, such as molecular dynamics (MD) simulations, are useful aids in the conformationat analysis of oligosaccharides and oligosaccharide-protein complexes; yet at present they have been developed only for neutral carbohydrates. The CPSs from N. meningitides and Group B Streptococcus, and from many other pathogenic bacteria, contain anionic carbohydrate residues. Accurate modeling of these molecules will require the extension and validation of our existing carbohydrate force field parameters (GLYCAM). To assist in this development, we will examine a number of anionic GAGs, such as hyaluronan, chondroitin and heparin sulfate as well as heparin, free and complexed to antithrombin III, whose conformational properties have been well characterized experimentally. Validation of the MD simulations will be based on comparisons with NMR and X-ray data and binding affinity measurements. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONGENIC NEOFORMANS
STRAINS
OF
SEROTYPE
A
CRYPTOCOCCUS
Principal Investigator & Institution: Wickes, Brian L. Assistant Professor; Microbiology and Immunology; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, TX 78229 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2006 Summary: (provided by applicant): Cryptococcus neoformans is an important human fungal pathogen that can cause life-threatening infections. Infections are opportunistic in nature and typically occur in immunocompromised patients, with AIDS patients being at greatest risk. Cryptococcosis is usually manifested as meningitis, which is often treated as incurable in AIDS patients and can require life-long antifungal therapy. Infections are worldwide with approximately 90- 95% of all infections being caused by serotype A strains. The importance of this fungus as a pathogen resulted in the solicitation and funding of a genome-sequencing project. The strain that was chosen, however, was a serotype D strain, which causes less than 10% of all infections. This strain was chosen because sexually compatible strains (designated MATalpha and MATa) exist, whereas compatible serotype A strains are not available due to the absence of a fertile MATa strain. An added significance of mating in C. neoformans is that virtually all infections are caused by one mating type (MATalpha). We have recently identified a serotype A MATa strain that is fertile and crosses efficiently with serotype A MATalpha strains, including strain H99, the standard laboratory strain for this serotype. The existence of this strain provides a powerful tool for studying C. neoformans because
Studies 15
it will enable traditional genetic studies to be performed in serotype A strains. This proposal consists of three aims. The first aim will prepare two congenic pairs of strains that differ only in mating type. Genetic markers will be inserted into these strains to make them useful tools for future genetic and molecular studies. The second aim will test the role of mating type in virulence. By using congenic strains in these experiments, the role of information at the mating type locus in virulence can be tested independent of non mating-type information. In the last aim, the serotype A MATa mating type locus will be cloned and mapped to determine its size. Presently three out of the four mating type loci of C. neoformans var. neoformans (comprised of serotype A and D) are in various stages of characterization. Isolation of the serotype A MATa locus will complete this study, which is significant because of the role that mating type plays in virulence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE--PHASE I / II CLINICAL TRIALS CORE Principal Investigator & Institution: Reardon, David; Duke University Durham, NC 27706 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): Core 3 will design, implement and review all clinical trials sponsored by the SPORE application. There are four major areas of therapeutic intervention to be evaluated by clinical trials overseen by the core. First, therapeutics to overcome chemoresistance will be evaluated. UG-BG, a potent inhibitor of 06alkylguanine- DNA alkyltransferase (AGT), the major mediator of chemoresistance among malignant gliomas, is ineffective and associated with significant toxicity when administered systemically. Therefore we will evaluate the compartmental administration of Ub-BG, as well as other agents identified in Project 4, via intrathecal injection for patients with neoplastic meningitis (NM) and intratumorally via intracerebral microinfusion (ICM) for patients with malignant brain tumors. Second, we will continue to evaluate therapeutics targeting tumor- specific markers (Project l), including armed and unarmed monoclonal antibodies (MAbs) and recombinant immunotoxins, delivered compartmentally via injection into the resection cavity or into the intrathecal space, or via direct intratumoral microinfusion. Therapeutic targets for these agents include EGFR, EGFRvIII, tenascin C, GP 240, MDRP3, GPNMB as well as others identified in Project 2. Our recent Phase I1 study showed that I-labeled antitenascin MAb 81C6 significantly improved survival for patients with newly diagnosed malignant glioma compared to conventional external beam radiotherapy and chemotherapy. Therefore, we are advancing our extensive preclinical and clinical studies with "'1-81 C6 and investigating the role of human and mouse chimeric MAbs, MAb fragments such as F(ab'), and alternative radioisotopes such as astatine- 211. The third major area of focus is the evaluation of administering therapeutics by intracerebral microinfusion as a method of achieving maximum intratumoral concentration while minimizing systemic exposure. and thereby significantly improving drug therapeutic index. Fourth, we are continuing to evaluate cytotoxic chemotherapeutics that have shown promising, preclinical efficacy in the extensive Duke panel of brain tumor cell lines and xenograft models. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORE--X RAY CRYSTALLOGRAPHY Principal Investigator & Institution: Sundaramoorthy, Munirathinam; University of Kansas Medical Center Msn 1039 Kansas City, KS 66160
16 Meningitis
Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: The success of several sequence genomics projects heralds a new era in the study of the gene products and many of them are attractive targets for drug design. The new proteomics research uses multidisciplinary approach to study the "cellular protein universe" using several high-throughput methods. X-ray crystallography plays a pivotal role in both proteomics and structure based drug design. The University of Kansas Medical Center has envisioned a plan to establish "Kansas City Proteomics Initiative" and will set up an X-ray crystallography lab as a part of this plan in the Department of Biochemistry. This will serve as the Core facility for COBRE investigators who apply crystallography to their research. Funds are requested from COBRE for its maintenance. The Principal Investigator will direct the Core and his Research Project is summarized below. Gram-negative bacteria Neisseria meningitidis and Escherichia coli K1 are associated with sepsis and meningitis. There is no promising vaccine against N. Meningitidis group B and E. coli K1. Their capsular polysaccharides are sialylated, which are structurally similar to those found in mammalian glycolipids. This host mimicry plays and important role in the pathogenecity by allowing the bacteria to evade the host's immune system. Thus, sialic acid (N-acetylneuraminic acid, NeuNAc) is a virulence factor in these pathogenic bacteria. The biosynthesis of polysialic acid involves the formation and activation of NeuNAc. In bacteria, these two steps are catalyzed by NeuNAc synthase and CMP-NeuNAc synthetase, respectively. Our long-term goal is to study the structure-function relations of these enzymes using molecular biology, protein chemistry, and crystallography methods and use the structural knowledge of rational drug design. The specific aims of this application are: Aim 1: NeuNAc synthases from N. meningitidis and E. coli K1. In bacteria, sialic acid is synthesized by the condensation of N-acetylmannosamine with polyenolpyruvate by NeuNAc synthase. The human enzyme uses the phosphorylated substrates. The differences in the substrate specificity between human and bacterial enzymes may be due to different active site structures. Selective inhibition of bacterial enzyme is a viable strategy to prevent the synthesis of sialic acid in the pathogen. We will overexpress, purify, and crystallize NeuNAc synthases from N. meningitidis and E. coli K1 for structural-functions studies. Aim 2: CMP-NeuNAc synthetase from E. coli K1. The E coli K1 CMP-NeuNAc synthetase is twice as large as the other bacterial enzymes and about the same size as the mouse enzyme, the only mammalian CMP-NeuAc synthetase is sequenced. The N-terminal half of the E. coli K1 sequence is highly homologous to other bacterial sequences, but the full-length sequence share a limited homology with the mouse sequence. We will crystallize the E. coli K1 CMP-NeuAc synthetase for structure determination. The structural differences of these functional homologues will be used to design drugs to target the bacterial enzymes specifically. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COXSACKIE MYOCARDITIS AND VIRAL PERSISTENCE IN THE HEART Principal Investigator & Institution: Whitton, J Lindsay. Professor; Scripps Research Institute 10550 N Torrey Pines Rd La Jolla, CA 920371000 Timing: Fiscal Year 2003; Project Start 01-JAN-1998; Project End 31-DEC-2007 Summary: (provided by applicant): Coxsackieviruses (CVB) are important human pathogens, causing myocarditis, meningitis, and other diseases, which may be lethal, especially in neonates. This proposal has five specific aims focused on CVB pathogenesis (Aims 1-3) and immunity (Aims 4, 5). Aim 1. Does CVB preferentially infect proliferating cells in vivo? We have shown, in tissue culture, that the cell cycle exerts a
Studies 17
dramatic effect on CVB gene expression & virus production. Is this also true in vivo, in the heart, central nervous system, or immune system? We shall identify proliferating cells in these tissues, and will determine if they are more susceptible to infection. If the heart is injured in vivo, does this alter its susceptibility to subsequent CVB infection? Aim 2. What component of the virus responds to the host cell cycle? Next, we shall study the viral side of the equation. We hypothesize that the internal ribosome entry site may be the viral "response element"; this will be evaluated in tissue culture, and in vivo. Aim 3. What role do the proposed CVB receptors play in tropism & pathogenesis in the heart & CNS? We shall evaluate the expression levels of the receptors. Do they change with age? Following infection / tissue damage, are the receptors upregulated in neighboring cells? Aim 4. How do CD8+ T cells contribute to the control of CVB infection? We have shown that, during CVB infection, CD8+ T cells can reduce viral titers, and that this effect does not require perforin. What effector functions are involved in the antiviral effect? Do these effector functions contribute to tissue damage?Aim 5. How does CVB so effectively avoid inducing strong CD8+ T cell responses? Most virus infections induce high levels of antiviral CD8+ T cells. How does CVB avoid this? Can we rectify the situation? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEAFNESS AND OSSIFICATION IN LABYRINTHITIS OSSIFICANS Principal Investigator & Institution: Brodie, Hilary A. Otolaryngology; University of California Davis Sponsored Programs, 118 Everson Hall Davis, CA 95616 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2004 Summary: (Adapted from the Investigator's Abstract) Labyrinthitis ossificans (LO) is the growth of pathologic new bone within the lumen of the cochlea. It is multifactorial in origin and may result in deafness. Profound hearing loss and LO in children are most commonly associated with meningogenic labyrinthitis. The relationship of LO to meningogenic cochlear pathology and its mechanism of induction have not been clearly defined. Cochlear implants are a significant treatment option for improving hearing and quality of life in these patients. However, LO can reduce the efficacy of cochlear implantation. The long-term objective of this research program is to understand the mechanisms which lead to the development, progression, and destructive aspects of LO. Such an understanding may lead to new strategies to prevent the devastating effects of hearing loss associated with this disease. The specific aims of this application are: (1) to correlate hearing loss with the temporal and spatial progression of bacterial meningitis from the subarachnoid space to the cochlea; (2) to correlate hearing loss with the temporal and spatial sequence for both labyrinthine fibrosis and ossification and the histopathology of cochlear tissues: spiral ganglion, organ of Corti, Reissner's membrane, stria vascularis, and spiral ligament; (3) to determine the relationship of bone lining cells to osteoblast formation and recruitment during labyrinthine neo-ossification; and (4) to determine the effects of decomplementation, non-steroidal anti-inflammatory compounds, and bacteriostatic vs. bactericidal antibiotics on neo-ossification and hearing loss. There are four hypotheses/specific aims outlined and they are as follows: Bacterial invasion of the cochlear labyrinth from the subarachnoid space correlates with hearing loss and occurs principally via the cochlear aqueduct and not the internal auditory canal; The destruction of cochlear tissue occurs subsequent to the arrival of inflammatory cells and not with the appearance of bacteria within the cochlea. Hearing loss may occur prior to observable pathology and reflect central auditory damage related to meningitis; Bone lining cells of the endosteum are activated and become mature osteoblasts and are the principal source of neo-ossification in labyrinthitis
18 Meningitis
ossificans; and The inflammatory response to suppurative labyrinthitis includes fibrosis and neo-ossification formation and causes cochlear tissue destruction. Inhibition of this process will result in a reduction in both hearing loss and bone deposition. Methods used: The investigators propose to use an experimental gerbilline model of LO, histomorphometry, fluorescent bone histomorphometry, transmission and scanning electron microscopy, autoradiography, and auditory brainstem evoked response. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DETERMINANTS OF INNATE IMMUNITY TO GROUP B STREPTOCOCCI Principal Investigator & Institution: Levy, Ofer; Brigham and Women's Hospital 75 Francis Street Boston, MA 02115 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2006 Summary: (provided by applicant): The central goal of this project is to understand the role of innate immunity in infections caused by Group B streptococci (S. agalactiae or GBS). GBS are the major cause of neonatal sepsis and meningitis and thus a leading cause of neonatal morbidity and mortality. GBS-induced inflammatory mediators include tumor necrosis factor (TNF) that, when excessive, can contribute to host morbidity and mortality. Recent evidence suggests that a variety of Gram-positive bacterial surface molecules activate the innate immune system via phagocyte innate immune receptors including cellular differentiation antigen-14 (CD14), complement receptors-3 and -4 (CR3/4), and Toll-like receptor 2 (TLR2). The candidate will further characterize bacterial and host determinants of innate immunity to GBS and test the following hypotheses: Specific molecular interactions between GBS surface components and phagocyte innate immune receptors mediate the host inflammatory response to GBS infection, that such responses are down-regulated by neutrophil-derived antimicrobial peptides that bind and neutralize inflammatory GBS surface molecules, and that these pro- and anti-inflammatory innate immune responses differ between newborns and adults. In Aim 1, GBS surface components that activate host phagocytes (i.e., neutrophils and monocytes) will be identified and characterized. In Aim 2, newborn and adult phagocytes will be compared with respect to expression and function of CR3/4, CD14, and TLR2. In Aim 3, putative neutrophil-derived peptides with anti-inflammatory activity against GBS will be isolated and characterized. The candidate seeks an intensive, formal, mentored training as preparation for becoming an independent scientist. As a specialist in pediatric infectious diseases, his long-term goal is to identify molecular pathways of innate immunity that might someday be modulated to improve outcomes of GBS and other bacterial infections in neonates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENINGITIS
DISCONTINUATION
ANTIFUNGAL
FOR
CRYPTOCOCCAL
Principal Investigator & Institution: Aberg, Judith; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: E COLI TRANSLOCATION ACROSS INTESTINAL EPITHELIUM Principal Investigator & Institution: Pietzak, Michelle M.; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, CA 90027 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 30-JUN-2004 Summary: This application for a Mentored Clinician Scientist Development Award (K08) seeks support for Michelle Pietzak, M.D., who has recently completed her fellowship in Pediatric Gastroenterology and Nutrition and joined the faculty as an Instructor of Pediatrics at Childrens Hospital Los Angeles (Assistant Professor pending). Under the mentorship of Kwang Sik Kim M.D., Dr. Pietzak will continue to pursue her basic investigations into the mechanisms by which Escherichia coli (E. coli) is able to translocate across intestinal epithelium and cause sepsis. E. coli is a leading cause of severe bacterial infections in premature infants, neonates, immunocompromised hosts, and children with central lines and primary intestinal diseases. Dr. Kim is a prominent researcher in the field of the pathogenesis of E. coli meningitis, having (a) established the virulence roles for the K1 capsular polysaccharide, outer membrane protein A, and S fimbriae using in vitro and in vivo models of the blood brain barrier developed in his lab and (b) identified several novel genes thought to be responsible for invasion of E. coli strain RS218 across the blood brain barrier, using these same models. E. coli strain RS218 is a clinical isolate from the cerebrospinal fluid of a human neonate with E. coli meningitis. Dr. Pietzak's project is focused on investigating the mechanisms by which E. coli strain RS218 is able to penetrate the intestinal epithelial barrier, both in vitro and in vivo. In earlier studies, Dr. Pietzak has used strain E44, a spontaneous rifampin resistant mutant of E. coli strain RS218, to demonstrate that this bacterium is able to invade two intestinal epithelial cell lines, Caco-2 and C2BBe-1. The specific aims of this proposal are to further characterize the invasive phenotype of E-44 in vitro, using both gentamicin invasion assays and a trans-well system. An in vivo model, using neonatal rats, will also be used to test the invasive phenotype of E-44. Environmental factors, which mimic the intraluminal gastrointestinal milieu, will be employed to examine their effects on E. coli invasion and translocation in vitro. The virulence of TnphoA transposon mutants, created in our lab and already shown to be noninvasive to the blood brain barrier in vitro and in vivo, will be determined for the intestinal epithelial barrier both in vitro and in vivo. The precise contribution of these genes to the intestinal translocation of E. coli strain RS218 will then be examined using additional molecular techniques. Under Dr. Kim's mentorship, and with Institutional support, Dr. Pietzak will be able to perfect her techniques in cell tissue culture and animal models of bacterial infection, as well as acquire new knowledge and skills in the sciences of bacterial genetics and molecular pathogenesis. Nurturing these ambitions in a collaborative environment will help Dr. Pietzak achieve her goal of becoming an independent investigator, who hopefully will be able to bring the results of her investigations from the benches of the lab to the bedsides of chronically ill children with gastrointestinal and other diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: E. COLI BINDING TO BRAIN ENDOTHELIAL CELLS Principal Investigator & Institution: Kim, Kwang S. Professor and Director; Pediatrics; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2004 Summary: (Adapted from the Applicant's Abstract): The principal investigator has established an infant rat model of experimental hematogenous meningitis, which mimics human E. coli meningitis (i.e., hematogenous infection of the meninges without
20 Meningitis
the need for adjuvant or direct inoculation of bacteria into cerebrospinal fluid). They have established an in vitro model of blood-brain barrier using brain microvascular endothelial cells (BMEC). Using both in vitro and in vivo systems and the BMEC model, they have shown that successful traversal of E. coli across the blood-brain barrier may be a complex process involving separate steps of E. coli-BMEC interactions, i.e., binding to BMEC and invasion of BMEC. They have shown that S fimbriae are the major E. coli structures contributing to binding to BMEC. They therefore hypothesize that the role of S fimbriae is to have a more intimate contact for circulating E. coli to BMEC to withstand blood flow, which may be required for subsequent crossing of the blood-brain barrier, but there is no information to support this hypothesis. The overall aim of the proposal is to study the role of binding via S fimbriae in the pathogenesis of E. coli meningitis, both in vitro (using BMEC in culture) and in vivo (using an experimental animal model of hematogenous E. coli meningitis that closely mimics the pathogenesis of human E. coli meningitis). The specific aims are: (1)to continue to construct isogenic S fimbriae operon deletion (delta sfaII) mutant of invasive E. coli K1 strain RS218 by chromosomal gene replacement (allelic exchange); (2)to examine the ability of S fimbriae negative (delta sfaII) mutant to bind and invade brain microvascular endothelial cells (BMEC) in vitro and in vivo; (3)to determine whether it is possible to restore the ability of S fimbriae negative (delta sfaII) mutant to bind and invade BMEC by complementation with the cloned sfaII gene cluster; (4)to assess which specific subunits of S fimbriae are responsible for binding to BMEC by constructing single gene deletion mutants (delta sfaIIS, delta sfaIIA, delta sfaIIG, delta sfaIIH); (5)and to identify and characterize BMEC glycoprotein(s) interactive with S fimbriae. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EARLY LYME--CNS INVASION Principal Investigator & Institution: Coyle, Patricia K. Associate Professor; State University New York Stony Brook Stony Brook, NY 11794 Timing: Fiscal Year 2001 Summary: Lyme disease is an important emerging infection caused by a tick borne spirochete B. burgdorfi (Bb). Originally characterized as an arthritis, it appears that neurologic involvement is also a significant early manifestation of the disease in North America. Neurologic complications of the disease can involve meningitis, facial nerve palsy (or other cranial neuropathy) and radiculoneuritis in early disseminated infection. It is also unclear at what point the infection changes from a localized skin erythema migrans (EM) to an early disseminated syndrome. The objective of this study is to characterize the frequency, clinical correlates and outcome of central nervous system infection in early Lyme disease. The study parameters will include clinical features, immune response, cerebrospinal fluid changes, neurocognitive disturbances, and psychosocial aspects of the disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EHRLICHIA CHAFFEENSIS SURFACE PROTEINS Principal Investigator & Institution: Walker, David H. Professor; Pathology; University of Texas Medical Br Galveston 301 University Blvd Galveston, TX 77555 Timing: Fiscal Year 2001; Project Start 30-SEP-1991; Project End 31-MAR-2005 Summary: (provided by the applicant): The long-term goal of this research is the elucidation of the mechanisms of protective immunity against Ehrlichia chaffeensis, the causative agent of human monocytotropic ehrlichiosis (HME). Achievement of this goal
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requires knowledge of which humoral and cellular immune mechanisms stimulated by ehrlichiae are effective in the clearance of ehrlichiae. HME is a life-threatening tickborne infection associated with adult respiratory distress syndrome, meningitis, and shock in immunocompetent patients, overwhelming infection in immunocompromised patients, and a fatality rate of 2.7 percent. More than 2,200 cases have been diagnosed with laboratory confirmation, and the incidence is 1,000 cases per 1,000,000 population in tick-exposed rural populations. The specific aims test the hypothesis that the immunodominant, surface-exposed p28 antigens stimulate protective immunity by antibodies and cellular mechanisms and determine the importance and mechanisms) of antibodies and cellular mechanisms of protective immunity in mouse models of HME. The research design includes sequencing of the loci of the p28 multigene families of major immunodominant surface proteins of Ehrlichia muris and a related ehrlichia (IOE) DNA and recombinant protein vaccines in the E. muris mouse model and the highly pathogenic IOE-C57BL/6 mouse model. Humoral immunity will be passive polyclonal and monoclonal antibodies to the conserved and variable regions of p28 families in IOE-infected mice including Fc-receptor knockout mice. Opsonization will be investigated in murine macrophages in vitro with E. muris and specific polyclonal and monoclonal antibodies. Cellular immune mechanisms will be elucidated using gene knockout mice (MHC Class I, MHC Class II, delta T-cell receptor, IFN-gamma, perforin, iNOS, and TNF-alpha receptor) and TNF-alpha depleted mice, immunohistochemical and flow cytometric analyses of the cell subsets and their cytokine profiles, adoptive transfer of T-lymphocyte subsets including T-cell clones in the outstanding new mouse model of HME. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EMERGING INFECTIOUS DISEASES AND URBANIZATION Principal Investigator & Institution: Ko, Albert I. Medicine; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2003; Project Start 20-SEP-1997; Project End 31-MAR-2008 Summary: (provided by applicant): The Division of International Medicine and Infectious Disease, Weill Medical College of Cornell University (Cornell) has had a joint training and research program on endemic tropical diseases with Brazilian institutions in the city of Salvador since the 1964. More recently, the investigations of Cornell and its Brazilian collaborators have brought to attention infectious diseases, such as epidemic leptospirosis, which have emerged in the urban setting due to rapid urbanization and increasing social inequality. Through the Fogarty-sponsored International Training in Emerging Infectious Diseases (ITREID) Program, we have been established at the Oswaldo Cruz Foundation (Fiocruz), Brazilian Ministry of Health in Salvador: 1) a multidisciplinary team of epidemiologists, clinicians, microbiologists and basic researchers, 2) on-going population-based surveillance for leptospirosis and bacterial meningitis; 2) a diagnostic laboratory that is now the national reference center for leptospirosis surveillance; 3) a molecular strain typing center, and 4) field sites to perform community-based longitudinal studies designed to identify determinants of transmission for leptospirosis and the etiologic pathogens for bacterial meningitis. Moreover, ITREID projects have convinced the Brazilian government to prioritize emerging infectious diseases such as leptospirosis, and in turn have led to national projects to sequence the Leptospira genome and develop a vaccine against leptospirosis. The infrastructure created at Fiocruz since 1996 provides a vehicle to pursue multidisciplinary training approaches for emerging infectious diseases. In this proposal, we will use leptospirosis and bacterial meningitis as disease models to address the
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following specific objectives: 1) Expand training opportunities that will provide Brazilian trainees at Fiocruz the capacity to develop treatment, control and prevention strategies for emerging infectious diseases; and 2) Work jointly with the Brazilian Ministry of Health to disseminate expertise already established at Fiocruz in laboratorybased surveillance, outbreak investigations and molecular epidemiology to other regions of Brazil. The proposal emphasizes the use of in-country expertise and resources to provide training. For the first aim, we propose long-term training to 6 predoctoral and 2 postdoctoral fellows each year to address specific needs in expertise within the areas of clinical and field epidemiology, molecular epidemiology, pathogenesis and biotechnology application to develop public health interventions. In-country training provided by outstanding Brazilian mentors will be augmented with short training experiences in the institutions of long-standing US collaborators. For the second aim, Fiocruz will work with the National Center of Epidemiology, Brazilian Ministry of Health in providing short-term training opportunities and a yearly course, the National Course in Molecular Epidemiology in Emerging Infectious Diseases, which are designed to enhance the capacity of local public health epidemiologists and reference laboratory staff to perform laboratory-based surveillance and apply molecular strain typing tools to epidemiological investigations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENTEROVIRUS 71 LEADER: TARGET FOR PEPTIDE INHIBITORS Principal Investigator & Institution: Thompson, Sunnie R. Microbiology and Immunology; Stanford University Stanford, CA 94305 Timing: Fiscal Year 2001; Project Start 01-MAR-2001 Summary: Every year hundreds of thousands of children are infected with enterovirus 71 (EV71). Infection with EV71 can lead to serious complications such as polio-like paralysis, encephalitis, meningitis or even death. Currently, there is no treatment or vaccine against EV71. EV71 belongs to the picornavirus family, whose members contain positive-stranded RNA genomes that are translated by an unusual mechanism of internal ribosome entry. The differences between the model of translational initiation of most cellular and viral mRNAs will be exploited to identify small peptides that can selectively inhibit the translation of the EV71 mRNA. Specifically, retroviruses expressing conformationally constrained peptide libraries will be used to infect cells expressing the EV71 5' non-coding region linked to an enhanced green fluorescent protein (EGFP) reporter gene and a cellular c-myc 5' non- coding region linked to an enhanced yellow fluorescence protein (EYFP). Infected cells which fail to express EGFP but still express EYFP will be isolated by cell sorting, and the gene encoding the putative inhibitor will be isolated. Studying the targets of the inhibitory peptides and characterizing the molecular interactions that they are disrupting will reveal more about how viruses function to recruit host cell molecules for their translation. Selection and characterization of intracellularly stable peptides that can inhibit the amplification of a viral RNA genome should level to novel ways in the search for antiviral therapeutics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ENTEROVIRUS RNA TRANSLATION AND REPLICATION Principal Investigator & Institution: Barton, David J. Assistant Professor; Microbiology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, CO 800450508 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-AUG-2004
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Summary: (provided by applicant): Enteroviruses cause a diverse spectrum of human diseases including conjunctivitis, myocarditits, aseptic meningitis, acute flaccid paralysis, and fatal systemic infections in neonates. Poliovirus, the prototypic enterovirus, is well characterized at the molecular level and still serves as the most appropriate virus for studies of RNA translation and replication. In this proposal, poliovirus mRNA translation and RNA replication will be studied in cell-free reactions capable of supporting the sequential translation and replication of poliovirus RNA. These reactions are advantageous because they support authentic translation and replication of poliovirus RNA while providing numerous technical advantages including the ability to synchronize viral mRNA translation and viral RNA replication. The interaction of cis-active RNA structures at the termini of poliovirus RNA will be examined. Temporally dynamic ribonucleoproteins form on poliovirus cis-active RNA structures to mediate and regulate the sequential steps of replication. Experiments will be performed to: 1) determine how the 5' cloverleaf RNA structure of poliovirus potentiates viral mRNA translation, 2) determine how translating ribosomes regulate, in part, the switch from viral mRNA translation to RNA replication, 3) determine how apparently distal cis-active RNA structures interact to regulate sequential steps of viral RNA translation and replication, and 4) determine the mechanisms behind the asymmetric replication of poliovirus RNA. These experiments will help elucidate the fundamental sequence of molecular interactions required for enterovirus RNA translation and replication. This information will provide for a better understanding of the mechanisms by which enteroviruses replicate. In particular, these studies will contribute substantial new information to support the popular new paradigm of 5'-3' RNA interactions in messenger ribonucleoprotein complexes and RNA replication complexes. The experiments directly test a hypothesis concerning the mechanism by which RNA replication machinery avoids ribosome-replicase collisions. Finally, the experiments test a new model that clearly explains the mechanisms controlling asymmetric RNA replication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ESCHERICHIA COLI INVASION OF BRAIN ENDOTHELIAL CELLS Principal Investigator & Institution: Huang, Sheng-He; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, CA 90027 Timing: Fiscal Year 2001; Project Start 01-JUL-1997; Project End 30-JUN-2002 Summary: (Adapted from the applicant's abstract): Bacterial meningitis continues to be associated with high morbidity and mortality despite advances in chemotherapy and supportive care. E. coli is the most common gram-negative organism that causes neonatal meningitis. Most cases develop as a result of hematogenous spread, but it is not clear how circulating E. coli traverse the brain microvascular endothelium, which constitutes the blood brain barrier. The PI has demonstrated that the invasion of brain microvascular endothelial cells (BMEC) by E. coli K1 is mediated by multiple factors. Two separate genetic loci, identified by the PI as pathogenicity islands (paiA and paiB) apparently contribute to E. coli meningitis. PaiA contains the 20 kb E. coli locus identified as the major invasion gene cluster in K1 E. coli strain RS218. A TnphoA insertion mutant of E. coli RS218 was unable to invade BMEC in tissue culture and to cause hematogenous meningitis in a newborn rat model. Encoded on paiA is ibe10, which encodes an 8.2 kDa protein displaying the characteristics of an integral membrane protein with four transmembrane domains. A recombinant Ibe10 protein was able to block invasion of BMEC by E. coli K1. Ibe10 was detected in 30% of clinical isolates of K1 E. coli causing meningitis. Six clones for Ibe10 have been isolated from a lambda Gem-
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12 library. A recombinant plasmid carrying a 15 kb E. coli fragment was able to complement the non-invasive TnphoA mutant 10A-23. And, in an appendix, the PI reports that he has succeeded in conferring invasiveness on a strain of E. coli K12 using an 18 kb fragment of paiA. The long term goal of this work is to develop novel strategies for the prevention and treatment of E. coli meningitis (such as vaccines) based on a full understanding of the molecular mechanisms responsible for E. coli invasion of the blood-brain barrier. The PI hypothesizes that the phenotype of E. coli invasion of the blood-brain barrier is encoded by the pathogenic E. coli K1-specific genetic determinants, the pai's. The proposal comprises two aims: Aim 1: To further characterize the role of the invasion gene cluster paiA and/or paiB in the pathogenesis of E. coli meningitis by using in vitro (BMEC invasion) and in vivo (infant rat) models and molecular and genetic approaches. Aim 2: To determine the function and functional domains of invasion protein ibe10 by identification of the BMEC receptor for ibe10, in vitro mutagenesis and epitope mapping. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FORMATION OF CORTICAL PLAQUES BY NEISSERIA Principal Investigator & Institution: So, Magdalene Y. Chair; Molecular Microbiol and Immun; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-MAY-2006 Summary: (provided by the applicant): The Neisseria type IV pilus modulates bacterial infectivity by mediating adhesion and inducing cell signaling pathways. Upon binding its receptor, CD46, the pilus causes a transient increase in cytosolic free Ca2+ levels, triggering endosome and lysosome exocytosis. Piliated bacteria next trigger elongation of microvilli and formation of cortical plaques at the plasma membrane beneath the site of contact. Cortical plaques contain clusters of Opa receptors, transmembrane signaling proteins, actin microfilaments and ezrin, a protein that tethers the membrane to the actin cytoskeleton. These plaques serve multiple signaling functions that promote bacterial infection. Unlike the Ca2+ response, which can be induced with purified pill, cortical plaque formation requires live diplococci and PilT, a protein that functions in pilus assembly and DNA transformation. PilT also controls pilus retraction, a process that drives twitching motility and the ability of diplococci to aggregate into microcolonies. Retraction generates substantial force on the substrate to which the pilus is attached. External forces placed on the membranes of eucaryotic cells result in the induction of kinase cascades, cytoskeleton reorganization and alterations in translation. The tension generated on the plasma membrane by retraction of pili during infection may therefore act as a signal to promote the formation of cortical plaques and subsequent bacterial invasion. Based on these and other observations, we propose a model for early events in pilus-induced cortical plaque formation. In this proposal, we describe experiments to test key predictions of this model. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FREQUENCY DOMAIN CEREBRAL OXIMETER FOR PEDIATRICS Principal Investigator & Institution: Kurth, Dean C. Attending Anesthesiologist; Near Infrared Monitoring, Inc. (Nim) 3401 Market St, Ste 140F Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 29-SEP-2002 Summary: Brain damage from hypoxia-ischemia represents a major health problem in pediatrics. At present, no method exists in clinical care to diagnose cerebral hypoxiaischemia in real-time at the bedside, thereby limiting prevention and treatment of the
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brain damage. Near infrared spectroscopy (cerebral oximetry) is an emerging optical technology with the potential to fulfill this role. In previous work, we built a prototype frequency domain near infrared cerebral oximeter and found it measures cerebral O2 saturation accurately. However, before clinicians will use cerebral O2 saturation to diagnose cerebral hypoxia-ischemia, the measure needs to be related to other known measures of hypoxia-ischemia, and the instrument needs to be engineered to the clinical environment. This fast-track proposal will develop a frequency domain near infrared cerebral oximeter to diagnose cerebral hypoxia-ischemia in real-time at the bedside for pediatrics (<8 years). Instrument development includes construction of "user-friendly" hardware and software, evaluation of its performance in a simulated clinical environment, and identification of critical cerebral 02 saturation-in piglets to diagnose hypoxia-ischemia. The instrument will be operable by the nurse caring for the child at the bedside and will display cerebral O2 saturation and messages to facilitate its operation. PROPOSED COMMERCIAL APPLICATION: The cerebral oximeter will be used in children at risk of hypoxic-ischemic brain damage. The population at risk, encompassing about 5% of pediatrics, includes sick premature infant and lull term infants, as well as children with congenital heart disease, sickle cell anemia, seizure disorders, or meningitis. The market is enormous as it consists of all hospitals and freestanding clinics treating this population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL SIMILARITIES IN RENAL AND COCHLEAR EPITHELIA Principal Investigator & Institution: Steyger, Peter S. Otolaryngology Head & Neck Surgery; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2003; Project Start 15-MAR-2003; Project End 28-FEB-2005 Summary: (provided by applicant): Aminoglycosides are clinically essential for treating life-threatening Gram-negative bacterial infections, e.g., meningitis, and in preventing infection in burns and premature babies. However, there is a high incidence of ototoxicity and sensory hair cell death. Sensitive hair cell function is dependent on a structurally and physiologically intact ear. Thus, studies to determine mechanisms of ototoxicity have used intact animals, or inner ear explants excised from animals. There are a number of functional, toxicological, and pharmacological similarities between inner ear cells and cells of the kidney tubules. To exploit these similarities, we have developed cloned sub-lines of currently-available kidney cell lines to determine their validity as in vitro models to study the mechanisms of aminoglycoside transport and toxicity in the inner ear. Using the aminoglycoside gentamicin, we propose to use cloned kidney cells to study two distinct aspects of aminoglycoside ototoxicity: 1) Like hair cells, proximal tubule epithelial cells of the kidney are among the few cell types that are toxicologically sensitive to clinical doses of aminoglycosides. These cell types also share pharmacological sensitivities to several other drugs. We will use a clone of OK cells, a proximal kidney tubule line, to determine the feasibility of using proximal tubule cells as valid in vitro models of aminoglycoside uptake and toxicity by hair cells. 2) Little work has been done to determine the mechanism of drug entry into the endolymph. Research suggests that hair cell uptake of aminoglycosides is across the apical membrane that is exposed only to the highly-regulated endolymph. Thus, pathways of drug entry into the endolymph will be highly-potent sites of intervention to prevent ototoxicity during treatment. The various epithelia surrounding the endolymph are cumbersome to acquire as explants in the quantity and proper configurations to facilitate direct examination of aminoglycoside transit across these epithelia. Therefore,
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we have developed a kidney distal tubule cell line to use as a model for aminoglycoside transport across the various epithelia enclosing the endolymph compartment. Distal tubule cells share several characteristics with inner ear epithelia such as the marginal cells of the stria vascularis. We will use a clone of MDCK cells, a distal tubule line, to determine the feasibility of using distal tubule cells as valid in vitro models for aminoglycoside transport across the epithelia enclosing the scala media. Results obtained from both studies will periodically be compared with animal models for confirmation. Preliminary data obtained with use of our cloned kidney cell lines have already dramatically changed our understanding of aminoglycoside entry into, distribution within, and transit across epithelia. Both of these in vitro models should provide powerful tools for finding co-therapeutics to reduce or eliminate ototoxicity during aminoglycoside treatment, blocking both toxic events in the hair cells and drug access to the endolymph and, thus, the hair cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISCOVERY
GBS:
EPIDEMIOLOGIC
CHARACTERIZATION
FOR
GENE
Principal Investigator & Institution: Foxman, Betsy; Professor; Epidemiology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Group B Streptococcus (GBS) is a major cause of neonatal sepsis and meningitis. First emerging as a pathogen in newborn nurseries in the 1970s, it is now a pathogen of concern in nursing homes, intensive care units and outpatient settings. Little is known about GBS virulence factors. The overall goals of this application are 1) to use genetic fingerprinting techniques to better describe the molecular epidemiology of GBS of several epidemiologically defined collections; and 2) to identify new genes associated with GBS disease. By combining epidemiologic information with molecular genetics, we can maximize our ability to detect GBS virulence-related genes associated with invasive disease, extra-intestinal colonization, transmission and antibiotic resistance. This strategy also gives us insight as to the relative importance of the identified genes and their potential mechanism. A better understanding of the molecular epidemiology and the identification of new GBS virulence genes will facilitate the discovery of new therapies and prevention strategies for GBS disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENE DISCOVERY FOR PNEUMOCOCCAL OTITIS MEDIA Principal Investigator & Institution: Pettigrew, Melinda M. Epidemiology and Public Health; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2006 Summary: (provided by applicant): Otitis media (OM) is the most common bacterial infection in the United States among young children for which medical care is sought, and Streptococcus pneumoniae strains are the leading cause of bacterial OM. These gram-positive diplococci colonize the respiratory tract in up to 50% of healthy children and only cause disease under special circumstances. Recent genomic sequencing projects and advancements in molecular biology have resulted in the identification of numerous putative virulence factors. These factors have mainly been studied in the context of invasive pneumococcal diseases such as pneumonia, or have been studied in one or a few laboratory strains. While more virulence factors remain to be discovered,
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the new challenge is to identify which of these many factors warrant further study, to link these factors specifically to OM pathogenesis, and to estimate the relative importance of these virulence factors among the S. pneumoniae strains in circulation. This project is built on the observation that S. pneumoniae strains differ in their ability to cause disease, and that these differences are likely due to genetic differences between strains that extend beyond the polysaccharide capsule. The goal of this project is to identify genes associated with pneumococcal OM and to evaluate the relative frequency of pneumococcal virulence genes among a collection of isolates obtained from healthy children and children with clinical disease. A four step interdisciplinary approach utilizing techniques of molecular biology and epidemiology will include: 1. Selection of S. pneumoniae strains for genomic subtraction with the highest potential to identify genes associated with OM. 2. Identification of DNA sequences (sPCR fragments) unique to strains causing OM (tester strains) and absent in strains from healthy carriers (driver strains) using genomic subtraction. 3. Epidemiologic screening of a large collection of isolates from healthy children and children with OM, meningitis, pneumonia, or bacteremia using sPCR fragments. 4. Identification of genes associated with sPCR fragments important for OM pathogenesis and description of their biological and clinical characteristics. Discovery of additional factors involved in streptococcal OM will facilitate the development of new strategies for the control and prevention of this important disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETIC IMMUNIZATION AGAINST PNEUMOCOCCAL DISEASE Principal Investigator & Institution: Zeng, Mingtao; Microbiology and Immunology; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Streptococcus pneumoniae is the most common bacterial cause of otitis media and acute respiratory infection and is estimated to result in over three million deaths in children every year worldwide from invasive diseases such as pneumonia, bacteremia, meningitis, and septicemia. The low efficacy of currently licensed pneumococcal polysaccharide vaccine has necessitated research into more efficient vaccines against pneumococcal disease. The long-term goal of this research is to develop a multi-component vaccine against pneumococcal disease, using genetically and antigenically conserved outer membrane proteins PspA, PsaA, and detoxified pneumolysin (PdB) from S. pneumoniae. Our hypothesis is that an effective pneumococcal vaccine should be composed of multiple conserved relevant antigens delivered preferably by a mucosal route in order to provide the best non-serotypedependent protection against S. pneumoniae infection. Intranasal and transcutaneous immunization with replication-incompetent adenoviral vectors have proved to be efficient and simple for immunization. This non-invasive vaccine delivery will undoubtedly enhance the compliance of a vaccination program. In this project, adenovirus and plasmid expression vectors encoding PspA, PsaA and PdB will be constructed. In order to obtain an optimal vaccination protocol, immunization regimens with different combinations of adenoviral vectors through the intranasal and transcutaneous delivery modes will be compared with the intramuscular injection of plasmid expression vectors. The specific aims of this project are: Specific Aim#1: To develop a replication-incompetent adenovirus-vectored vaccine against Streptococcus pneurnoniae. Specific Aim #2: To compare the mucosal and systemic immunity elicited by adenovirus-vectored vaccine through intranasal and transcutaneous administrations with that elicited by plasmid expression vectors through intramuscular injection.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETIC MUTATIONS THAT PREDOPOSE TO INFECTIOUS DISEASE Principal Investigator & Institution: Butler, Bruce; Scripps Research Institute 10550 N Torrey Pines Rd La Jolla, CA 920371000 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2007 Summary: The innate immune response is dependent upon a discrete collection of proteins that mediate the detection of microbial invaders and their elimination. Only a handful of these proteins are known at present, and among them, the Toll-like receptors and associated signaling proteins play a prominent role as sensors. The program of which this Bridging proposal is a part will permit the identification of many critical genes involved in the innate immune response. We propose to examine each of these genes in turn, starting with the Toll-like receptors and moving to new genes as they are discovered. Our ultimate goal is to determine whether mutations at these loci contribute to susceptibility to sepsis in humans, or influence the outcome of sepsis once it is established. The approach taken is one in which modem techniques for mutation detection will be used to assay genetic load within the coding region at each locus, in disease populations and in ethnically matched control populations. In particular, we will emphasize the use of advanced methods for mutation detection, coupled with highthroughput sequencing to achieve this end. In accordance with the emerging principle that most complex human diseases may be ascribed to low-frequency codominant mutations affecting multiple loci, it is expected that mutations will be over-represented in specific loci within a disease population, given that those loci encode genes that are important in fighting infection. Preliminary work has supported this principle as it applies to the TLR4 locus in meningococcal disease: there is a significant excess ofmissense mutations at this locus in the disease population, compared with controls. We intend to generalize the principle, seeking to establish the importance of rare mutations at multiple loci in the pathogenesis of diverse infections. This proposal will entail extensive interactions between the Forward Genetics Core, the Genomics Core, and the Sequencing Core. Mutational data bearing on the involvement of specific genes in sepsis will quickly be disseminated to the scientific community at large through a webbased information system. Ultimately, these studies may foretell susceptibility to infection, and explain the strong heritability of infectious diseases in molecular terms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENETIC SCREEN FOR VIRULENCE GENES IN C NEOFORMANS Principal Investigator & Institution: Lodge, Jennifer K. Assistant Professor; Biochem and Molecular Biology; St. Louis University St. Louis, MO 63110 Timing: Fiscal Year 2001; Project Start 01-MAR-1999; Project End 29-FEB-2004 Summary: The Biochemistry and Molecular Biology Department at St. Louis University School of Medicine is an ideal environment for the candidate to focus on a novel and potentially prolific research project identifying genes required for pathogenesis in the opportunistic fungal pathogen, Cryptococcus neoformans. The University offers a dynamic research environment including interactions with other mycologists, molecular geneticists and biochemists, and a generous allotment of space and equipment for the candidate to conduct a productive research program. The candidate has been committed to a carer in biological research and now has the opportunity to make a significant contribution to biomedical research and public health. The proposed research will
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identify new genes which are essential for pathogensis of the C. neoformans. C. neoformans causes cryptococcal meningitis in 6-10 percent of patients with AIDS. As a geneticlly manipulable haploid organism with several key molecular genetic tools already available, C. neoformans is an excellent model for other opportunistic fungal pathogens. To identify fungal genes that are essential for pathogenesis, "signaturetagged" mutagenesis, a novel screen which has been highly successul in Salmonella, will be adapted for use in C. neoformans. Mutants strains of C. neoformans will be generated by insertion of a unique "signature-tag" randomly throughout the genome. The mutant strains will be pooled and injected into a mouse. A strain that fails to proliferate in the animal host will be identified by the absence of its signature-tag in the genomic DNA of the recovered pooled organisms. Strains which are confirmed to be less virulent, will be analyzed thoroughly and the genes which have been disrupted by the signature tag will be cloned and characterized. Some of the genes identified in this screen could increase our understanding of which factors contribute to the ability of an organism to be an opportunistic pathogen. Other genes may prove to be promising new leads for novel antifungal targets. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETICS OF PICORNAVIRUS RNA REPLICATION Principal Investigator & Institution: Flanegan, James B. Professor; Molecular Genetics & Microbiol; University of Florida Gainesville, FL 32611 Timing: Fiscal Year 2001; Project Start 01-JAN-1992; Project End 30-APR-2002 Summary: The Picornaviridae, a family of small positive-strand RNA viruses includes a large number of important human pathogens that cause a wide variety of diseases, including respiratory infections, meningitis, encephalitis, poliomyelitis, myocarditis and hepatitis. Viral RNAs with deletions in the capsid coding region of the viral genome act as replicons and are efficiently translated and replicated in the host cell. Replicons with most of the polyprotein coding sequence deleted can replicate in in vitro reactions containing viral proteins synthesized in trans from a non-replicating helper RNA. In this proposal, molecular genetic techniques are being used to investigate poliovirus RNA replication. A mutagenic analysis of structure-function relationships for viral proteins and RNA sequences, genetic complementation assays in vivo and in vitro, genetic recombination assays and the isolation and characterization of revertant viruses are being used to define the genetic elements that are required for the replication of the viral genome. Complementation assays have been developed that can be used in transfected cells and in RNA replication assays in vitro. Both conditional and nonviable mutations can be characterized in these assays. The recent demonstration that all of the viral proteins required for RNA replication can be synthesized in trans provides a powerful new approach for genetic analysis of RNA replication. The following specific aims are proposed to continue these studies : (1) Further characterize the cis and trans genetic elements in the viral genome using a mutagenic approach and complementation assays in vivo and in vitro, (2) develop RNA recombination assays for use in the in vitro replication assays, (3) identify cis-active sequences in the viral genome that are required for RNA replication, and (4) characterize RNA sequences and structures in the 3'NTR which are required for viral RNA replication, and test the proposed model for generating revertants in the 3'NTR. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENETICS STREPTOCOCCUS
OF
VIRULENCE
OF
TYPE
III
GROUP
B
Principal Investigator & Institution: Rubens, Craig E. Professor; Children's Hospital and Reg Medical Ctr Box 5371, 4800 Sand Point Way Ne, Ms 6D-1 Seattle, WA 98105 Timing: Fiscal Year 2001; Project Start 01-JUL-1985; Project End 30-JUN-2004 Summary: Group B streptococci (GBS) remain the most significant bacterial pathogen causing neonatal sepsis, pneumonia, and meningitis in the USA despite chemoprophylaxis strategies for preventing this infection recommended by the CDC. Although serotype III GBS account for the majority of infections, newer serotypes are emerging, eg. type V. We have demonstrated the importance of the capsular polysaccharide (CPS) to GBS virulence. Using transposon mutagenesis we identified a 20Kb region of the type III chromosome responsible for the biosynthesis of the type III capsular polysaccharide. 16 genes have now been identified by sequencing analysis which are organized according to function, putatively involved in regulation, chain length determination, export, pentasaccharide repeating unit synthesis, and sialic acid synthesis. The genetic organization is similar to that observed for the genes encoding complex polysaccharide synthesis in other gram (+) and gram (-) bacteria. Several cps genes share homology with cps genes in other organisms, although we have identified unique genes as well, which require further characterization. We have identified the first sialic acid (SA) synthesis genes in a gram (+) bacteria which share functional homology with the neu genes responsible for sialic acid and CPS synthesis in E. coli K1. This proposal seeks to extend our investigation of the type III cps gene loci. The type III cps genes are transcribed as a large polycistronic message and therefore to investigate their function we will need to develop non-polar mutations in each of the 16 genes. These mutants will be critical for investigating gene function within GBS and will be derived in aim 1, using contemporary genetic methods we developed for this organism. Each wild type gene will be cloned during the mutagenesis process, which will be important for subsequent complementation studies. Aim 2 will investigate the unique SA synthesis genes, exploiting our recent observations that they complement homologue mutations in E.coli K1. During this investigation we will perform complementation analysis of the non-polar mutants with the SA synthesis genes from E.coli, will confirm the biochemical function of each gene, and identify the sialyltransferase gene responsible for linking sialic acid to CPS. Aims 3 and 4 will begin to characterize mutants in the putative glycosyltransferases, chain length, and export loci using complementation with homologue genes from S. pneumoniae type 14 and biochemical analysis, to identify, their functional role in cps synthesis. These studies should enhance our understanding of the genetic basis of CPS expression in GBS and other encapsulated gram (+) pathogenic bacteria. They may also provide clues to the evolution of new GBS serotypes which are now causing human infections. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENOME ANALYSIS OF STREPTOCOCCUS AGALACTIAE Principal Investigator & Institution: Tettelin, Herves' S. Associate Investigator; Institute for Genomic Research Rockville, MD 20850 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 29-SEP-2003 Summary: (provided by applicant): Group B streptococci (GBS) or Streptococcus agalactiae are weakly beta-hemolytic, facultatively anaerobic Gram-positive cocci, which have emerged over the past 50 years as the most significant bacterial cause of neonatal sepsis, pneumonia, and meningitis. GBS account for 30-50 percent of neonatal bacterial
Studies 31
infections and increases in adult GBS infections have also been noted. This demonstrates that GBS infections remain an important public health problem. We propose to sequence the 2.1 Mb genome of S. agalactiae serotype Ia strain A909 using a genome-wide random shotgun approach. We will then use the final assembled sequence and its complete annotation to perform detailed comparative genomics analyses between serotype Ia and other organisms causing pneumonia and meningitis. These analyses will allow to identify virulence determinants shared by all organisms or specific to individual ones. These determinants will be related to Drs. Jones and Rubens? experiments on signature tagged mutagenesis and TnphoZ translational fusion (identification of secreted proteins) mutant libraries constructed through transposon insertions in strain A909. Regions where transposons inserted will be aligned to the genome sequence to identify the genes affected. A subset of the mutants conserved across serotypes will be analyzed in the rat sepsis model to evaluate their virulence. This collaborative effort will provide extensive preliminary data for future proposals relevant to understanding the pathogenesis of S. agalactiae infections. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GLOBAL PATHOGENESIS
REGULATORY
INTERACTIONS
IN
BACTERIAL
Principal Investigator & Institution: Akerley, Brian J. Microbiology and Immunology; Microbiology and Immunology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: (provided by applicant): Haemophilus influenzae efficiently and chronically colonizes the human nasopharyngeal mucosa, and is capable of causing invasive disease including otitis media, pneumonia, and, more rarely, meningitis. A number of factors involved in H. influenzae virulence have been identified in the pre-genomic era. Taking advantage of the genome sequence and the advent of new technologies, such as global expression profiling, we intend to advance understanding of critical virulence characteristics of this organism. Lipopolysaccharide (LPS) structural modifications are essential virulence determinants for H. influenzae. Using expression profiling with DNA microarrays, complemented by classical approaches, we have recently uncovered a previously unappreciated link between redox regulation and LPS modifications in H. influenzae. In addition, we have isolated a mariner transposon insertion mutation in H. influenzae that disrupts redox control over one such modification (addition of a phosphorylcholine epitope, termed ChoP, to the LPS) and also results in a pronounced colonization defect in an animal model of H. influenzae infection. These observations are of potential significance for in vivo modulation of the LPS structure by environmental signals. We propose to use such signaling and regulatory mutants generated in our laboratory to examine the role of redox signaling in controlling virulence genes in H. influenzae. Global genomic approaches we have developed for studies of H. influenzae will facilitate our analysis of how LPS modifications are modulated in response to environmental conditions. We will also determine whether other genes that play a role in pathogenesis are coregulated, inversely regulated, or constitutively transcribed under the varied redox conditions that affect LPS modification. We believe that these studies will provide important insights into the relationship between physiological adaptations to the host environment and the coordinated production of bacterial cell-surface structures critical for interactions with host cells or for evading the immune response. Specifically, we will: 1. Characterize the redox control mechanisms involved in the regulation of the ChoP cell surface LPS
32 Meningitis
modification. 2. Investigate the role of signaling pathways in H. influenzae in the context of epithelial cell interactions and in a model of respiratory tract infection. 3. Examine coordinate regulation of virulence factors by redox signaling systems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GROUP B STREP TYPE II CONJUGATE VACCINES WITH ALUM Principal Investigator & Institution: Molrine, Deborah C. Director of Clinical Affairs; Children's Hospital (Boston) Boston, MA 021155737 Timing: Fiscal Year 2001 Summary: Phase I, multi-center, randomized, double-blind study. Group B Streptococcus type III - tetanus toxoid conjugate vaccine will be administered to healthy, non-pregnant adult volunteers. A single dose of one of three vaccine concentrations with or without alum will be given intramuscularly. Subjects will be randomized to one of four groups. Backround: Group B Streptococcus (GBS, Streptococcus agalactiae) has been recognized as a major cause of neonatal sepsis and meningitis in the United States for more than 25 years. It is also a significant cause of pregnancy-related morbidity (i.e. bacteremia, chorioamnionitis, urinary tract infection) affecting at least 50,000 women annually in the United States. There has been increased recognition during the past decade that GBS infections are a major public health problem in nonpregnant adults. It has been estimated that in the U.S. about 8,000 cases of GBS disease occur annually among persons 15 years of age and older. Risk factors that hae been identified for GBS disease in nonpregnant adults include age <60 years, chronic illnesses such as diabetes mellitus, cirrhosis, renal failure, neurologic disease, and immunosuppression from cancer or human immunodeficiency virus infection. The spectrum of clinical disease from GBS in adults includes primary bacteremia, skin and soft tissue infections, osteomyelitis, urosepsis, pneumonia, meningitis and endocarditis. Approximately 20% of cases of adult GBS disease are fatal. A strategy to prevent GBS disease through active immunization would potentially be of benefit not only for pregnant women and their newborns, but also for nonpregnant adults with defined risk factors. Purpose: 1) To asses the safety of a single injection of monovalent type III GBS polysaccharide-tetanus toxoid conjugate vaccines at different dosages with or without alum in healthy nonpregnant adults. 2) To determine the effect of an adjuvant, alum, on the immunogenicity of monovalent GBS type III polysaccharide-tetanus toxoid conjugate vaccines. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GROUP B. STREPTOCOCCI AND TOLL-LIKE RECEPTORS Principal Investigator & Institution: Golenbock, Douglas T. Professor, Chief; Medicine; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, MA 01655 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Group B streptococci (GBS) are the leading cause of neonatal sepsis, the third most frequent cause of bacterial meningitis and an increasingly important cause of bacteremia and sepsis in adults in the United States today. Preliminary studies have identified a novel proinflammatory component of GBS, which we have designated GBS-factor (GBS-F). Based on experiments in mice with targeted genetic deletions in Toll-like receptor (TLR) expression and on experiments with engineered cell lines, we have determined that responses to GBS-F require expression of CD14, TLRs 2 and 6, and the Toll-adapter protein, MyD88. Activation of
Studies 33
this receptor complex by GBS-F initiates important signaling events such as the activation of NF-kB, the phosphorylation of MAP kinases, the formation of proinflammatory cytokines, and the intracellular production of the toxic oxidant peroxynitrate. In contrast, although other components of GBS appear to engage TLRs, the exact identity of contributing TLRs is entirely unknown. The overall goal of this proposal is to identify and define components of GBS, focusing first on GBS-F, and their cognate Toll-like receptors (TLRs). We propose to characterize the structure of GBS-F and assess its function in vitro and in vivo. Furthermore, we will determine if TLR2, and related downstream signal transduction molecules, mediate a variety of important innate immune responses to GBS, including leukocyte chemotaxis and the intracellular killing of bacteria. Finally, we intend to determine what other TLRs, and associated signal transduction molecules, are involved in GBS recognition and response. The data learned from these studies should help in the development of rational therapeutic strategies to interfere with the deleterious hyperinflammation triggered by GBS and similar microbial organisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HEALTH BURDEN OF CO INFECTING DEER ASSOCIATED ZOONOTIC CNS DISEASE Principal Investigator & Institution: Krause, Peter; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, CT 060302806 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HEMOGLOBIN MENINGOCOCCI
UTILIZATION
AND
VIRULENCE
OF
Principal Investigator & Institution: Stojiljkovic, Igor; Microbiology and Immunology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-DEC-1998; Project End 30-NOV-2002 Summary: Description (Adapted from the applicant's abstract): Hemoglobin is the most abundant reservoir of iron in the body. Pathogenic microorganisms have developed surface-exposed, Hb-binding receptors that enable the assimilation of Hb-iron. The PI and others have shown that the possession of Hb-binding receptors represents a virulence trait for bacteria. These receptors have, however, only recently become the object of investigation, and our understanding of Hb-iron is therefore very limited at present. In this respect, N. meningitidis, the most common causative agent of meningitis in children in the US, expresses different Hb-iron acquisition systems. The PI has recently identified and partially characterized the Hb-binding outer membrane receptor (HmbR) of Neisseria meningitidis HmbR was expressed in all tested N. meningitidis strains. HmbR is likely a virulence factor because an hmbR mutant was impaired in virulence in an infant rat model. The mechanism and protein domains by which HmbR (or any other Hb bacterial receptor) binds and uses Hb as a source of iron are unknown. To fully understand the role of Hb-iron acquisition in virulence, the PI proposes to identify and characterize all meningococcal systems involved in Hb utilization. The PI and others have identified a second and third Hb- acquisition system of meningococci. The PI will genetically characterize the third system and use welldefined mutants in all three systems to assess the role of Hb-iron acquisition in virulence of meningococci. The study of Hb-iron acquisition systems will not only contribute to
34 Meningitis
our understanding of meningococcal virulence, but could also identify new vaccine targets against N. meningitidis. Finally, understanding Hb-iron acquisition systems may assist scientists in design of a new family of Hb-based blood substitutes that do not increase the risk of infection by Hb-utilizing bacteria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HIPPOCAMPAL DENTATE GYRUS INJURY IN NEONATAL BACTERIAL Principal Investigator & Institution: Pleasure, Samuel J.; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 31-AUG-2007 Summary: Bacterial meningitis in newborns leads to brain damage and subsequent neurologic sequelae including learning and memory deficits. In an infant rat model of neonatal bacterial meningitis, damage to the dentate gyrus of the hippocampal formation occurred regularly and showed two fundamentally distinct forms: (1) Scattered apoptotic injury confined to cells in the subgranular zone and (2) injury of the lower blade of the dentate gyrus with clusters of pyknotic appearing cells. Since the hippocampus is critical for learning and memory function, damage to it may be the basis for the learning deficits in survivors of bacterial meningitis. Indeed, damage to the dentate gyrus was associated with learning deficits in experimental meningitis. The dentate gyrus of the hippocampus is unique in two respects. First, the morphogenesis occurs very late in development in both rodents and humans, perhaps making it more vulnerable to pathologic insult at later developmental stages than other brain regions. Second, the dentate gyrus is a continuously developing system throughout life, containing progenitor cells able to multiply and give rise to new neurons. This has been implicated in the ability to form new memories and learn new tasks later in life. In meningitis, the progenitor cells appear to be selectively damaged. We will test the hypothesis that bacterial meningitis in young animals leads to selective damage within the dentate gyrus, including the progenitors or their immediate progeny, giving rise to neuroanatomical and functional abnormalities that underlie some of the permanent neurologic deficits affecting survivors of bacterial meningitis. Specifically, we will determine the nature of cell death in the dentate gyrus (apoptosis or necrosis); we will identify the cells damaged by the meningitic process )progenitor cells, immature or mature granule cell neurons, interneurons, glia); we will identify pathophysiologic factors leading to cell death (e.g., ischemia, excitatory amino acids, oxygen radicals, cytokines); and we will define in adult animals the neuroanatomical and functional consequences of damage to the immature dentate gyrus. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HUMAN ANTIBODIES TO CRYPTOCOCCUS NEOFORMANS Principal Investigator & Institution: Pirofski, Liise-Anne A. Professor; Medicine; Yeshiva University 500 W 185Th St New York, NY 10033 Timing: Fiscal Year 2001; Project Start 01-DEC-1993; Project End 30-NOV-2003 Summary: (Adapted from the Applicant's Abstract): Cryptococcal meningitis remains a cause of morbidity and mortality in HIV-infected (HIV+) individuals and new modalities are needed for therapy. Profound CD4+ T cell deficiency is found in HIV+ individuals with cryptococcosis, though only a subset of patients develop infection. Therefore, additional immunologic defects probably predispose some patients to cryptococcal infection. In the previous grant period, this group demonstrated
Studies 35
differences in the specificity and titer of antibodies to GXM in HIV- and HIV+ individuals. These groups are relatively resistant and susceptible to infection, respectively. The authors showed that human antibodies to GXM are derived from VH3 genes. Together with others' reports of decreased VH3 positive B cells in HIV+ individuals, their findings support the idea that combined with underlying cellmediated immunity, qualitative and quantitative differences in antibodies to GXM may play a role in the protection of HIV-, and susceptibility of HIV+ individuals to cryptococcosis. This hypothesis will be investigated in this proposal with 3 interrelated aims. First, the authors will use purified antibody subsets from HIV- and HIV+ individuals to determine if idiotype and isotype-specific subsets of antibodies to GXM alter the course of experimental cryptococcosis in normal and immunodeficient mouse strains. In this aim they will also construct and compare VH3 gene libraries from B cells of HIV- and HIV+ individuals with and without cryptococcosis to determine if the frequency of specific VH3 gene segment expression of somatic mutation is correlated with resistance or susceptibility to C. neoformans. Second, they will generate human mAbs to GXM in human immunoglobulin transgenic mice by splenic fusion and determine their VH3 usage, specificity, and functional efficacy in vitro and in experimental cryptococcosis. Third, they will isolate peptide epitopes of the mAbs from phage libraries and use them to compare the specificity of antibodies to GXM from HIVand HIV+ individuals with and without cryptococcosis. The authors believe that these studies will reveal if antibody repertoire differences contribute to cryptococcal pathogenesis and provide novel human mAbs and peptide mimotopes for passive and active vaccination approaches for therapy of human cryptococcosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HUMAN CELLULAR IMMUNE RESPONSES TO LEPTOSPIRA Principal Investigator & Institution: Klimpel, Gary R. Microbiology and Immunology; University of Texas Medical Br Galveston 301 University Blvd Galveston, TX 77555 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Leptospirosis, a zoonotic disease caused by spirochetes of the genus Leptospira, is transmitted to humans via urine of infected mammals. Found worldwide in temperate and tropical climates, it is a public health threat in the U.S. and abroad. Human infections by Leptospira have a broad spectrum of clinical manifestations, ranging from asymptomatic seroconversion to undifferentiated febrile syndrome, with or without aseptic meningitis, to fulminant jaundice, renal failure and hemorrhage with a fatality rate up to approximately 25%. There is no vaccine to prevent human leptospirosis and veterinary vaccines may not be used in humans because of toxicity. Little is known about how this organism interacts with human lymphocytes and/or the mechanisms of leptospiral pathogenesis or immunity. We propose to examine molecular and cellular interactions of Leptospira with human peripheral blood mononuclear cells (PBMC) with a focus on different T cell populations. We have found that leptospires activate T cells in PBMC from Leptospira-naive humans, leading to proliferation and production of high IFN gamma levels. Our hypothesis is that Leptospira activation of T cells expressing the alpha/beta or gamma/delta form of the T cell receptor for antigen plays an important regulatory role in protective immunity and immunopathogenesis associated with human infections due to Leptospira spp. Our aims are to: 1) Determine the cell:cell interactions and cytokine profiles of PBMC cultures exposed to Leptospira, and characterize the phenotype, function, and specificity of T cells activated in such cultures; 2) Identify and purify Leptospira components that activate T cells; and 3) Determine the relationship between peripheral blood T cell
36 Meningitis
phenotype and function and disease severity of human leptospirosis patients in an endemic region in the Peruvian Amazon. Learning how Leptospira interact with the human immune system will lead us to understand the pathogenesis of leptospirosis and how to develop vaccines and strategies to control the associated pathology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IDENTIFYING AND REDUCING ERRORS WITH SURGICAL SIMULATION Principal Investigator & Institution: Fried, Marvin P.; Montefiore Medical Center (Bronx, Ny) Bronx, NY 104672490 Timing: Fiscal Year 2001; Project Start 27-SEP-2001; Project End 31-AUG-2004 Summary: The training of a surgeon requires the acquisition of a number of characteristics. These include a knowledge base (cognitive), problem formulation, decision processing, psychosocial relationships and others that can be evaluated and graded by objective testing such as National Board or Specialty Certifying examinations. Critical to the surgeon are the technical skills that are at the core of the profession. This proposal responds to the need to create a battery of sophisticated devices and objective measurements to teach and evaluate the inherent technical ability of trainees. We hypothesize that by innovative, state- of-the-art simulation, devices that train both surgical tasks and skills through repetitive proctored challenges, without risk to patients, will allow for detection and analysis of surgical errors and "near misses". In an analogy to flight simulation, "near miss" detection is where potential errors are found and complications prevented Using a number of otolaryngology residencies, a controlled training curriculum will be developed based on complimentary simulation tools [the endoscopic sinus surgery simulator (ES3), minimally invasive surgical trainer virtual reality (MIST VR), perceptual and 3- dimensional testing] with objective metrics used for assessment of trainees. Technical errors will be identified, quantified and used to train and monitor surgical performance and for outcomes analysis to improve patient safety. Some current validated metrics include: time- to-completion, errors, economy of motion and psychomotor tracking. Correlation with psychometric parameters (perception, psychomotor, visio-spatial, cognitive mapping, etc.) will be used to identify technical errors and to validate both the simulator and the curriculum. The collaborating investigators and institutions have expertise in the areas of metrics, curriculum, database development, simulator creation and modification, and outcomes analysis. Endoscopic sinus surgery is the operation substrate since it is frequently performed (greater than 300,000 procedures annually) and carries a significant risk of injury to the contiguous structures ofthe eye (loss of vision and /or eye motion) and brain (CSF leakage, meningitis, death). The ES3 is also the most advanced surgical simulation device existing and based largely on jet pilot flight simulation (Lockheed Martin). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMMUNOSENESCENCE AND CHLAMYDIA PNEUMONIAE Principal Investigator & Institution: Fresa, Kerin L. Pathology, Microbio/Immunology; Philadelphia College of Osteopathic Med 4170 City Ave Philadelphia, PA 19131 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 30-APR-2004 Summary: (the Applicant's Abstract): With increasing age, there is increased incidence and severity of infectious diseases, including pneumonia, meningitis and sepsis, as well as many non-infectious diseases including cancers, heart disease, Alzheimer' s disease and other dementias. The obligate intracellular bacterial parasite Chlamydia
Studies 37
pneumoniae is an established pathogen for respiratory infection. Recent evidence from a number of laboratories suggests that C. pneumoniae may be a factor in the pathogenesis of a number of non-respiratory diseases including Alzheimer's disease and atherosclerosis. It has been repeatedly hypothesized that increased incidence of infectious and other diseases with age may be the result of age alterations in the immune system, particularly in cell mediated immune reactions. It is well established that T cell function, as measured in vivo by delayed type hypersensitivity reactions and in vitro as proliferative responses to antigenic or mitogenic stimulation, both decline with age. While infection with C. pneumoniae as well as other Chlamydial species induces production of antibodies, recent evidence suggests that cell mediated immune mechanisms play a key role in recovery from infection as well as immunopathology associated with Chlamydial infection. It has not been established whether old animals are able to clear infection by C. pneumoniae or remain chronically infected. It also remains unknown whether the immune response, particularly the cell-mediated immune response, to acute chlamydial infection is altered with age. Finally, the extent to which the cell-mediated immune response to Chlamydia, or lack thereof, contributes to the pathogenesis of diseases such as atherosclerosis or Alzheimer's disease is entirely speculative. We propose here to begin to address these issues in a mouse model. The working hypothesis is that the cellular immune response against C. pneumoniae declines with age. The Specific Aims of this project are: 1) To assess whether aging is associated with alterations in the clinical course of experimental intranasal infection of mice by C. pneumoniae; and 2) To assess whether there are age-associated changes in the immune response to C. pneumoniae. Specifically, we will examine proliferative responses, generation of cytotoxic T cells, and production of Th1 associated cytokines (IL-2 and IFN-g). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INHIBITORS OF KD08-PHOSPHATE SYNTHASE AS ANTIBIOTICS Principal Investigator & Institution: Green, David W.; Cubist Pharmaceuticals, Inc. 65 Hayden Ave Lexington, MA 02421 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 29-SEP-2002 Summary: (provided by applicant): The increasing occurrence of pathogenic bacteria that are resistant to historically successful antibiotics has driven the need to develop new classes of drugs that have a unique mechanism of action. Gram-negative pathogens pose a serious health threat as they can be the causative agents of life-threatening conditions such as septicemia (Escherichia coli), meningitis (Haemophilus influenzae) or pyrogenic infections in burn patients and diabetics (Pseudomonas aeruginosa). 3deoxy-D-manno-octulosonic-8-phosphate synthase (KDO8PS; EC 4.1.2.16) has been demonstrated to be an essential enzyme for gram-negative pathogen viability as it carries out a key step in the biosynthesis of the outer membrane lipopolysaccharide component, namely the condenstaion of phosphoenolpyruvate and arabinose-5phosphate to form 3-deoxy-D-mann-octulosonic-8-phosphate. We propose to identify inhibitors of KDO8PS that can be further developed into antibiotics for use in treating infections by gram-negative pathogens. The specific aims are to clone and express the gene for KDO8PS from E. coli and P. aeruginosa, purify the enzyme to homogeneity, and develop assays for high throughput screening and compound characterization that can be used to identify and develop inhibitors of KDO8PS as potential antibiotics. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INOS AND COX2 CEREBRAL BLOOD VESSELS Principal Investigator & Institution: Faraci, Frank M. Professor; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2001 Summary: Endothelial and neuronal isoforms of nitric oxide synthase (NOS) appear to play a major role in regulation of cerebral circulation. The overall objectives of this project is to examine the influence of inducible NOS II and inducible cyclooxygenase (COX-2) on cerebral blood vessels. Both NOS II and COX-2 may be expressed in blood vessels in response to proinflammatory stimuli and under some pathophysiologi-cal conditions. The investigators propose to examine the influence of NOS II and COX-2 on vascular tone and permeability of the blood-brain barrier, and to examine mechanisms which regulate expression of these genes. To define the role of NOS iI in cerebral vessels, studies will now be performed using two state-of-the-art molecular approaches - NOS II knockoutmice and local overexpression using adenoviral- mediated gene transfer of NOS II. The functional importance of nuclear factor-Kappa Beta in mediating these responses will be examined. There may be interactions between the NOS and COX systems. Studies in NOS II knockout mice will allow examination of the functional importance of COX-2 in the presence and absence of NOS II. Interleukin-10 (IL-10) is an anti-inflammatory cytokine which protects against endotoxin shock. The role of IL- 10 in blood vessels is not known. Using IL-10 knockout mice, we plan to examine the hypothesis that interleukin 10 is a major endogenous regulator of expression of NOS II and COX-2 in cerebral vessels. Preliminary data support this hypothesis. Thus, state-ofthe-art approaches will be used to study the role of NOS II, COX-2, and IL-10 in cerebral blood vessels. The studies should provide new insight into regulation of the cerebral circulation. Expression of these genes may be important in brain under several pathophysiological conditions including meningitis, ischemia, and in response to inflammatory stimuli. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IPC1 ROLE IN REGULATION OF PHAGOCYTOSIS OF C NEOFORMANS Principal Investigator & Institution: Del Poeta, Maurizio; Medical University of South Carolina 171 Ashley Ave Charleston, SC 29425 Timing: Fiscal Year 2002; Project Start 26-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): The long-term objective of this project is to elucidate the roles, mechanisms, and functions of inositol-phosphoryl ceramide synthase 1 (Ipc1) in cell regulation and fungal pathogenesis, focusing on Cryptococcus neoformans. Cryptococcus neoformans is an opportunistic pathogen that primarily infects immunocompromised patients. Infection initiates in the lung following inhalation, spreads hematogenously to the brain, and results in meningoencephalitis. It is the most common cause of fungal meningitis worldwide (8, 56). Since the lung is the port of entry for C. neoformans, phagocytosis by alveolar macrophages represents the first host immune response against the fungal organism. If phagocytosis succeeds by killing the organism there will be no disseminated disease. On the other hand, C. neoformans possesses the ability to produce virulence factors, which protect the fungal cells from the phagocytosis and/or the killing by the host alveolar macrophages. Therefore, the determination of how this opportunistic pathogen interacts with alveolar macrophages will lead to the understanding of the molecular mechanism(s) by which C. neoformans disseminates and, thus, produces disease. Ipc1 is a fungus-specific enzyme encoded by
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the essential IPC1 gene (also called AUR1). It regulates the formation of complex sphingolipids (essential components of the membranes), the levels of phytoceramide and sphingoid bases (implicated in stress responses), and diacylglycerol (a wellestablished mitogen and activator of protein kinase C). Therefore, the regulation of Ipc1 might represent an important factor in the maintenance of crucial cellular functions. In the case of a fungal opportunistic pathogen (such as C. neoformans), the impairment of Ipcl activity could exert a significant impact on host-fungus interactions, either by modification of the production of virulence factors (fungal-factors) or/and by modification of the immune responses (host-factors). In our previous studies, we regulated the expression of the essential IPC1 gene by using the GAL7 promoter. We found that C. neoformans is no longer pathogenic in an animal model of cryptococcal meningitis when Ipc1 is down-regulated (54). In our ongoing studies to understand how Ipc1 regulates Ohyto Ipc1 pathogenicity of C. neoformans, we find that downregulation of Ipc1 increases phagocytosis whereas up-regulation of lpc1 decreases phagocy:tosis by the host alveolar macrophages. In preliminary epistasis analysis, we identified, through differential display RT-PCR, a novel protein, inhibitory protein 1 (IPI), which exerts antiphagocytic property, and whose level of expression is regulated by lpc1. Based on these observations, we HYPOTHESIZE that Ipc1 regulates the pathogenicity of C. neoformans in part by affecting its phagocytosis through the expression of lPI. Therefore we will: Specific Aim 1. To determine the mechanisms by which Ipc1 regulates IPI. Since Ipcl regulates in opposing directions the levels of two bioactive molecules, phytoceramide and DAG, and activates the transcription of IPI, we hypothesize that IPI expression is modulated by a transcription factor, which could be regulated by the level of phytoceramide or DAG. Therefore, in this specific aim we will: A) evaluate the transcriptional activation of IPI by Ipc1; and B) determine the effect of phytoceramide and DAG on this mechanism of regulation. Our hypothesis predicts that Ipcl regulates IPI at the transcriptional level and these studies will allow us to establish whether the lipids modulated by Ipc1 regulate this molecular mechanism through a transcription factor. Specific Aim 2. To establish the role of IPI in the regulation of pathogenicity of C. neoformans. Since IPI exerts an anti-phagocytic effect, we hypothesize that the increase of IPI by Ipc1 protects fungal cells from alveolar macrophages. Therefore in this specific aim we will: A) establish the effect of modulation of IPI on phagocytosis by alveolar macrophages; and B) determine the role of IPI on virulence of C. neoformans in the animal models. Our hypothesis predicts that IPI represents a virulence factor, protecting the fungal cells against phagocytosis by alveolar macrophages. Using our animal models, these studies will allow us to determine the impact of IPI on the initiation and the consequent dissemination of the infection from the lung to other organs and tissues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IRON ACQUISITION AND PNEUMOCOCCAL INFECTION Principal Investigator & Institution: Tai, Stanley S.; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2001 Summary: Children under two years of age, the elderly, and individuals with underlying disease are to great risk of developing pneumococcal otitis media, septicemia, meningitis, and pneumonia. Antibiotic prophylaxis and vaccination are the two major methods to treat and prevent invasive pneumococcal infections. However, the success of antibiotic treatments has been limited by the recent isolation of penicillinor multi-drug resistant pneumococci. The current pneumococcal vaccine, a mixture of
40 Meningitis
capsular polysaccharide of 23 most prevalent of possible 84 stereotypes, only elicits type-specific antibodies and can not provide protection against infection of other Streptococcus pneumoniae serotypes not used in the vaccine preparation. To control pneumococcal disease would require a new knowledge about the biology of S. pneumoniae. The long range goal of this investigation is to study how S. pneumoniae survives in infected animals where most of iron molecules are sequestered by ironbinding proteins, such as hemoglobin, transferrin, and lactoferrin. Iron limitation restricted the growth of S. pneumoniae and the limited growth could be restored by the addition of hemin or hemoglobin. Pneumococcal cells have a great ability to bind hemin. Several hemin binding proteins have been identified in the cell lysate of S. pneumoniae with the major species migrated as a molecular mass of 43 kDa. The specific aims of this proposal are employing genetic and immunological methods to seek answers to the following question: 1). What is the genetic determinant of 43-kDa hemin binding protein? 2). What roles does 43-kDa HBP play in the hemin acquisition of S. pneumoniae? 3) What roles does 43-kDa HBP play in S. pneumoniae infection in experimental animals? Results generated from the proposed studies not only will provide us with basic information about the iron acquisition of S. pneumoniae, but will allow us to gain insight into the pathogenic mechanism of S. pneumoniae disease. The knowledge obtained in this study will have practical applications as well in designing effective therapeutic strategy and agents for the control of pneumococcal disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ISCHEMIC BRAIN INJURY IN NEONATAL MENINGITIS Principal Investigator & Institution: Tauber, Martin G.; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2001 Summary: Approximately 15,000 cases of bacterial meningitis occur each year in the United States. Meningitis in newborns has a particularly poor prognosis with mortality rates up to 35% for cases caused by group B streptococci (GBS), a major pathogen of neonatal meningitis. Only 50% of survivors of GBS meningitis are neurologically intact, while 21% have severe neurologic sequelae, including global mental retardation, cerebral palsy, and uncontrolled seizure disorder's. The goal of our research is to identify the mechanisms that lead to brain injury in neonatal meningitis in order to develop new therapies that protect the brain. The hypotheses to be tested in the present grant are (1) meningitis leads to global and focal Cerebral blood flow changes; (2) cerebral blood flow is modulated by the interplay of vasodilative and vasoconstrictive mediators; (3) ischemia resulting from cerebral hypoperfusion is a major factor leading to brain damage; and (4) hallmarks of parenchymal brain damage include the release of excitatory amino acids and activation of glial cells (as evidenced by the expression, of cytokines). These hypotheses will be tested in an infant rat model of neonatal meningitis that closely mimics the human disease and in primary cultures of neurons, astrocytes, and microglia. The project has five specific aims: 1. To analyze cerebral blood flow in a rat model of GBS neonatal meningitis and to correlated blood flow changes with the occurrence of tissue hypoxia and the development of neuronal injury. 2. To identify molecular mediators involved in the modulation of cerebral blood flow in the rat model of GBS neonatal meningitis. Using specific inhibitors/agonists, we will focus on the role of nitric oxide as potentially beneficial vasodilator and on endothelin as potentially harmful vasoconstrictor. 3. To examine the contribution of excitatory amino acids (EAA)to neuronal injury in the infant rat model of GBS meningitis by determining whether animals treated with different EAA antagonists have reduced brain injury
Studies 41
compared to control animals. 4. To characterize glial cell activation and the expression of selected cytokines (IL-1beta, TNF-alpha, IL-6, TGF-beta) in the GBS meningitis rat model. We will also examine the contribution of cytokines to the development of brain injury in the model: 5. To analyze in primary cultures in vitro which of the factors that play a role in the pathophysiology of meningitis lead to cytokine expression in glial cells, either by direct stimulation of glia or through thee effect on neurons. We will also examine whether the cytokines induced in glial cells have a beneficial or harmful effect on neuronal injury caused by EAA and ischemic conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ISOLATION AND CHARACTERIZATION OF GBS VIRULENCE GENES Principal Investigator & Institution: Clancy, Kathryn A.; Children's Hospital and Reg Medical Ctr Box 5371, 4800 Sand Point Way Ne, Ms 6D-1 Seattle, WA 98105 Timing: Fiscal Year 2001; Project Start 01-AUG-2001 Summary: Group B streptococci (GBS) are the leading cause of human neonatal pneumonia, sepsis and meningitis in the United States. The high incidence of infant mortality associated with GBS infection has led to a significant research effort focused on GS pathogenesis and the identification of virulence-related factors. However, the characteristics of GBS that are critical to the virulence of this pathogen and disease progression largely remain unknown. The long-term goals of this proposal are to gain a better understanding of the molecular basis for BS virulence in the human host and to identify important protein targets for the development of preventative and therapeutic measures such as vaccines and novel antimicrobials. Specifically, the aims of this proposal are to isolate putative virulence proteins from GBS and investigate the role of these proteins in the disease process. Gene fusion technology using alkaline phosphatase as a reporter enzyme will be employed to isolate secreted proteins from GBS, which are thought to be enriched for factors that participate in bacterial-host cell interactions, and have been shown to contribute to bacterial virulence in other microbial systems. Bacterial strains deficient for the putative protein effectors will be constructed and examined in vivo animal sepsis and infection models, which, in concert with in vitro cell-culture adherence and invasion assays, will help to characterize the function of the identified proteins and their importance in disease. The isolation of putative protein effectors from GBS is hoped to help identify future targets for therapeutic studies and development to provide treatment and protection against GBS infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LEUKOCYTE TRANSMIGRATION IN NEONATAL CANDIDA MENINGITIS Principal Investigator & Institution: Lossinsky, Albert S.; Huntington Medical Research Institutes 734 Fairmount Ave Pasadena, CA 91105 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2005 Summary: (provided by applicant): Neonatal meningitis produced by opportunistic pathogenic microorganisms such as the yeast Candida albicans is an inflammatory condition that can occur during the first month after birth and is a leading cause of neurodegenerative states and morbidity in premature and immunocompromised infants. Meningitis in neonates is attributable to the incomplete development of the CNS, the blood-brain barrier (BBB) and the immune system. The precise nature of adhesion and transmigration of pathogenic organisms and leukocytes across the BBB
42 Meningitis
during inflammatory conditions remains unclear and is an issue of great interest in modern medicine. This research program will focus at the mechanisms of adhesion and transmigration of C. albicans and inflammatory leukocytes that appear in response to the microorganisms during the process of meningitis. Our study will be conducted in an in vivo model of experimentally induced meningitis in neonatal rats. Our hypothesis states that the pathogenic yeast C. albicans initially induce the inflammatory state in the meningeal blood vessels. Subsequently, leukocytes adhere to and traverse the endothelial cell (EC) barrier stimulated by the local release of chemoattractant substances in response to the yeast cells. The entire process of adhesion and transmigration across the BBB is facilitated by adhesion molecules including ICAM-1, PECAM-1 and VCAM-1 either across the ECs by a transcellular pathway, through EC junctional complexes by a paracellular pathway, or by both mechanisms. Our specific aim of the project will be to define and compare the light microscopic, immunohistochemical, ultrastructural and immunoultrastructural nature of adhesion and transmigration of a virulent strain of C. albicans, and the different major subsets of inflammatory leukocytes including neutrophils, mononuclear cells and lymphocytes that appear in response to the yeast-induced meningoencephalitis in neonatal rats. This will lay the groundwork for us to investigate how adhesion molecules regulate the attachment and transmigration of pathogenic yeast cells and leukocytes across the BBB via specialized anatomical "gateways to the brain" through either modified EC conduitlike structures, open EC junctional complexes or by both pathways. Such studies will hopefully establish a framework that may lead to the development of therapeutic intervention for the treatment of neonatal meningitis and several other inflammatory conditions of the CNS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LISTERIA AND SHIGELLA USE HOST CELL ACTIN Principal Investigator & Institution: Southwick, Frederick S. Professor; Medicine; University of Florida Gainesville, FL 32611 Timing: Fiscal Year 2002; Project Start 01-JUL-1993; Project End 31-MAY-2007 Summary: (provided by applicant): The gram-positive bacillus Listeria monocytogenes predominantly infects immunocompromised patients, causing bacteremia and meningitis while the gram-negative bacillus Shigella flexneri infects normal hosts causing severe diarrhea and dehydration. The pathogenesis of Listeriosis and Shigellosis absolutely requires these intracellular bacteria to usurp the host cell's contractile system. Listeria and Shigella induce host cell actin to assemble into rocket tails that rapidly propel the bacteria through the cytoplasm, allowing their cell-to-cell spread and avoidance of the humoral immune system. Actin assembly occurs in a discrete polymerization zone directly behind the motile bacteria. This region blocks the host cell actin-regulatory proteins, gelsolin, CapZ and CapG, that normally cap the fast growing ends of actin filaments. This blocking activity allows actin filaments to rapidly assemble in this discrete zone. Two of these proteins, gelsolin and CapG, require micromolar calcium to function. We will: Aim I - Elucidate how Listeria blocks barbed end-capping proteins in the polymerization zone. Pyrenyl actin and right angle light scattering will be used to examine how profilin combined PIP2 and VASP or N-WASP effects actin filament capping by CapG, CapZ and gelsolin. Capping inhibition by Listeria will be investigated in brain cell free extracts before and after depletion of profilin and VASP. Localization of PIP2 (well known to block capping activity) in Listeria and Shigella infected cells will be studied using a GFP labeled probe. The effects of blocking PIP2 production using the PI kinase inhibitors Wortmannin and quercetin, infecting cells
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with Listeria ActA mutants lacking PIP2 binding sites, and ActA mutants lacking VASP binding sites will be examined. Aim II - Study the Calcium-Dependence of Listeria and Shigella actin-based motility. Calcium is a critical signal for turning on and off actin regulatory proteins, and we have found that the chelator BAPTAM blocks Shigella actinbased motility and slows the disassembly of Listeria rocket tails. The Ca2+-sensitivity of N-WASP and vinculin, cell proteins unique to Shigella-induced actin assembly, as well as gelsolin will be studied. These investigations should clarify key regulatory pathways required for Listeria- and Shigella-induced actin assembly and may identify new therapeutic targets for treating Listeriosis and Shigellosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LISTERIA PROTEINS EFFECTS ON CELL FUNCTION Principal Investigator & Institution: Potter, Terry A. Associate Professor; National Jewish Medical & Res Ctr and Research Center Denver, CO 80206 Timing: Fiscal Year 2001; Project Start 01-JUL-1997; Project End 30-JUN-2003 Summary: (Adapted from applicant's abstract): The bacterium Listeria monocytogenes (LM) is a widespread, food borne pathogen that is responsible for periodic outbreaks of disease, causing gastrointestinal disease, sepsis, and in some cases, fatal meningitis. Listeriosis is often associated with an immunocompromised state, and in AIDS patients, it occurs at an incidence approximately 300 times greater than that found in the nonAIDS population. LM is taken up by different cells including macrophages. Upon internalization by macrophages, the bacterium can have two possible fates: (1) It can escape into the cytoplasm where it can replicate and subsequently invade other cells; (2) It remains within a phagocytic vesicle and is killed. They have obtained preliminary evidence which suggests that the pathway leading to either of these two possible outcomes is dictated by the mode of entry of the bacterium into the macrophage. If LM is taken up via the receptor for the third complement component (CR3), it does not escape into the cytoplasm and is killed. If LM enters a macrophage by binding of the bacterial internalin A (InlA) molecule to an as-yet unidentified surface molecule on the macrophage, the bacterium escapes into the cytoplasm and replicates. By analogy to the uptake of other bacteria, it is likely that the signal transduction events associated with the cell surface receptor molecules are initiated upon binding of LM to the macrophage. In this proposal they will conduct experiments to test the hypothesis that LM that enter a macrophage via interaction between InlA and its receptor will not be killed by the macrophage. First, they will define the role of In1A in binding, phagocytosis, and killing of LM by listericidal versus nonlistericidal macrophages. Second, they will delineate the molecular events within macrophages resulting from interaction between LM In1A and its putative macrophage receptor. They will define the signal transduction events which occur following binding of LM to the putative In1A receptor, and compare them to events initiated upon binding of LM to CR3. Third, they will attempt to identify, characterize and isolate the In1A receptor. These experiments should provide valuable information on the interaction of LM with phagocytic cells and may provide insights into the phagocytosis and killing of other intracellular bacteria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: M DESIGN/EVALUATION
TUBERCULOSIS
CTL
EPITOPES:
VACCINE
Principal Investigator & Institution: Clayberger, Carol A. Associate Professor; Cardiovascular Surgery; Stanford University Stanford, CA 94305
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Timing: Fiscal Year 2003; Project Start 15-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Tuberculosis (TB) is the leading cause of death from a single infectious agent (Mycobacterium tuberculosis (Mtb)), causing approximately 3,000,000 deaths each year. Although TB can be effectively treated with a combination of antibiotics, drug resistant Mtb strains have recently emerged which are classified as Category C biological agents. Thus, it is widely felt that the long term control of TB will require the development of a more effective vaccine. Mycobacterium bovis Bacille Calmette-Guerin (BCG), the current anti-TB vaccine, is quite variable in its ability to protect against TB but is effective against tuberculosis meningitis, suggesting that for the foreseeable future, new TB vaccines will be given as an adjuvant or boost to BCG. Thus, understanding the immune response to both Mtb and BCG is critical for the development of an improved vaccine for TB. An increasing body of evidence indicates that both CD4+ and CD8+ T lymphocytes are critical to a protective immune response against Mtb. However, little is known about the antigens targeted by protective immune responses against Mtb in humans. Such information is required for the rational development and clinical evaluation of new, more effective TB vaccines. We propose here to characterize the human CD4+ and CD8+ T cell response to a panel of Mtb antigens in order to identify correlates with protective immunity. Antigens to be tested include proteins as well as peptide epitopes restricted by HLA-A2, an allele expressed by approximately 50% of the population. Some of these proteins and epitopes were selected from a subset of Mtb genes that are highly expressed under specified conditions and whose products are predicted to localize to the extracellular milieu, while the remainder represent previously identified HLA-A2 restricted epitopes. The T cell response to these antigens will be evaluated in peripheral blood leukocytes from three different groups of BCG immune and/or Mtb infected individuals: i. Neonates immunized a birth with one of 4 strains of BCG; ii. Individuals infected with Mtb but who do not progress to disease (latent TB infected individuals); and iii. PPD+ TB patients and PPD- "anergic" TB patients. Some of these peptide epitopes will be used to develop epitope oligomers which will be used to analyze anti-Mtb responses In vitro and in vivo. Lastly, the localization and function of Mtb peptide specific memory T cells will be studied in vivo. Correlates of protective immunity can be used to identify or prioritize protective antigens and vaccine candidates, to optimize vaccine dosing, schedules, adjuvants, etc., and to provide early evidence of efficacy. For TB, which takes years to decades to develop after infection with Mtb, immune correlates with protection are an attractive, and perhaps essential, supplement to efficacy trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MASS SPECTROMETRY OF BACTERIAL GLYCOCONJUGATES: HAEMOPHILUS DUCREYI & AIDS Principal Investigator & Institution: Gibson, Bradford; Professor; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2001; Project Start 01-MAR-2000; Project End 28-FEB-2002 Summary: The major emphasis of this project is to apply and advance mass spectrometric methods for the analysis of bacterial glycoconjugates. Our major scientific goal is to obtain an understanding of the structures and functions of the surface glycolipids or lipooligosaccharides (LOS) from pathogenic Neisseria and Haemophilusspecies. These studies include Haemophilus influenzae, Haemophilus ducreyi, Neisseria meningitidis and Neisseria gonorrhoeae. Hemophilus influenzae is responsible for a variety of serious adult and infant diseases e.g., meningitis, pheumonia. Haemophilus ducreyi causes the sexually transmitted disease, chancroid,
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which has also been identified as a significant independent risk factor in the transmission of AIDS. LOS components from these organisms contain some of the major epitopes or antigenic determinants, and we have shown that many of them are similar to glycolipid structures present in human tissue. One of our current hypothesis is that the similarity to human glycoconjugates is a form of host mimicry, perhaps providing a means for the bacteria to evade the host defenses, or to adhere and/or invade various human cell types. In H. ducreyi, we have shown the most strains contain LOS that are sialylated, and differences in sialylation have been correlated to its cytotoxicity and ability to adhere to human skin cells. An understanding of the structures and immunochemistry of LOS from these pathogenic bacteria could provide the means to develop a carbohydrate-based vaccine and/or drugs that could interfere with key evasion or adhesion processes. In addition, we will plan to investigate the structure of an important adhesion molecule, presumably belonging to the glycosylaminoglycan glyconjugate structure class, in pathogenic Chlamydia trachomatis. Therefore, we propose to develop more sensitive mass spectrometric-based strategies for the structural characterization of these bacterial glycoconjugates. Our ultimate aim is to develop massspectrometric techniques that will have the sensitivity to analyze samples directly from clinical samples (picomole to femtomole amounts) without in vitro growth, which is known to alter the distribution and abundances of the outermembrane lipooligosaccharides. We propose to use both electrospray and matrix-assisted laser desorption ionization methods to achieve this latter goal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MATRIX METALLOPROTEINASES AND THE BLOOD-BRAIN BARRIER Principal Investigator & Institution: Rosenberg, Gary A. Chairman & Professor; Neurology; University of New Mexico Albuquerque Controller's Office Albuquerque, NM 87131 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Matrix metalloproteinases (MMPs) disrupt the blood-brain barrier (BBB) in many neuroinflammatory diseases. They are secreted as latent enzymes, which are activated by proteases and free radicals and inhibited by tissue inhibitors of metalloproteinases (TIMPs). Gelatinase A (MMP-2) and B (MMP-9) attack extracellular matrix around blood vessels. Cell cultures of astrocytes produce latent MMP-9 when stimulated by lipopolysaccharide (LPS), and microglia form active MMP-9. Microglia secrete stromelysin- 1 (MMP-3), which may be the activator of MMP9. Intracerebral injection of LPS induces cytokines, free radicals, and proteases that simulate the neuroinflammatory response by producing active forms of the MMPs and opening the BBB. We hypothesize that the balance between the MMPs and the TIMPs controls the permeability of the BBB, and that MMP-3 contributes to the BBB damage by activation of proMMP-9, while TIMP-3 protects the BBB by inhibiting the MMPs. To test the hypothesis, we propose to use mice lacking the MMP-3 or TIMP-3 genes. Specific Aim 1: To determine the relationship of the expression of the cytokines, MMPs, and TIMPs to the BBB damage after an intracerebral injection of LPS in mice. 3H-sucrose (m.w. 342) and 14C-dextran (m.w. 50-90 kDa) will be used for BBB permeability measurements. Expression of mRNA for TNF-alpha, IL-1beta, MMP-2, -3, and -9, and TIMP-1 and -3 will be measured by realtime rtPCR. Zymography and immunohistochemistry of the MMPs and TIMPs will be used to determine proteins and cellular localization. Specific Aims 2 and 3: To study the role of MMP-3 (aim 2) and TIMP-3 (aim 3) in BBB proteolysis by the use of MMP-3 and TIMP-3 null mice. BBB
46 Meningitis
permeability will be measured with radiolabeled tracers, and the effect of gene knock out on the production and activation of the MMPs will be measured by zymography and rt-PCR. Specific Aim 4: To identify the molecular mechanisms involved in the protection of the BBB by corticosteroids, tetracycline derivatives, and synthetic MMP inhibitors. BBB disruption is a major factor in multiple sclerosis, Guillain-Barre Syndrome, meningitis, and cerebral bleeding after thrombolysis. Understanding the molecular events in the BBB disruption by MMPs will provide a rational basis for drug design, and will lead to novel treatments in many important neurological diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISM OF ANTIBODY PROTECTION AGAINST C. NEOFORMANS Principal Investigator & Institution: Morrison, Sherie L. Professor and Chair; Microbiol & Molecular Genetics; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2003; Project Start 01-DEC-2002; Project End 30-NOV-2007 Summary: (provided by applicant): Cryptococcus neoformans causes a lethal meningoencephalitis in 8 percent of AIDS patients in the US. Current treatment is inadequate as 10-20 percent of patients die from cryptococcal meningitis despite aggressive antifungal therapy, and individuals who survive beyond the initial treatment period must be maintained on life-long therapy to prevent relapse. Because of these therapeutic limitations, antibodies have been considered as prevention and treatment for C. neoformans infection. Anti-capsular monoclonal antibodies can prolong the life of lethally infected mice and increase the effectiveness of antifungal agents in vivo. Previous observations indicate that functions mediated by the constant regions of these antibodies are crucial in determining their protective potential. Consistent with this idea are preliminary studies we have done in genetically deficient mice showing that antibody interactions with certain Fc receptors (FcRs) are important in mediating protection, while the presence of complement may be detrimental to antibody efficacy, particularly in the absence of FcR binding. Over the past several years, we have developed a large library of recombinant antibodies with a variety of different functional properties. We will now graft anti-cryptococcal variable regions onto these antibodies to examine, both alone and in combination, the contribution of such characteristics as FcR binding, complement activation, avidity and half life to efficacy in an animal model of infection with C. neoformans. We will first confirm the functional properties of these antibodies in vitro by testing FcR binding, antibody-dependant cell mediated cytotoxicity (ADCC), and complement activation and determine their pharmacokinetics in vivo. We will then test in vivo efficacy against infection with C. neoformans. Specifically, we will investigate whether antibody efficacy depends on i) in vivo persistence, ii) ability to activate complement, iii) engagement of FcRs or iv) effective cross-linking of surface antigen. The experiments proposed here are designed to explore the hypothesis that antibodies with different constellations of functional properties will have differing degrees of efficacy. Murine infection with C. neoformans is a particularly relevant system because a murine monoclonal antibody is currently undergoing Phase I evaluation for the treatment of cryptococcal meningitis in AIDS patients. If this trial proves promising, the experiments proposed will provide the basis for selecting the best therapeutic candidates for further study. A clear definition of what properties correlate with efficacy should allow us to move forward in designing effective therapeutic antibodies for treatment of disease in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISMS OF ISCHEMIC NEONATAL BRAIN INJURY Principal Investigator & Institution: Ferriero, Donna M. Professor; Neurology; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 24-SEP-2002 Summary: Support is requested to continue a multidisciplinary program that was begun in 1993 under the auspices of a P2O from NINDS. Through the study of a variety of pathological states such as perinataI asphyxia, neonatal stroke and neonatal infection, patterns and mechanisms of ischemic neonatal brain injury will be elucidated. It is the hypothesis of this proposal that the integrity of the blood brain barrier, cerebral perfusion, excitatory amino acid release availability of neurotrophic factors and substrates of intermediary metabolism, are critically important factors in the pathogenesis of neonatal brain injury. Through an integration of human research and basic science research we plan to study the role of these factors in the pathogenesis of neonatal ischemic brain injury. Taking what we observe in the human condition, we will develop new animal models and techniques, as well as use existing animal models and tissue culture paradigms with established methodology to unravel mechanisms. Through continuous in situ monitoring of injury viaMRI/MRS and near infrared spectroscopy(NIRS), we will be better equipped to study these mechanisms and meet our ultimate goal of providing therapies in the nursery for ischemic brain injury. Each project is conceptually interrelated and utilizes the scientific core for a centralized facility for all experimental manipulations. The programs four projects are 1) MRI predictors of outcome after perinatal asphyxia in humans, 2) Fructose bisphosphate in asphyxial brain injury 3) Neurotrophins in neonatal hypoxic-ischemic brain injury and 4) Mediators of ischemic brain injury in neonatal meningitis. Through these varied approaches we will investigate the cellular, molecular and physiological mechanisms of hypoxia/ischemia in the developing nervous system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISMS OF PYRIDOXAL-5'-PHOSPHATE DEPENDENT ENZYMES Principal Investigator & Institution: Phillips, Robert S. Professor; Chemistry; University of Georgia 617 Boyd, Gsrc Athens, GA 306027411 Timing: Fiscal Year 2001; Project Start 01-SEP-1989; Project End 01-MAY-2004 Summary: (adapted from applicant's abstract): The investigators are studying the mechanism of pyridoxal-5'-phosphate-dependent enzymes that break or form carboncarbon bonds. These enzymes include tryptophan indole-lyase, tyrosine phenol-lyase, tryptophan synthase, bacterial and human kynureninases, and aspartate betadecarboxylase. They are evaluating the reaction mechanism of tyrosine phenol-lyase and tryptophan indole-lyase. The investigators are determining the roles of specific amino acids in catalysis and reaction specificity by both site-directed mutagenesis and by synthesis of a C-terminal peptide containing unnatural amino acids. The investigators are probing the mechanism of the reaction of these enzymes by various kinetic techniques, including rapid scanning stopped flow spectrophotometry and rapid chemical quench. They will design, synthesize, and evaluate novel inhibitors of tryptophan indole-lyase that may be useful in the treatment of Haemophilus influenzae meningitis. The potent competitive inhibitors of kynureninase that they are designing and synthesizing, based on their studies of the bacterial enzyme, have been patented and are undergoing studies to evaluate their potential in the treatment of neurological disorders such as stroke. The investigators will determine and compare the structure
48 Meningitis
and reaction mechanism of bacterial and human kynureninases as well as aspartate beta-decarboxylase. More information on the structure and mechanism of kynureninases mat lead to the design of other more selective and potent inhibitors. The central role of pyridoxal-5'phosphate-dependent enzymes in the metabolism of amino acids and amines and in the biosynthesis of important bioactive metabolites, makes them attractive targets for the design of mechanism-based inhibitors which may be useful for drugs. Thus the results of this research are likely to make a significant contribution to the goal of improving health care for Americans in the future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MELANOGENESIS IN CRYPTOCOCCUS NEOFORMANS Principal Investigator & Institution: Nosanchuk, Joshua; Medicine; Yeshiva University 500 W 185Th St New York, NY 10033 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 30-JUN-2003 Summary: Melanin synthesis has been associated with virulence for a variety of microbial pathogens. However, little is known about either melanogenesis or the structure of melanin. The experimental system that Dr. Nosanchuk will study is that of Cryptococcus neoformans, a pathogenic fungus which causes life-threatening meningitis in 5-10 percent of patients with AIDS. This system has several unique advantages for the study of melanin and virulence, including the fact that melanized and non-melanized cells can be easily generated by simply growing the organism with or without a variety of phenoloxidase substrates. In addition, melanogenesis in C. neoformans is catalyzed by a single enzyme. Dr. Nosanchuk proposes a novel approach to the study of melanin and melanogenesis C. neoformans by applying the technology of phage display libraries to identify melanin-binding peptides that will comprise unique reagents for the study of melanin. Furthermore, murine monoclonal antibodies (mAbs) will be generated that bind melanin. Melanin-binding peptides and mAbs will be used to study melanization in vitro and in vivo. The objectives are to determine whether melanogenesis occurs in vivo and to obtain information on the structure of melanin. Four specific aims are proposed: 1. To identify peptides which bind melanin; 2. To study the antibody response to melanin and generate melanin-binding mAbs; 3. To explore the structure of melanin using biochemistry, phage display peptide libraries and mAbs; and 4. To use peptides and mAbs to study C. neoformans melanogenesis in vivo and in vitro. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENINGOCOCCAL LIPOOLIGOSACCHARIDE & MUCOSAL PATHOGENESIS Principal Investigator & Institution: Stephens, David S. Director; Medicine; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-JAN-1993; Project End 31-DEC-2002 Summary: The long-term objectives of this research program are to help define the genetic, structural and pathogenic basis of meningococcal endotoxin (lipoligosaccharide[LOS]). The recent dramatic increases in meningococcal infections in part of the United States and the emergency of penicillin-resistant meningococcal, emphasize pathogenesis. The principle investigator s approach utilized novel genetic techniques for meningococcal(e.g., Tn916 mutagenesis), biochemical and physical analysis of LOS structure; and human tissue assays to assemble a detailed model of meningococcal LOS and to provide insights into how Los influences pathogenesis. This
Studies 49
application is directed at understanding the structural-functional relationship of the meningococcal LOS inner core, Flu (GlcNAc) Hep2KD02LipidA. LOS inner core structure is predicted to influence LOS assembly, human immune recognition of the meningococcus and interactions with soluble and cellular human proteins. In Specific Aim 1, genetic determinants that are responsible for LOS inner core oligosaccharide chain synthesis and heterogeneity in serogroup B meningococcal will be characterized: (1) by investigation of the ace (alpha chain elongation) operon which contains the UDPGlu: heptosyl (ll) lipooligosaccharide alpha 1, 2 N- acetylglucosamine transferase (rfaK) and the putative UDP-Glu heptosyl (1) lipooligosaccharide beta 1, 4 glucosyltransferase (IgtF); (2) by study of alpha chain initiation, and additions of phosphate derivatives and saccharides to Hepll; and (3) by understanding the deep rough Tn916 mutant 469 (KD02LipidA) at both genetic and structural levels. In Specific Aim 2, the role of Los in two important events that occur during group B meningococcal infection will be investigated. They propose that the LOS inner core, in particular the Hepll structure, facilitates group B meningococcal entry into human nasopharyngeal epithelial cells. In addition, genetically and structurally defined LOS mutants will be used to determine how expression of hep2KD02-Lipid A LOS enhances sensitivity of encapsulated meningococcal to killing by classical pathway complement-mediate mechanisms of human serum. Such data has application to the design of meningococcal vaccines currently in development (e.g. inclusion of truncated LOS molecules in outer membrane vesicle vaccines), and should provide insights into the unique features of meningococcal endotoxin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MIMETICS MENINGITIDIS
OF
CAPSULAR
EPITOPES
OF
NEISSERIA
Principal Investigator & Institution: Granoff, Dan M. Senior Scientist; Children's Hospital & Res Ctr at Oakland Research Center at Oakland Oakland, CA 94609 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2005 Summary: Description (Adapted from the applicant's abstract) The long-term objective of this study is to increase our understanding of the immunologic properties of molecular mimetics of a bacterial polysaccharide that also is an autoantigen. Mimetics can act as antigens, bind to antibody receptors on B cells, and elicit serum antibody responses to the nominal antigen. Yet, little is understood about the properties of antigenic mimetics that contribute to their immunogenicity. Nor is much known about the quality of the antibody response with respect to conferring protection against a pathogen. Neisseria meningitidis group B (NmB) polysaccharide is an excellent model to investigate these questions. NmB is a major cause of meningitis and sepsis. The mechanism of protection is well defined (serum antibody), and reliable assays exist for measurement of antibody binding to the polysaccharide antigen, functional antibody against the bacteria, and passive protection in an infant rat model of bacteremia. Efforts to develop a NmB vaccine have been hampered by poor immunogenicity of the polysaccharide capsule, which cross-reacts with host polysialic acid. The PI's laboratory has prepared a panel of murine monoclonal antibodies (Mabs) that react with capsular polysaccharide epitopes on NmB that are distinct from host polysialic acid. These Mabs are bactericidal and confer passive protection in animal models. The PI's hypothesis is that mimetic antigens identified by these Mabs will be able to elicit protective anticapsular antibody responses that are specific for the pathogen, avoiding the risk of autoantibody. Further, that the best mimetics will be those that adopt relatively stable conformations. To search for such mimetics, the PI proposes to screen phage libraries
50 Meningitis
displaying independently folding peptides, or search for constrained protein mimetics within immunoglobulin scaffolds (single chain variable (ScFv) anti-idiotypes). The mimetics will be investigated for their ability to elicit anticapsular antibody responses. The Ig isotype, antibody functional activity to the bacteria, and immunoglobulin variable region gene usage in response to the mimetics, will be compared to that elicited by the nominal antigen. A central question will be whether a mimetic identified with a Mab that reacts specifically with encapsulated NmB strains, but not with host polysialic acid, will elicit protective antibody responses without autoantibody activity. Additional questions will be whether the repertoire of the antibody response to the mimetic is similar or different than that elicited by the nominal polysaccharide, and what effect, if any, the antibody repertoire may have on protection. Taken together, the data will provide important information on the properties of mimetic antigens with chemical structures that are distinct from that of the nominal polysaccharide antigen. The results also may identify new candidate molecules for inclusion in a future vaccine for prevention of NmB disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR POLYSIALYTRANSFERASES
MECHANISMS
OF
ALPHA
2,8-
Principal Investigator & Institution: Troy, Frederic A. Professor; Biological Chemistry; University of California Davis Sponsored Programs, 118 Everson Hall Davis, CA 95616 Timing: Fiscal Year 2001; Project Start 01-MAY-1998; Project End 30-APR-2004 Summary: The 2,8-linked polysialic acid (polySia) glycotope is involved in cell migration and cell adhesion and thus plays a central role in the regulation of mammalian developmental processes. It is also an important tumor-associated oncodevelopmental antigen on a number of human cancers. On neurotropic E. coli K1 and Neisseria meningitidis Gp.B, the polySia capsule is a neurovirulent determinant associated with neonatal meningitis in humans. Therefore, it is important to understand the molecular mechanism of polySia chain synthesis, and how synthesis is controlled. These are the long-term objectives of our studies. The enzymes responsible for synthesis of polySia ar the CMP-Sia: 2,8 polysialytransferase (polySTs), designated PST and STX in mammals and NeuS in E. coli K1. There is no primary sequence homology between the mammalian and bacterial polySTs, yet all three catalyze synthesis of identical polySia chains. A key hypothesis to be tested is that PST, STX and NeuS achieve the same catalytic functions by rearranging conserved amino acid motifs spatially in their active sites to bind CMP-Sia and initiate polySia chain synthesis while bound to the enzyme. The Specific Aims of this grant are three-fold. Aim 1 will characterize by biochemical methods the length of the polySia chains synthesized by membrane-bond and soluble constructs of PST and STX derived from transfected N-CAM(+) and (-) cells. The nature of the potential reducing terminus in N-CAM (-)/polySia(+) transfected cells will als be determined. Aim 2 includes structure-function studies that will investigate the structural basis for polysialylation. Active site cysteine and conserved basic amino acid motifs implicated in catalysis and processivity will be studied by site-directed mutagenesis. Aim 3 will use in vitro reconstitution experiments to determine, "how many enzymes does it take to synthesize polySia?". Successful completion of these studies will provide basic information for understanding the molecular mechanism of polysialylation, and the critical domains of the polySTs involved. This will also have important implications for basic studies relating to neural development and plasticity, neoplastic disease and molecular microbiology and pathogenesis, and provide a necessary framework for future studies.
Studies 51
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MUCOSAL DEFENSE BY IGA AGAINST S PNEUMONIAE Principal Investigator & Institution: Janoff, Edward N. Professor; Medicine; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, MN 554552070 Timing: Fiscal Year 2001; Project Start 01-MAR-2001; Project End 28-FEB-2006 Summary: (adapted from the investigator's abstract): Streptococcus pneumoniae is a common invasive mucosal pathogen. Local and systemic manifestations range from asymptomatic colonization, to sinusitis and otitis media, to community-acquired pneumonia, bacteremia, and meningitis, resulting in up to 40,0000 deaths/year in the US alone. The local host and bacterial factors that determine whether S. pneumoniae causes no disease, mucosal disease, or invasive disease are not well-characterized. We propose to characterize the mechanisms of control of pneumococcal infections operative at the initial steps in their pathogenesis from nasopharyngeal colonization to aspiration into upper respiratory mucosae and alveoli, prior to alveolar injury and invasion into tissue and blood. We have shown that IgA reactive with pneumococcal capsular polysaccharide (PPS) mediates killing by neutrophils by both complement-dependent and -independent conditions. IgA and IgG may both contribute to defense of the lower respiratory tract by initiating killing by macrophages and neutrophils and by inhibiting adherence to epithelial cells. We will characterize the molecular and biochemical features of PPS-specific Ig which determine their functional role, their effective interactions with local phagocytic cells, as well as the adaptive mechanisms of the organism which may subvert these protective mechanisms. Hypotheses: (1) Molecular and biochemical characteristics of capsule-specific IgA and IgG (e.g., mutation rates of immunoglobulin genes (VH), momeric, polymeric, and secretory structure of IgA, avidity, and pattern of IgA glycosylation) determine their functional efficiency to inhibit adherence and mediate killing by phagocytes. (2) Bacterial virulence factors (e.g., IgA1 protease, choline-binding protein A, and phase variation) subvert the ability of PPSspecific IgA to control S. pneumoniae. (3) The local host environment (e.g., complement, C-reactive protein) determines the phagocytes' ability of IgA and IgG to initiate killing of S. pneumoniae. The specific objectives of this proposal are designed to illuminate the unique features of the local host-pathogen interaction and defense against these extremely common and serious mucosal infections with S. pneumoniae in children and adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NATURAL ANTIBODY AGAINST GROUP B STREPTOCCOUS IN MICE Principal Investigator & Institution: Butko, Peter; Chemistry and Biochemistry; University of Southern Mississippi Box 1, Southern Sta Hattiesburg, MS 39406 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: (Verbatim from Applicant's Abstract): Group B streptococcus (GBS, Streptococcus agalactiae) is the most common cause of neonatal sepsis and meningitis in the USA. A humoral factor has been discovered in normal mouse serum which protects the animals against GBS infection. It is hypothesized that the protective factor is natural IgM antibody. Two goals of the proposed research are: (i) To confirm that the antibody is of the IgM type and that it is protective against experimental GBS infections in vivo; (ii) to identify the antigenic target for this antibody on the bacterial surface. To these aims, several clinical isolates and mutant strains of GBS, in combination with in
52 Meningitis
vitro enzyme-linked immunosorbent assays (ELISA) and in vivo mouse protection experiments will be utilized. Results obtained with mice as animal model may open a new avenue of investigation into possible role of natural antibodies in human immunity to GBS infection and bacterial infection in general, with possible implications for immunotherapy. The results also may provide impetus to the research on the antigenic targets on GBS, possibly other than the capsular polysaccharide, which would have implications for current GBS vaccine efforts. A non-scientific goal of this project is to increase the intensity of health-related undergraduate research and teaching in a midsize rural university with no medical school and to increase diversity in the work force in the academic research and medicine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NICOTINE & IMMUNOPATHOGENESIS OF CRYPTOCOCCAL MENINGITIS Principal Investigator & Institution: Sopori, Mohan L. Senior Scientist and Director; Lovelace Biomedical & Environmental Res Environmental Research Inst Albuquerque, NM 87185 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Opportunistic infections of the central nervous system are common complication in acquired immunodeficiency syndrome (AIDS) patients. Cryptococcus neoformans (Cne) is an encapsulated yeast that causes often fatal cryptococcal meningoencephalitis (CM) in 7-30% of AIDS patients. While highly active anti-retroviral therapy has successfully decreased the incidence of many opportunistic infections, it is less effective in decreasing the incidence of opportunistic fungal infections in advanced AIDS patients. The host's response to Cne is a complex interplay between the innate and adaptive immunities. In animal models, the inability to increase the brain levels of proinflammatory cytokines or promote leukocyte migration into the brain is typically associated with lethal CM. Thus, "proinflammatory" responses are required to contain Cne infection in the central nervous system. Epidemiological studies show that cigarette smoking is a significant risk factor in cryptococcosis and other opportunistic fungal infections, and >85% of AIDS patients with cryptococcosis are cigarette smokers. However, the mechanism by which smoking affects the pathogenesis of Cne is totally unknown. We have demonstrated that cigarette smoke suppresses the immune system, and nicotine (NT) is a major immunosuppressive component of cigarette smoke that causes T cell anergy and inhibits the inflammatory responses. Our preliminary studies suggest that chronic NT treatment inhibits chemokinesis/chemotaxis and the migration of leukocytes to the site of inflammation, decreases brain IL-1beta expression in response to an inflammatory stimuli such as turpentine and Cne, and promotes growth and early dissemination of Cne into the brain. Therefore, we hypothesize that cigarette smoke/NT modulates both the innate and adaptive immune responses to Cne, thus facilitating its dissemination to the brain and the development CM. To test this hypothesis and to identify mechanism(s) by which NT facilitates brain infection by Cne, the following studies are proposed: 1. To investigate the effects of NT on Cne-induced innate immunity, including the expression of proinflammatory cytokines/chemokines in the brain and the response of leukocytes to cytokines/chemokines that are affected by Cne, to establish the kinetics of Cne and leukocyte migration into the brain and the development of CM, and to examine the effects of NT on the Cne-induced fever response. 2. To ascertain the effects on the adaptive immune responses including generation of anti-Cne antibodies, proliferative and delayed-type hypersensitivity responses to cryptococcal antigens, and generation of
Studies 53
cytotoxic T cells to immunodominant epitopes of Cne proteins, as well as to evaluate the protective function of T cells that migrate into the brain after Cne infection. 3. To investigate the mechanisms by which NT suppresses the migration of leukocytes toward the site of infection. These studies, we believe, will delineate the mechanism(s) by which smoking/NT encourages dissemination of Cne and, perhaps, other fungal infections into the brain of AIDS patients, and identify potential therapeutic targets for treatment of CM. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATHOGENESIS OF CRYPTOCOCCAL MENINGOENCEPHALITIS Principal Investigator & Institution: Lee, Sunhee C. Professor; Pathology; Yeshiva University 500 W 185Th St New York, NY 10033 Timing: Fiscal Year 2001; Project Start 16-DEC-1998; Project End 30-NOV-2002 Summary: (Adapted from Applicant's Abstract) Cryptococcal meningoencephalitis is caused by Cryptococcus neoformans, an encapsulated fungus which is ubiquitous in urban environments. Infection is thought to occur via the respiratory system following inhalation of C. neoformans. The respiratory infection is often transient or inapparent, but subsequent systemic cryptococcoses often result in cryptococcal meningoencephalitis, the classical presentation of cryptococcoses. Cryptococcal meningitis is incurable in patients with AIDS, despite antifungal treatments. The hypothesis to be tested in this proposal is that microglia and astrocytes can function as effector cells in cryptococcal meningoencephalitis and that modulation of their effector function by cytokines and opsonins may modify the course and the outcome of cryptococcal infection. The first Specific Aim will study the interaction of microglia with C. neoformans, and the role of cytokines and capspule-specific antibodies in modifying the interaction. Particular emphasis will be placed on the role of mAbs developed in this Institution that have been shown to offer protective immunity in murine infection. In the second Specific Aim, the fate of C. neoformans- infected microglia will be determined, since evidence suggests phagocyte killing as a novel mechanism of host injury induced by C. neoformans. The hypotheses to be tested include that the mode of phagocyte death can determine the fate of organisms. By defining the host cell parameters that successfully lead to killing of C. neoformans, the applicants hope to be able to optimize the therapy. In the third Specific Aim, interactions of C. neoformans and HIV-1 in microglia will be determined. Since most patients with cryptococcal meningitis also harbor HIV-1 virus in the CNS, it will be of paramount importance to examine the role of HIV-1 in modifying antifungal effector mechanisms exerted by microglia. In the fourth Specific Aim, they will test the hypothesis that C. neoformans alter the cytokine and chemokine milieu in the CNS which, in turn, modulates antifungal and antiviral activity of microglia and astrocytes. The last Specific Aim will define the role of nitric oxide synthase in anticryptococcal activity in human CNS and in culture. Specifically, they will determine if cytokine-activated astrocytes can synergize with microglia to promote intracellular killing by providing nitric oxide. These experiments will use human brain cells thus permitting the direct correlation of the observed results to potential therapeutic intervention in man. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PHOSPHOLIPASE REGULATION OF MONOCYTE CHEMOTAXIS TO MCP-1 Principal Investigator & Institution: Cathcart, Martha K. Member; Molecular Medicine; Cleveland Clinic Lerner Col/Med-Cwru Cleveland, OH 44195
54 Meningitis
Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2007 Summary: (provided by applicant): Monocytes are major participants in inflammatory responses and are mediators of chronic inflammation. Monocyte chemotactic factor 1 (MCP-1) is a critical chemotactic factor involved in attracting monocytes from the blood into tissues. This chemotactic cytokine has been shown to be a particularly important for the extravasation of monocytes into vessel walls in atherogenesis. Atherosclerosis-prone mice, when rendered deficient in either MCP-1 or its receptor, CCR2, develop significantly less atherosclerosis than their normal counterparts. Furthermore, MCP-1 has also been associated with a series of other chronic human inflammatory diseases including rheumatoid arthritis, viral meningitis, psoriasis, and inflammatory bowel disease. To date, we have a very cursory understanding of the signal transduction pathways regulating the chemotactic response of monocytes to MCP-I. In this application we propose experiments to elucidate the pathways regulating this central inflammatory process. Recent studies from our laboratory have identified a novel role for phospholipases A2 in regulating monocyte chemotaxis. When primary monocytes are rendered deficient in the expression of either cPLA2 or iPLA2 they fail to respond to the chemotactic stimulus of MCP-I. These pathways appear to operate independently in regulating the chemotactic response. It is clear that lipid signaling pathways are integral regulators of this monocyte chemotactic response. In this proposal we present a research plan to investigate how these PEA2 pathways regulate chemotaxis. In Aim 1 we will determine how these phospholipases relate to the few other pathways that have been identified in regulating MCP-l-induced monocyte chemotaxis and in the process we will explore the best approaches for selectively intervening in this process. We will examine the contributions of phospholipase D and AA metabolites in regulating chemotaxis and will explore the role of phospholipases in influencing cytoskeletal rearrangement and other cell processes involved in monocytic responses to MCP-1. These studies will significantly advance our understanding of this key inflammatory event. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PLECONARIL (VP63843) THERAPY--INFANTS W/ ENTEROVIRAL MEN Principal Investigator & Institution: Edwards, Kathryn M.; Vanderbilt University 3319 West End Ave. Nashville, TN 372036917 Timing: Fiscal Year 2001 Summary: HYPOTHESIS: STUDY OBJECTIVES: A) VIROLOGIC EFFICACY- PRIMARY OBJECTIVE of this investigation is to determine if administration of pleconaril to infants w/enteroviral meningitis results in more rapid clearance of virus from various body sites. B) SAFETY- determine the safety of administration of pleconaril to infants w/enteroviral meningitis. The DAIDS Pediatric Toxicity Tables will be utilized. C) PHARMACOKINETICS- the pharmarmacokinetics of pleconaril administered to infants over a seven day period will be defined as a function of age. D) CLINICAL EFFICACYthe effects of pleconaril on resolution of meningitis symptoms will be assessed. SPECIFIC AIMS: STUDY ENDPOINTS: A) PRIMARY- Percentage of patients shedding virus (as detected by viral culture) from the oropharynx (i.e. throat) four days after beginning study drug. B) SECONDARY- 1) Duration (in days) of non-polio enteroviral shedding from any site, as detected by viral culture and/or PCR. 2) Resolution of meningitis symptoms (Appendix III). 3) Safety (see Section IX.D.4 for list of safety labs). 4) Pleconaril pharmacokinetics. C) TERTIARY- Development of viral resistance to pleconaril during course of viral shedding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies 55
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Project Title: PRETARGETING STRATEGIES MALIGNANCY RADIOIMMUNOTHERAPY
FOR
CENTRAL
NERVOUS
Principal Investigator & Institution: Zalutsky, Michael R. Professor; Duke University Durham, NC 27706 Timing: Fiscal Year 2001 Summary: The overall objective of this proposal is to improve the clinical utility of radiolabeled monoclonal antibodies (MAbs) for the treatment of CNS tumors. Our hypothesis is that the efficacy of radioimmunotherapy is critically dependent on the type of nuclide and MAb labeling method that are used. During the past few years, we have developed novel strategies for labeling MAbs with the radioimmunotherapy and emits beta-particles with a maximum range in tissue of 102 mm. Astatine-211 decays by the emission of alpha-particles, which have a range of only a few cell diameters and a higher relative biological effectiveness than beta-particles. This nuclide might be ideal for the treatment of neoplastic maningitis. Fluorine-18 sis a positron emitter, and MAbs labeled with 18F offer the attractive possibility of using positron emission tomography (PET) to quantitate the distribution of labeled MAbs. PET imaging could provide more accurate dosimetry for both tumor and normal tissues and greatly facilitate radioimmunotherapy planning. The goal of this work is to be able to transfer our radiohalogenation technologies to the clinical domain as expeditiously as possible. These studies will be performed using chimeric Mel-14 and its fragments. This MAb was selected because of its potential utility for the treatment of gliomas and melanomas, particularly via intratumoral and intrathecal delivery. In addition, the selection of chimeric Mel-14 is supported by the encouraging results obtained in extensive preclinical work and clinical pilot studies that we have performed with murine Mel-14 F(ab')2. The specific aims of this project are: a) to label intact chimeric Mel-14 IgG and its fragments with 131I, 211At, and 18F using N-succinimidyl [131I] iodobenzoate, [211At] astatobenzoate, and [18F] fluorobenzoate, respectively, without compromising immunoreactivity; b) to determine the pharmacokinetics of radiohalogenated intact chimeric Mel-14 and its fragments in subcutaneous, intracranial, and neoplastic meningitis human tumor xenograft models; c) to investigate the in vitro radiotoxicity of 131I- and 211At-labeled intact chimeric mel-14 and its fragments in human tumor 2 cell lines; d) to evaluate the toxicity of 131I- and 211At-labeled intact chimeric Mel-14 and its fragments in normal and athymic mice; and e) to determine the therapeutic potential of intact chimeric Mel-14 and its fragments labeled with equitoxic doses of 131I and 211At in subcutaneous, intracranial, and neoplastic meningitis human tumor xenograft models. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROLONGED THROMBOPLASTIN TIME IN FEBRILE CHILDREN Principal Investigator & Institution: Willwerth, Ben M.; Children's Hospital (Boston) Boston, MA 021155737 Timing: Fiscal Year 2001 Summary: The hypothesis for this study is that the prolongation of the partial thromboplastin time (PTT) is caused by a lupus anticoagulant, which is likely produced in response to viral infections. The study will attempt to identify the cause of prolongation of the PTT in children with fever and petechiae, and may help the scientific community better understand the interaction between viral and bacterial infections and the human clotting system. Background: Children with fever and petechiae are known to be at increased risk for serious bacterial infections, including bacteremia, sepsis, and
56 Meningitis
meningitis. Previous studies have attempted to identify the incidence of and risk factors for serious bacterial illnes in these children. A recent study found that only 2% of children with fever and petechiae had bacteremia or sepsis. They noted that prothrombin time (PT) or PTT was prolonged in 28% of children with fever and petechiae. Though these children were not noted to have bleeding problems related to their prolonged coagulation times, this finding suggested that the source of the fever and petechiae in these children interacts with the human clotting system in a fashion that the investigators have yet to identify. The study will include 3 distinct patient populations: 1) children with fever and petechiae without bacteremia or sepsis; 2) children with fever without petechiae; and 3) children with neither fever nor petechiae. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGIONAL AGT DEPELTION OF CNS AND LEPTOMENINGEAL TUMORS Principal Investigator & Institution: Friedman, Henry S. Professor; Pediatrics; Duke University Durham, NC 27706 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2005 Summary: (provided by applicant) Central nervous system (CNS) neoplasms which either arise in the brain or metastasize from an extraneural primary site, are highly malignant tumors refractory to all conventional therapy. Similarly, patients with neoplastic meningitis from virtually any tumor such as melanoma, sarcoma or breast carcinoma do poorly, with mean survival following leptomeningeal spread measured in months. The major impediment to successful treatment is de novo or acquired resistance to chemotherapy. Temozolomide is an imidazole tetrazinone similar to dacarbazine, requiring conversion to the active methylating agent MTIC. Methylating agents, including temozolomide, produce cytotoxicity due to a lethal cycle of mismatch repair following cellular misrecognition of O(6)-methylguanine. Recent preclinical and clinical studies have confirmed the activity of temoxolomide in the treatment of malignant glioma. Unfortunately, the majority of patients ultimately display resistance to temozolomide. The two primary mechanisms of resistance to temozolomide and other alkylating agents are the enzyme O(6)-alkylguanine-DNA alkyltransferase (AGT) and a deficiency in the DNA mismatch repair pathway. Of these two mechanisms, AGT plays a primary role in resistance to temozolomide by removing the alkyl groups from the O(6) position of guanine, in effect reversing the cytotoxic lesion of temozolomide. The sensitivity of tumor cell lines to temozolomide and the alkylating agent BCNU can be correlated with AGT levels. Regional therapy of CNS parenchymal or leptomeningeal neoplasms with intratumoral or intrathecal administration respectively, offers the potential benefit of enhancing delivery to the target neoplasm while minimizing delivery and hence toxicity to systemic organs. We have previously demonstrated the activity and modest toxicity of intrathecal temozolomide in the treatment of athymic rats bearing subarachnoid AGT-human malignant gliom xenografts. We have extended these results and demonstrated the activity and safety of temozolomide delivered by intracerebral microinfusion in the treatment of malignant gliomas intracranially in athymic nude rats. The specific aims of this proposal are: 1. To define the role of intratumoral O(6)-BG and other AGT inhibitors in enhancing systemic or intratumoral temozolomide therapy of malignant glioma; 2. To define the role of intrathecal AGT inhibitors in enhancing system or intrathecal temozolomide therapy of neoplastic meningitis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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•
Project Title: REGULATION OF THE (POLY) SIALIC ACID VIRULENCE FACTOR Principal Investigator & Institution: Vimr, Eric R. Associate Professor; Animal Sciences; University of Illinois Urbana-Champaign Henry Administration Bldg Champaign, IL 61820 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 31-MAY-2003 Summary: The broad objective of this proposal is to increase our understanding of bacterial polysaccharide synthesis in pathogenic microorganisms. The K1 antigen, or polysialic acid capsule is a homopolymer of alpha2,8- linked sialyl residues. Synthesis of the capsule depends on about 15 genes of the kps pathogenicity locus that is organized into at least two convergently transcribed operons, one of which is controlled by the thermoregulated kpsF promoter. The anti-recognition functions of sialic acids (antiphagocytosis; inhibition of antibody-independent complement fixation; molecular mimicry of host antigens) make these unique nine- carbon carboxy sugar acids important determinants of virulence in diverse human and animal pathogens. Escherichia coli K1 is a leading cause of neonatal meningitis and a frequent cause of urinary tract infections in children and bacteremia in adults. Vaccination against these diseases may not always be practical, and conventional drug therapy is problematic. Alternative or improved therapies may emerge from a better understanding of capsular polysaccharide expression. Objectives of the application are to understand the molecular mechanisms of capsule thermoregulation and sialic acid precursor biosynthesis. This information is necessary for construction of defined mutants that will allow us to unambiguously determine the association between capsule and lipopolysaccharide O antigen during disease. To accomplish these objectives, we will pursue three specific aims. First, thermoregulation will be investigated with an in vitro transcription system designed to determine the intrinsic sensitivity of the kpsF promoter to temperature. The role of a positive regulator will be determined by isolation and characterization of mutants that no longer regulate the kpsF promoter. Second, the origin of sialic acid biosynthetic precursor, N- acetylmannosamine, will be determined by genetic and biochemical approaches. Finally, the role of the capsule and its association with O antigen will be determined using defined mutants in an animal model of E. coli K1 meningitis and bacteremia. At the completion of this research, we expect to have clearly delineated the relative contributions of cell surface polysaccharides to pathogenesis. We also expect to have identified specific new targets for potential therapeutic developments aimed at blocking capsule expression in vivo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ROLE OF COMPLEMENT PROTEINS IN E. COLI MENINGITIS Principal Investigator & Institution: Nemani, Prasadarao V.; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, CA 90027 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): Neonatal E. coli K1 meningitis is the most common serious infection of the central nervous system with unchanged rates of mortality and morbidity. Survivors of this disease suffer a number of complications including mental retardation and speech impairment. Limited knowledge about the pathogenesis and pathophysiology of this disease hampered the efforts to develop new therapeutic strategies for the prevention. For example, most cases of E. coli K1 meningitis occur via hematogenous spread, but it is unclear how the circulating E. coli evades the hostdefense mechanisms. The investigator's studies have shown that outer membrane protein A (OmpA) of E. coli contributes to resistance to serum bactericidal activity. In
58 Meningitis
addition, OmpA interacts with a brain specific 95 kDa receptor for E. coli invasion of the blood-brain barrier (BBB). The E. coli invasion of the BBB was significantly reduced in the presence of adult human serum (AHS) when compared to cord blood serum (CBS) using the investigator's in vitro model of the BBB, the cultured brain microvascular endothelial cells (BMEC). His data further showed that OmpA binds to C4-binding protein, a complement fluid phase regulator, in significant quantities from AHS when compared to CBS. A compelling observation is that the binding of C4-binding protein to OmpA blocked the E. coli invasion of BMEC, suggesting that it is competing with the OmpA-receptor. The investigator hypothesized that binding of C4BP to OmpA blokcs the E. coli invasion of BMEC and that low levlels of C4BP may contribute to the susceptibility of neonates to E. coli meningitis. He will pursue this hypothesis by study of the following specific aims. 1. To determine the binding site of C4BP on OmpA that blocks E. coli invasion of BMEC, and 2. To assess the effect of anti-OmpA antibody, OmpA-peptides, and C4BP-peptides on E. coli invasion of BMEC in the newborn rat model of hematogenous meningitis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF TRAJ IN NEONATAL E. COLI SEPSIS AND MENINGITIS Principal Investigator & Institution: Badger, Julie L.; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, CA 90027 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): Despite the use of modern therapeutics and diagnostic measures, neonatal bacterial sepsis and meningitis continues to be a disease with unacceptable rates of morbidity and mortality. The fatality rate of this disease is 1575 percent; furthermore, approximately 50 percent of meningitis survivors have significant neurological and developmental abnormalities. The primary, route of infection for E. coli K1 (the most common causative agent of gram-negative meningitis) is oral. Following intestinal colonization, bacteria translocate through the GI tract to extra-intestinal sites of mesenteric lymph nodes (MLN), liver, spleen, and the blood. E. coli K1 then multiply systemically within the bloodstream reaching a necessary threshold of bacteremia to gain access to the central nervous system (CNS). Recently we identified an E. coli K1 plasmid-encoded blood-brain barrier (BBB) invasion gene, traJ, with homology to traJ of various F-like plasmid tra operons. Our preliminary data indicate that the traJ mutation specifically attenuates dissemination from the MLN to the liver, spleen, blood, and the CNS in the neonatal rat. In addition, although animals orally infected with the traJ mutant demonstrated a decrease or no recoverable bacteria in the liver or spleen, these tissues showed a significant inflammatory response. In vitro studies determined that the traJ mutant is taken-up less by macrophages and shows a loss of a 55 kDa-secreted protein. The central hypothesis of this application is that TraJ controls the expression of a set of genes whose products (i.e., 55 kDa secreted protein) are involved in E. coli K1 dissemination, systemic infection and crossing the BBB, and these events within the disease process occur via TraJ-dependent interactions with professional phagocytes. The following proposed experiments are designed to test and substantiate our hypotheses. We aim to 1) Elucidate the genetic and molecular characteristics of the traJ region and plasmid, evaluate the ability of the endogenous plasmid to self-transfer, and determine the potential role of the traJ-containing plasmid in E. coli K1 neonatal rat virulence, 2) Evaluate the function of the TraJ-regulated proteins (i.e., 55 kDa-secreted protein) in E. coli K1 systemic dissemination and meningitis, and 3) Determine the mechanism of TraJ-dependent host inflammatory response in the neonatal rat. Improved knowledge of molecular mechanisms for early
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systemic dissemination and the exact interplay of the host inflammatory response during these events will assist in achieving our long-term goal of identifying novel rational approaches to development of new treatments and preventive strategies for E. coli K1 sepsis and meningitis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SIGNAL TRANSDUCTION AND VIRULENCE IN C NEOFORMANS Principal Investigator & Institution: Alspaugh, Andrew J,. Assistant Professor; Medicine; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 30-JUN-2002 Summary: Dr. Alspaugh is a clinical/research fellow in the division of Infectious Diseases at Duke University. he is pursuing a career in academic medicine with a specific, scientific focus in the pathogenesis of infectious diseases. He has previous research experience in molecular genetics and in the immunology of cryptococcal infections. After his clinical infectious disease training, he has been working under the mentorship of Joseph Heitman and John Perfect studying signal transduction pathways in the human fungal pathogen Cryptococcus neoformans, and has identified that certain signaling elements are associated with pathogenicity in this organism. In his current environment at Duke, which includes regular interaction with other investigators interested in studying pathogenic fungi, he has a unique opportunity to continue his development as a research physician. He will be an active participant in both the Division of Infectious Disease as well as the Departments of Genetics and Pharmacology. Elements of signal transduction pathways are remarkably conserved from fungi to man. Dr. Alspaugh is especially interested in those signaling pathways which are activated in pathogens in response to host factors and which are associated with pathogenicity. Recently, heterotrimeric G- proteins have been identified as signaling elements essential for pathogenicity in the plant fungal pathogens Cryphonectria parasitica and Ustilago maydis. By homologous recombination, Dr. Alspaugh created mutant strains of the human pathogen Cryptococcus neoformans with a functional deletion of GPA1, the gene encoding a G alpha protein homolog. The gpa1 mutant cells were defective in mating and in the ability to express two well-established virulence traits, polysaccharide capsule and melanin. In a rabbit model of cryptococcal meningitis, the gpa1 mutant cells were markedly attenuated for virulence. Reintroduction of the wild-type GPA1 gene suppressed all of the mutant phenotypes, as did the addition of cAMP to the mutant cells. These findings implicate a novel signaling pathway in C. neoformans in which the GPA1 proteins transmits several external signals into the cell and, by regulating cAMP levels, regulates the important cellular processes of mating and pathogenicity. Dr. Alspaugh plans to further evaluate this signaling pathway, identifying upstream receptors and downstream molecules, to beer understand the process of pathogenicity in this organism and other fungi. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SIGNAL TRANSDUCTION PATHWAYS REGULATING VIRULENCE Principal Investigator & Institution: Heitman, Joseph B. Professor; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-MAR-2001; Project End 28-FEB-2002 Summary: Fungal infections are increasing as a result of AIDS, transplantation, and high dose chemotherapy. However, existing antifungal agents are limited to amphotericin B, azoles, and flucytosine, and drug resistant isolates are emerging. We propose to
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elucidate signal transduction cascades regulating virulence of Cryptococcus neoformans, the leading cause of fungal meningitis and a common opportunistic pathogen. Several features make C. neoformans an ideal model fungal pathogen. The organism exists as haploid cells with a defined sexual cycle. Gene disruption by homologous recombination is now possible, and established animal models permit analyses of mutant strains and candidate drugs in a virulence setting. These advances provide tools to elucidate signaling cascades regulating virulence traits of this organism, including capsule and melanin production in response to host signals, and to explore the association between virulence and MATalpha mating type. We have discovered that the G protein Gpa1 is required for mating and capsule and melanin production in C. neoformans. gpa 1 mutant strains are avirulent in an animal mode of cryptococcal meningitis. The phenotypes of gpa 1 mutant cells are suppressed by cAMP, suggesting Gpa1 regulates an adenylyl cyclase/cAMP/protein kinase A cascade. We have cloned C. neoformans homologs of Ras1, the PKA catalytic subunit and the Sch9 kinase, which are known to regulate an analogous G protein/cAMP dependent signaling pathway that regulates pseudohyphal differentiation in S. cerevisiae. In both S. cerevisiae and C. albicans, a MAP kinase signaling pathway also regulates filamentation and virulence. We and others have identified components of a homologous MAP kinase cascade in C. neoformans. Our studies reveal mutants lacking the G beta protein Gpb1, the MAP kinase Cpk1, or the STE12 transcription factor homolog have mating defects and virulence studies with these mutants are in progress. We propose to delineate the MAP kinase and G protein/cAMP dependent signaling cascades regulating C. neoformans virulence to understand regulation of pathogenesis and to identify novel antifungal drug targets. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STATUS EPILEPTICUS OUTCOMES IN THE UNITED STATES Principal Investigator & Institution: Trevathan, N E. Neurology; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 09-JUL-2001; Project End 30-JUN-2002 Summary: (taken from abstract) Status epilepticus (SE) is a common, life- threatening medical emergency that is experienced by about 150,000 people in the United States (US) each year, with up to 40,000 SE-associated deaths. In spite of treatments that are often effective, systematic emergency diagnostic and therapeutic protocols for SE are lacking in most hospitals. Unless diagnostic and therapeutic interventions are specifically directed to subpopulations of patients who will benefit most, it is unlikely that significant improvements in the care of patients with SE will be achieved rapidly. Data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP-3) have been recently used to describe the general characteristics of inpatients in the US with SE, and to demonstrate that SE increases the odds of all-cause mortality among inpatients in the US after controlling for co-morbid conditions and other potential confounding variables. Stroke, closed head injury, bacterial meningitis, and viral encephalitis are among the most common significant co-morbidities among hospitalized patients with SE. The long-term goals of our research are to: (a) Characterize the sub- populations of hospitalized patients in the US at highest risk for developing SE, and identify those inpatients who experience a significant increase in the odds of death associated with SE; (b) Propose a systematic intervention strategy for SE diagnosis and treatment for these sub-populations that minimizes medical errors, enhances rapid Diagnosis, and improves clinical outcomes; and (c) Study the effectiveness of the new proposed SE diagnostic and therapeutic delivery system among
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hospitalized patients. During this one-year grant period, we will extend our initial analyses of SE using the NIS HCUP-3, 1988-1997, to achieve the following Specific Aims: (1) Using the NIS data we will determine the frequency, the trends in frequency, and the geographic variations of SE among hospitalized patients in the US with bacterial meningitis, viral encephalitis, closed head injury, and/or stroke; (2) Using the NIS data, we will determine the impact of SE on the odds of death, controlling for potential confounding variables, among inpatients in the US with bacterial meningitis, viral encephalitis, closed head injury, and/or stroke; (3) Using the NIS data, we will conduct four separate analyses to determine the factors that increase the odds of developing SE among inpatients with bacterial meningitis, viral encephalitis, closed head injuries, and/or stroke. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRUCTURAL ANALYSIS OF ENTEROVIRUS CELL ENTRY PATHWAYS Principal Investigator & Institution: Hogle, James M. Professor; Biological Chem & Molecular Pharm; Harvard University (Medical School) Medical School Campus Boston, MA 02115 Timing: Fiscal Year 2002; Project Start 01-DEC-1983; Project End 31-MAR-2007 Summary: (provided by applicant): Over the past 10 years poliovirus and its close relatives (Coxsackieviruses, echoviruses and rhinoviruses) have emerged as model systems for probing the cell-entry mechanisms of nonenveloped viruses. These viruses are responsible for a variety of human diseases including: common colds, summer flu, poliomyelitis, encephalitis, meningitis, and a variety of cardiomyopathies. In previous funding periods several forms of poliovirus relevant to cell entry have been characterized by a combination of biochemical and structural studies. These studies together with work in other laboratories have led to a working model for the cell entry process that has striking similarities to models for the cell entry of enveloped viruses. The model frames the cell entry process in terms of several specific structural questions: 1) How does receptor binding lead to conformational changes that are required for subsequent steps in cell entry? 2) What is the sequence of conformational changes that ultimately leads to cell entry and the release of the viral RNA? 3) What is the role of the membrane in the formation of the virus receptor complex and the induction of conformational changes? 4) What is the nature of the interaction of the virus with the cell membrane that leads to the internalization of the RNA? 5) How is the RNA released from the particle and into the cell? In the coming funding period the questions will be addressed by a combination of structural and biochemical studies. Existing structures of the poliovirus/receptor complex and cell entry intermediates will be extended to the highest possible resolution using a combination of cryoelectron microscopy and x-ray crystallography. Conditions for stabilizing additional cell-entry intermediates in the poliovirus cell entry pathway will be optimized, and these intermediates will be characterized by cryoelectron microscopy and biochemical studies. The structure of the complex of echovirus 11 with its receptor DAF (CD55) will be determined by cryoelectron microscopy. Receptor-decorated liposomes will be used as a simple in vitro model system for biochemical studies of the early events in cell entry. This system also will be used to characterize the structure of the poliovirus/Pvr complex in the context of the membrane, to characterize the structure of the A particle/membrane complex, and to characterize structures responsible for release of the viral RNA by cryoelectron microscopy. These studies will provide a series of snapshots of the virus in the process
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of entering the cell that will serve as a context for the development of more detailed models of the cell entry mechanism of polio and related viruses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRUCTURAL STUDIES OF BACTERIAL HYALURONATE LYASE ENZYME Principal Investigator & Institution: Jedrzejas, Mark J. Microbiology; University of Alabama at Birmingham Uab Station Birmingham, AL 35294 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 08-MAY-2001 Summary: The objective of this research proposal is to develop a better understanding of the structural properties and mechanism of action of S. pneumoniae hyaluronate lyase enzyme. The long term objective is to better understand the mechanism of invasion of host tissue and the penetration of host defenses by S. pneumoniae and other Grampositive bacteria. Such understanding may lead to the development of new antibacterial therapeutic agents. S. pneumoniae is the most common cause of fatal pneumonia in the elderly, and it is one of the most common causes of middle ear infections and meningitis in children. The present vaccine consists of a mixture of 23 different capsular polysaccharides. While this vaccine is very effective in young adults, it is only about 60 percent effective in the elderly. In children less than 2 years of age the vaccine is ineffective and is not recommended due to the inability of this age group to mount an antibody response to the penumococcal polysaccharides. Antimicrobial drugs such as penicillin have diminished the risk of pneumococcal disease. However, in most parts of this country, up to 35 percent of pneumococcal strains are now resistant to penicillin and the frequency of multidrug resistant strains is steadily increasing. It has been recently suggested that certain pneumococcal proteins such as hyaluronate lyase, pneumolysin, and pneumococcal surface protein A (PspA) could be used as potential vaccine or drug targets for development of new cure. Hyaluronate lyase is a major surface protein of S. pneumoniae with possibly antigenetically variable properties that might be essential for full pneumococcal virulence. Thus, hyaluronate lyase might represent one of the best alternatives for a pneumococcal vaccine or drug target especially when combined with other pneumococcal virulence factors such as PspA or pneumolysin. We have expressed in E. coli, purified, and crystallized fully active forms of hyaluronate lyase enzyme from S. pneumoniae and Group B Streptococcus. The specific aims of the research proposed in this application are directed towards: a) the determinatin of the crystal structure of the hyaluronate lyase enzyme; b) thoroughly characterizing the properties and mapping the active site of this enzyme utilizing oligonucleotide mediated site directed mutagenesis. The results will enhance our knowledge about mechanisms involved in the action of the enzyme and in the pathogenesis of S. pneumoniae bacteria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STRUCTURE/FUNCTION OF BACTERIAL ADHESION PILI Principal Investigator & Institution: Bullitt, Esther S. Assistant Professor; Biophysics; Boston University Medical Campus 715 Albany St, 560 Boston, MA 02118 Timing: Fiscal Year 2001; Project Start 01-MAY-1998; Project End 30-APR-2003 Summary: The aim of this research is to understand the structure and assembly of adhesion pili found on pathogenic bacteria, thereby providing insight into how the architecture of these pili supports their role as a virulence factor. Bacterial survival and colonization require attachment of the bacteria to hosts. In many stains, this process is initiated and maintained by pili; in Escherichia coli that cause pyelonephritis, adhesion
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and virulence depend on P-pili. Hib-pili expressed on the surface of Haemophilus influenzae mediate H. flu's colonization of the upper respiratory tract, and thus its ability to cause diseases such as childhood meningitis, otitis media, and pneumonia of the elderly. As bacteria become more resistant to traditional antibiotics, it is important to develop new therapies against bacterial infections. Structural information about adhesion pili will provide a basis for future rational design of new therapies to prevent bacterial binding or to remove pathogenic bacteria bound to the human host. The proposed research addresses this long-term goal through structural studies of bacterial adhesion pili. These studies focus on: 1) electron microscopy and three-dimensional (3D) helical reconstruction of P-pili preserved in vitreous ice and of Hib-pili negative stain, 2) controlled damage/recovery of pili to investigate the possibility of re-formation of intact helical filaments, 3) investigation of the 3-D structure of P-pili with mutant structural proteins (pilins), to examine regions of the PapA pilin essential for their assembly into tightly coiled helical filaments, 4) bacterial attachment assays, to assess the effect of mutations and the effect of damage on bacterial binding, and 5) in vitro reconstitution of hetero-pilin polymers from chaperone-pilin complexes, to improve our understanding of the bioassembly process of a prototypical macromolecule. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STUDY OF S PNEUMONIAE VIRULENCE GENE REGULATION Principal Investigator & Institution: Camilli, Andrew; Associate Professor; Molecular Biol & Microbiology; Tufts University Boston Boston, MA 02111 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 14-SEP-2004 Summary: (provided by applicant): The overall goal of our research is to understand the pathogenicity of Streptococcus pneumoniae, the most common cause of bacteremia, bacterial meningitis, otitis media and community-acquired pneumonia in the U.S.A. Current capsule-based vaccines, which only contain a subset of the capsular types in circulation, do not provide adequate protection from pneumonia and otitis media, which account for the majority of S. pneumoniae morbidity. Despite more than a century of research, understanding of S. pneumoniae virulence factors is limited. Furthermore, almost nothing is known concerning the regulation of S. pneumoniae virulence factors during infection. These limitations, plus an increasing incidence of antibiotic-resistance mandate increased study of the pathogenicity of this organism. We have completed a large-scale screen that resulted in the identification of 233 genes that are essential in a murine model of pneumonia. Additionally, we tested the importance of each of these genes in murine models of bacteremia and nasopharygeal carriage. Included among these novel virulence factors are 21 surface proteins, and 20 putative regulators that we hypothesize coordinate tissue-specific virulence gene expression. The first goal of the proposed work is to gain an understanding of both the regulation and mechanisms of action of two factors hypothesized to localize to the bacterial surface and interact with host components. Mutational analyses and virulence assays will be combined to define their interacting domains. The second goal is to identify major virulence gene regulons and their modes of coordination during infection. Five putative transcription factors identified in our screen will be placed under inducible expression, and the subset of genes regulated by each will be determined by transcriptional profiling on microarrays. For selected genes, the level of expression during nasopharyngeal carriage in mice and humans will be determined using quantitative RTPCR. The requirement for each cognate regulator for expression of these virulence genes during infection of mice will be confirmed. These studies will enhance our knowledge and understanding of S. pneumoniae-host interactions and virulence mechanisms, and
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will constitute the first broad study of S. pneumoniae virulence gene regulation. These studies will aid in the development of novel vaccines, and will suggest new targets for antimicrobial drug development. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SUBSTANCE P, NO & MICROGLIA IN CNS INFLAMMATION Principal Investigator & Institution: Nathan, Barnett R. Neurology; University of Virginia Charlottesville Box 400195 Charlottesville, VA 22904 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: In the next 5 years I plan to study in vitro and in vivo the interactions of microglia, macrophages, substance P and nitric oxide as well as the effect of these substances on mitochondrial function. Substance P (SP) has effects as a pain mediator in the spinal cord and has vasoactive properties. It also plays a significant role in the pathogenesis of neurogenic inflammation, being released from peripheral nerve terminals and causing precapillary vasodilatation, postcapillary plasma extravasation and histamine release. Nitric oxide (NO) is known to play a role in bacterial meningitis and also has immunomodulatory and vasoactive properties. Peripheral blood macrophages and central nervous system (CNS) microglia share similar immunogenic properties and may be derived from the same cell line. Microglia are suspected to play a role in the pathophysiology of a wide variety of inflammatory CNS diseases and the mediators for this microglial induced injury may be modulators such as substance P and nitric oxide. The underlying hypothesis which provides the framework for all of the proposed studies is that substance P (SP), nitric oxide(NO) and microglia play a central role in the pathophysiology of bacterial meningitis (BM) and other acute CNS inflammatory conditions. The overall goal of this application is to investigate the effects of SP and NO on macrophage and microglia functions in in vitro and in vivo systems. This overall goal will be approached by addressing the following specific hypotheses. Hypothesis 1: Substance P plays a central role in bacterial meningitis, both through its direct immunomodulatory effects and through its effects on nitric oxide. In stimulated phagocytic cells there is an upregulation of preprotachykinin and SP receptor message. Hypothesis 2: Nitric oxide plays a central role in the pathophysiology of bacterial meningitis. There is upregulation of inducible nitric oxide synthase (iNOS) message resulting in increased production of NO. SP modulates iNOS via inhibition of iNOS message. Hypothesis 3: Both the resident and transient phagocytic cells in the CNS (microglia and macrophages) participate in the pathophysiology of bacterial meningitis. SP and NO modulate their effects in CNS inflammation via these cells. Hypothesis 4: The ultimate site for the effects of SP and NO may be the mitochondrial respiratory chain enzymes of these phagocytic cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE NEUROPATHY
ROLE
OF
NUTRITION
IN
VIRUS-INDUCED
OPTIC
Principal Investigator & Institution: Beck, Melinda A. Associate Professor; Pediatrics; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2003; Project Start 15-APR-1999; Project End 31-MAR-2007 Summary: (provided by applicant): Coxsackievirus A9 (CA9) and a variant, impaired in replication but persistently present in CSF over several months, were isolated from patients' CSF specimens during an epidemic of optic and peripheral neuropathy in Cuba
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in the early 1990's. The epidemic was clearly related to dietary deficiencies in several nutrients, including the antioxidants selenium, vitamin E, and lycopene. We are studying these isolates in the context of our previous work in mice, which demonstrated that deficiency of selenium or vitamin E can lead to increased severity of both Coxsackievirus B3 myocarditis and influenza pneumonia, with concomitant mutations in the viral genome. These mutations are reproducible, and the mutant strains have increased virulence for mice with normal nutriture. We hypothesize that host nutritional deficiencies induced mutations in CA9, leading to a new viral variant with altered pathogenic potential. We have completed genomic sequence analysis of three Cuban CA9 isolates from neuropathy patients and of five meningitis isolates from before the epidemic. Phylogenetic analysis shows the neuropathy isolates to be different, with a unique mutation near the active site of 2a protease that may contribute to the altered capsid proteins previously demonstrated in the variant virus. Using homologous regions among the CA9 already sequenced, we designed improved primers for sequencing the variant, which required special methods for RNA isolation because of apparent instability and/or very limited quantity. We have produced full-length cDNA from the variant, and sequences in the 5' non-translated region are consistent with a CA9 not identical to the other isolates. Using electron microscopy, we have demonstrated typical picornavirus virions in thin sections of CA9, but not of the variant, although the latter produces abundant viral antigen as demonstrated by immunofluorescence with homologous antiserum. We have produced mutations in CB3 by in vitro exposure to hydrogen peroxide in cell culture, and we will now apply the methods developed to CA9. In this continuation proposal, our objectives are 1) to characterize the quasispecies populations of the CA9 and variant isolates from Cuban patients; 2) to determine the role of the 2a protease and other mutations in altering the capsid proteins and replication patterns of the variant; 3) to determine the effects of repeated passage of CA9 and variant viruses in cells exposed to, or protected from, oxidative stress; and 4) to study the capsid morphology of the variant by comparing it to normal CA9 using cryo-electron microscopy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TNFGAMMA PERMEABILITY
EFFECTS
ON
BLOOD
BRAIN
BARRIER
Principal Investigator & Institution: Miller, Donald W. Associate Professor; Pharmaceutical Sciences; University of Nebraska Medical Center Omaha, NE 681987835 Timing: Fiscal Year 2001; Project Start 01-JUL-1997; Project End 30-APR-2003 Summary: (Adapted from Applicant's Abstract): Tumor necrosis factor-alpha (TNF-a) is a cytokine released in response to inflammatory events in the body. The increased levels of TNF-a in the central nervous system observed in conditions such as multiple sclerosis, bacterial meningitis, viral infections and brain ischemia suggest that the cytokine may be involved in the pathogenesis of these diseases. A major cellular target for TNF-a is the endothelium, where increases in coagulant activity, cell adhesiveness and vascular permeability are observed. Indeed, exogenous administration of TNF-a produces significant increases in blood-brain barrier (BBB) permeability. Therefore, understanding the mechanisms through which TNF-a produces changes in the permeability of brain microvessel endothelial cells that form the BBB, may provide insight into the cause and effective treatment of inflammatory events within the central nervous system. The proposed studies will examine the effects of TNF-a on BBB permeability on two distinct levels. First, primary cultured bovine brain microvessel endothelial cells (BBMEC) will be used as an in vitro model of the BBB to examine the
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cellular factors involved in the permeability effects of TNF-a. The hypothesis to be examined is that inhibition of actin stress filament formation in the cells will prevent increases in BBMEC monolayer permeability observed with TNF-a. The specific aims for the in vitro studies will be to evaluate the effects that 1) inhibition of Rho-mediated GTP binding proteins, 2) alterations in cyclic nucleotide signaling pathways, and 3) inhibition of arachidonic acid metabolism has on TNF-alpha-induced changes in actin filament formation and BBMEC monolayer permeability. Secondly, the effects of TNF-a on BBB will be evaluated in vivo. The hypothesis for the in vivo studies is that changes in BBB permeability observed under inflammatory conditions in the brain are directly correlated to the amount of TNF-a released. For these studies, microdialysis probes will be implanted into the cortex of rats. The specific aims for the in vivo portion of the proposal are to 1) determine the dose-response relationship between cortically administered TNF-a and increases in BBB permeability, and 2) correlate the endogenous release of TNF-a following cortical injection of bacterial toxin or cerebral blood flow occlusion with changes in BBB permeability. Microdialysis probes will be used to deliver exogenous TNF-a to specific sites in the cortex as well as sampling endogenously released TNF-a. Together, the proposed studies will provide a better understanding of the mechanisms involved in TNF-a effects on BBB permeability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSCRIPTIONAL BIOSYNTHESIS
REGULATION
OF
GBS
CAPSULE
Principal Investigator & Institution: Cieslewicz, Michael J. Medicine; Harvard University (Medical School) Medical School Campus Boston, MA 02115 Timing: Fiscal Year 2001; Project Start 01-FEB-2001 Summary: (provided by applicant): Streptococcus agalactiae (Group B Streptococcus or GBS) is a common cause of neonatal pneumonia, sepsis and meningitis. Acapsular GBS mutants exhibit decreased virulence in mice suggesting that the capsular polysaccharide is a major virulence factor. Strains of GBS are found to express nine different capsule serotypes, Ia, Ib and II-VIII. We have focused our study on one of the most important in GBS capsule serotypes in human infection, type Ia. The GBS operon that directs synthesis of the type Ia capsule consists of 16 genes and is predicted to contain two promoters. The first promoter is upstream of the first gene, cpsIaA. A second, downstream promoter is predicted to lie upstream of cpsIaE. A non-polar cpsIaA deletion mutant exhibits decreased capsule expression at the surface of the cell, yet individual capsule chains in the cpsIaA deletion mutant and its parent wild-type strain are the same molecular size. Additionally, transcription of genes downstream of cpsIaA is down-regulated in a cpsIaA deletion mutant. These results are suggestive of CpsIaA acting as a transcriptional activator. In this proposal we will determine the transcriptional organization and relative promoter strength of the type Ia GBS capsule operon. In addition, we will determine if CpsIaA directly modulates transcription of the type Ia capsule genes. Experiments outlined in this proposal will lead to a better understanding of transcriptional regulation of GBS capsule biosynthesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSGENIC MOUSE MODEL FOR ECHOVIRUS PATHOGENESIS Principal Investigator & Institution: Racaniello, Vincent R. Professor; Microbiology; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 30-APR-2005
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Summary: (provided by applicant): Animal viruses initiate their replicative cycles by attaching to a cellular membrane receptor, followed by entry into the cell. Identification of the poliovirus receptor, Pvr, was essential for the establishment of a transgenic mouse model for poliomyelitis. Although a great deal is known about the pathogenesis of poliovirus infection, relatively little is understood about how echoviruses cause disease. Echoviruses are important human pathogens and are responsible for aseptic meningitis, neonatal sepsis, myocarditis, exanthemas, respiratory illness and gastrointestinal disease. Because most echovirus strains only replicate in humans, a mouse model has not been available for studying echovirus pathogenesis. The object of work in this proposal is to isolate transgenic mice that express human cell receptors for echovirus, to establish a new animal model for studying echovirus pathogenesis. We propose to isolate transgenic mice that express VLA-2, a heterodimeric integrin consisting of alpha2 and beta1 subunits, which is known to be the cell receptor for echovirus types 1 and 8. Three specific aims are planned. First, human cDNA encoding the alpha2 and beta1 subunits of VLA-2 will be placed under the transcriptional control of the human betaactin promoter, and used to establish transgenic mice that express both proteins. Second, tissues and organs of VLA-2 transgenic mice will be examined by Northern and Western blot analysis and immunohistochemistry for expression of VLA-2 RNA and protein. Third, the susceptibility of VLA-2 transgenic mice to echovirus type 1 infection by different routes, as well as the location of virus replication after inoculation, will be determined. In addition, the ability of echovirus to spread from muscle and intestine to the central nervous system by axonal transport will be determined. Fourth, experiments will be done to determine if an immune response is mounted during echovirus 1 infection of VLA-2 transgenic mice. Knock-out mice will be used to study the role of the immune response in limiting or exacerbating echovirus pathogenesis. Transgenic animal models would enable studies on the sites of echovirus replication, the mechanisms of viral spread, and the basis of echovirus tissue tropism. Establishment of a small animal model may yield information about echovirus pathogenesis that could stimulate development of echovirus vaccines or antiviral drugs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATING SEPSIS WITH PAF ACETYLHYDROLASE Principal Investigator & Institution: Prescott, Stephen M. H.A. & Edna Benning Presidential Profess; Intermountain Reg Cancer Netwk; University of Utah 200 S University St Salt Lake City, UT 84112 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2004 Summary: In this application we propose to test if removal of PAF and related phospholipids reduces the mortality associated with certain forms of sepsis. To test this hypothesis, we will examine the effect of administration of recombinant PAF acetylhydrolase, the enzyme that inactivates PAF and related phospholipids, to animals undergoing sepsis. We will use survival as the endpoint but will also characterize the response to enzyme administration by comparing cytokine levels in animals treated with placebo or with the recombinant protein. We will utilize two experimental models of sepsis: cecal ligation and puncture and sepsis induced by injection of Neisseria meningitidis. As a clinical corollary, we will determine the levels of PAF acetylhydrolase activity and cytokine levels in the plasma of patients undergoing sepsis and meningococcemia. An important goal of these studies, in addition to testing the potential of PAF acetylhydrolase as a therapeutic agent, is to identify patient groups that are likely to benefit the most from PAF acetylhydrolase administration. Recent clinical studies have failed to demonstrate that anti-inflammatory or immunomodulatory agents
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have beneficial effects in the treatment of sepsis. A possible explanation for this observation is that the patient population studied included subjects in whom a variety of different mechanisms resulted in sepsis. This may have precluded the ability of the agent(s) tested to show a beneficial effect in a limited group of patients because such effects would be lost in the analysis of the entire patient group. Our hypothesis is that the definition of sub-populations with similar etiologies will be a key factor in our understanding of sepsis. This approach will facilitate identification of markers to characterize the evolution and outcome of the disease as well as identify novel therapies. For example, patients suffering from meningococcemia-related sepsis can be identified as a homogeneous sub-population of septic patients. The studies proposed here may facilitate the molecular identification and treatment of populations that can significantly benefit from PAF acetylhydrolase administration. These studies will be carried out primarily in Brazil, as an extension of NIH SCOR grant P50 HL50153 (Project 5). They constitute an ideal complement to the studies currently being performed by Drs. Prescott and Stafforini, who are the Principal Investigator and Project Director of Project 5 of the SCOR in Acute Lung Injury, respectively. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT FOR GBS COLONIZATION IN PREGNANT WOMEN Principal Investigator & Institution: Bhatt, Bakul M.; Biomedical Development Corporation 500 Sandau, Ste 200 San Antonio, TX 78216 Timing: Fiscal Year 2001; Project Start 20-SEP-1997; Project End 31-MAY-2004 Summary: (Adapted from Applicant's Abstract): The goal of this project is to further develop Iocide, a novel iodine-based antimicrobial technology, for use as a topical bacteriocide for group B streptococci (GBS) in the vaginal tract of pregnant women during the intrapartum period. GBS is the leading cause of neonatal bacterial disease and death, and most frequently occurs in neonates as sepsis, meningitis, and pneumonia. Despite clinical advances to date, GBS continues to be a major cause of illness and death among newborns. Due to the limitations of current clinical strategies, a need exists for alternate approaches to prevent GBS-related neonatal disease. The following specific aims have been designed to achieve this goal: 1) to optimize the formulation of the Iocide vaginal gel, 2) to determine the effective range of Iocide in vitro, 3) to demonstrate safety and efficacy to the Iocide in animals, and 4) to determine safety and efficacy of Iocide in human clinical trials. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: TUBERCULOSIS IMMUNITY IN YOUNG CHILDREN Principal Investigator & Institution: Lewinsohn, Deborah A.; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2003; Project Start 15-MAY-2003; Project End 30-APR-2007 Summary: (provided by applicant): Tuberculosis (TB) is one of the most important causes of infectious morbidity and mortality worldwide. Young children are more likely to contract infection with and develop severe disease from the causative agent Mycobacterium tuberculosis (Mtb). These clinical observations likely reflect fundamental differences in the immune systems of young children and adults. Critical differences relevant to TB immunity include the propensity for infants and young children to develop TH2-type CD4+ T cells in response to immunogens, deficiencies in the development of TH1-type T cells in response to pathogens, and deficiencies in
Studies 69
macrophage and dendritic cell (DC) function. We propose to systematically define, in young children (less than or equal to 10 years of age), these important differences relevant to the successful containment of Mtb infection. The specific aims are: 1) To determine if severity of disease following Mtb infection in young children is associated with TH2-type Mtb-specific immunity, and conversely, if absence of disease following Mtb infection is associated with TH 1-type Mtb-specific immunity. 2) To determine if immunologic immaturity is associated with the development of TH2-type Mtb-specific immunity following Mtb infection, and conversely if immunologic maturity is associated with the development of TH 1-type Mtb-specific immunity following Mtb infection. 3) To evaluate aspects of innate immunity relevant to Mtb infection by characterizing the phenotype and function of macrophages and DC from cord blood derived from healthy neonates in comparison to macrophage and DC function in healthy adults. These studies may contribute to a more complete understanding of TB immunity in young children, and hence 'facilitate the development of an improved TB vaccine for this vulnerable population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: USING BIOCHEMICAL MARKERS TO DETECT ABUSIVE HEAD TRAUMA Principal Investigator & Institution: Berger, Rachel P. Professor; Children's Hosp Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, PA 15213 Timing: Fiscal Year 2003; Project Start 14-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): Child abuse is a leading cause of serious traumatic brain injury (TBI) in infants and young children. Proper diagnosis of abusive head trauma (AHT) is difficult even for experienced, astute physicians. Misdiagnosis is common and can have catastrophic medical consequences for patients. Aside from increased awareness, there are currently no established strategies or diagnostic tests to help physicians properly identify AHT. A screening test that could alert physicians to the possibility of AHT and thereby aid in proper and timely diagnosis, could have an enormous impact. Biochemical markers of brain injury are released from the brain after TBI and diffuse into cerebrospinal fluid (CSF) and/or serum, where their concentrations can be measured. CSF and serum concentrations of three of these biochemical markers -neuron-specific enolase (NSE), S100B, and myelin-basic protein (MBP) - are sensitive indicators of mild, moderate and severe TBI in adults and children. These markers may therefore have the potential to act as diagnostic adjuncts to complement physician acumen in properly diagnosing AHT. Specific Aim 1 is to determine the sensitivity and specificity of serum NSE concentrations for detecting AHT in infants at increased risk of AHT and to determine whether the use of a panel of NSE, S100B and MBP improves sensitivity or specificity when compared with NSE as a single marker. Specific Aim 2 is to determine whether increases in CSF and serum NSE, S100B and/or MBP are specific to TBI or whether their concentrations can be affected by four non-traumatic neurological insults: hypoxic-ischemic encephalopathy, meningitis, progressive encephalopathy and seizures. The candidate is a pediatrician at Children's Hospital of Pittsburgh (CHP). This Mentored Career Development Award will allow the candidate to pursue a unique and highly integrated mentored program in pediatric neurotrauma and child abuse. Pittsburgh is an ideal environment for this type of program because of the resources of CHP, the Safar Center for Resuscitation Research and The Child Advocacy Center. Dr. Patrick Kochanek, the primary mentor for this award, is internationally recognized for his work in the field of pediatric TBI, has served as a
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mentor on multiple K awards and is the PI of an NICHD-funded training grant (T32) in pediatric neurointensive care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VIRULENCE GENES HAEMOPHILUS INFLUENZAE Principal Investigator & Institution: Smith, Arnold L. Professor and Chair; Molecular Microbiol and Immun; University of Missouri Columbia 310 Jesse Hall Columbia, MO 65211 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 16-SEP-2002 Summary: (provided by applicant): Haemophilus influenzae is a human-restricted bacterium which can exist as an upper respiratory commensal, but also cause focal and/or systemic disease. More than 95 percent of the nasopharyngeal isolates lack capsules and are not serotypeable, and cause focal infections, while encapsulated (and rare nontypeable) strains cause sepsis and meningitis. The genome of both commensal and pathogenic isolates is 250 kb (on average) larger than the avirulent laboratory strain (Rd KW2O) whose genome sequence was published in 1995. We have found that the genome of strain Rd KW2O is a "scaffold" on which genes, gene clusters and operons encoding virulence factors are inserted, usually at the Haemophilus-specific DNA uptake sites. Using differential hybridization we will identify those DNA loci that permit nasopharyngeal colonization by commensals, and the additional putative virulence loci in pathogenic isolates. Each of these DNA fragments and the flanking DNA, will be sequenced until the Rd KW2O scaffold is identified. All sequence information will be posted on the UW Genome Center web site. Using strict criteria for homology (not conventional criteria) putative virulence genes will either be deleted or mutated and the virulence of the mutant compared to the parent in a relevant in vitro and/or in vivo infection model. For example a putative adhesin present in a lower respiratory tract isolate could be tested with human respiratory epithelial cell lines, and with primary human respiratory epithelium growing at an air-liquid interface in tissue culture. One unique isolate, an untypeable strain causing meningitis in an immunocompetent child immunized with a Hib-conjugate vaccine appears to be a member of a clade; we wish to confirm the preliminary finding and initiate a global database (in collaboration with the MLST Haemophilus Center) for these vaccine-failure isolates. With an understanding of the molecular mechanisms of colonization versus infection, strategies for prevention and intervention can be devised. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENINGITIS
VORICONAZOLE
IN
SUPPRESSION
OF
CRYPTOCOCCAL
Principal Investigator & Institution: Muschatt, David M.; Tulane University of Louisiana New Orleans, LA 70118 Timing: Fiscal Year 2001 Summary: Among persons with advanced HIV infection, cryptococcal meningitis remains the most common invasive fungal infection and fourth most common opportunistic infection. AIDS-associated cryptococcal meningitis also is not easily treatable. In most instances, patients require life-long suppressive treatment because current anti-fungal therapy rarely eradicates the infection. Therefore, the purpose of this study is to determine if voriconazole, a research medicine, is safe, effective and tolerated as a suppressive treatment for cryptococcal meningitis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VP 63843 IN TREATMENT OF ENTEROVIRAL MENINGITIS IN ADOLESCENTS&ADULTS Principal Investigator & Institution: Young, Kelly D.; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, CA 90502 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “meningitis” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for meningitis in the PubMed Central database: •
A critical role for neutralizing-antibody-producing B cells, CD4 + T cells, and interferons in persistent and acute infections of mice with lymphocytic choriomeningitis virus: Implications for adoptive immunotherapy of virus carriers. by Planz O, Ehl S, Furrer E, Horvath E, Brundler MA, Hengartner H, Zinkernagel RM. 1997 Jun 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=21252
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A cryptic cause of cryptococcal meningitis. by Cheung MC, Rachlis AR, Shumak SL. 2003 Feb 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=143553
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A role for pneumolysin but not neuraminidase in the hearing loss and cochlear damage induced by experimental pneumococcal meningitis in guinea pigs. by Winter AJ, Comis SD, Osborne MP, Tarlow MJ, Stephen J, Andrew PW, Hill J, Mitchell TJ. 1997 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=175634
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A Uropathogenicity Island Contributes to the Pathogenicity of Escherichia coli Strains That Cause Neonatal Meningitis. by Houdouin V, Bonacorsi S, Brahimi N, Clermont O, Nassif X, Bingen E. 2002 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=128312
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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Ability of Escherichia coli isolates that cause meningitis in newborns to invade epithelial and endothelial cells. by Meier C, Oelschlaeger TA, Merkert H, Korhonen TK, Hacker J. 1996 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=174088
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Activity of LY333328 in Experimental Meningitis Caused by a Streptococcus pneumoniae Strain Susceptible to Penicillin. by Gerber J, Smirnov A, Wellmer A, Ragheb J, Prange J, Schutz E, Wettich K, Kalich S, Nau R. 2001 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90624
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Amphotericin B Colloidal Dispersion Combined with Flucytosine with or without Fluconazole for Treatment of Murine Cryptococcal Meningitis. by Diamond DM, Bauer M, Daniel BE, Leal MA, Johnson D, Williams BK, Thomas AM, Ding JC, Najvar L, Graybill JR, Larsen RA. 1998 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105493
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An Alternative Animal Model for Comparison of Treatments for Cryptococcal Meningitis. by Najvar LK, Bocanegra R, Graybill JR. 1999 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89093
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Antimicrobial Resistance in Haemophilus influenzae Isolated during PopulationBased Surveillance for Meningitis in Salvador, Brazil. by Reis JN, Lima JB, Ribeiro GS, Corderio SM, Salgado K, Reis MG, Ko AI. 2002 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=128747
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Antimicrobial Susceptibilities of Group B Streptococci Isolated between 1992 and 1996 from Patients with Bacteremia or Meningitis. by Fernandez M, Hickman ME, Baker CJ. 1998 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105636
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Aseptic meningitis after treatment with amoxicillin. by Czerwenka W, Gruenwald C, Conen D. 1999 Jun 5; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27894
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Aseptic meningitis in Germany associated with echovirus type 13. by Diedrich S, Schreier E. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=57743
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Aspergillus Meningitis: Diagnosis by Non-Culture-Based Microbiological Methods and Management. by Verweij PE, Brinkman K, Kremer HP, Kullberg BJ, Meis JF. 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88672
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Bactericidal activity against cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with acute bacterial meningitis. by Klugman KP, Friedland IR, Bradley JS. 1995 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162869
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Bactericidal activity against intermediately cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with bacterial meningitis treated with high doses of cefotaxime and vancomycin. by Doit C, Barre J, Cohen R, Bonacorsi S, Bourrillon A, Bingen EH. 1997 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=164066
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Blockade of NMDA receptor subtype NR2B prevents seizures but not apoptosis of dentate gyrus neurons in bacterial meningitis in infant rats. by Kolarova A, Ringer R, Tauber MG, Leib SL. 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=212551
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BMS-284756 in Experimental Cephalosporin-Resistant Pneumococcal Meningitis. by Rodriguez-Cerrato V, Ghaffar F, Saavedra J, Michelow IC, Hardy RD, Iglehart J, Olsen K, McCracken GH Jr. 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90788
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Cerebrospinal fluid bactericidal activity against cephalosporin-resistant Streptococcus pneumoniae in children with meningitis treated with high-dosage cefotaxime. by Friedland IR, Klugman KP. 1997 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=164030
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Cerebrospinal fluid penetration of amikacin in children with community-acquired bacterial meningitis. by Gaillard JL, Silly C, Le Masne A, Mahut B, Lacaille F, Cheron G, Abadie V, Hubert P, Matha V, Coustere C. 1995 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162520
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Characterization of a Laboratory-Derived, High-Level Ampicillin-Resistant Salmonella enterica Serovar Typhimurium Strain That Caused Meningitis in an Infant. by Chiu CH, Chu C, Su LH, Wu WY, Wu TL. 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127154
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Characterization of Mycobacterium tuberculosis Complex Isolates from the Cerebrospinal Fluid of Meningitis Patients at Six Fever Hospitals in Egypt. by Cooksey RC, Abbadi SH, Woodley CL, Sikes D, Wasfy M, Crawford JT, Mahoney F. 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=130952
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Cheap vaccine needed for Africa's meningitis epidemic. by Maskalyk J. 2002 Nov 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=134309
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Clindamycin therapy of experimental meningitis caused by penicillin- and cephalosporin-resistant Streptococcus pneumoniae. by Paris MM, Shelton S, Trujillo M, Hickey SM, McCracken GH Jr. 1996 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163069
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Cochlear implant recipients at risk for meningitis. by Wooltorton E. 2002 Sep 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=122034
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Combination therapy with fluconazole and flucytosine in the murine model of cryptococcal meningitis. by Nguyen MH, Najvar LK, Yu CY, Graybill JR. 1997 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163860
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Comparative Efficacies of Terbinafine and Fluconazole in Treatment of Experimental Coccidioidal Meningitis in a Rabbit Model. by Sorensen KN, Sobel RA, Clemons KV, Calderon L, Howell KJ, Irani PR, Pappagianis D, Williams PL, Stevens DA. 2000 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=101607
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Comparative Genomics Identifies the Genetic Islands That Distinguish Neisseria meningitidis, the Agent of Cerebrospinal Meningitis, from Other Neisseria Species. by Perrin A, Bonacorsi S, Carbonnelle E, Talibi D, Dessen P, Nassif X, Tinsley C. 2002 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=133019
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Comparative In Vitro Killing Activities of Meropenem, Imipenem, Ceftriaxone, and Ceftriaxone plus Vancomycin at Clinically Achievable Cerebrospinal Fluid Concentrations against Penicillin-Resistant Streptococcus pneumoniae Isolates from Children with Meningitis. by Fitoussi F, Doit C, Benali K, Bonacorsi S, Geslin P, Bingen E. 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105574
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Comparison of Fluconazole and Itraconazole in a Rabbit Model of Coccidioidal Meningitis. by Sorensen KN, Sobel RA, Clemons KV, Pappagianis D, Stevens DA, Williams PL. 2000 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89905
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Concentrations of Cefpirome in Cerebrospinal Fluid of Children with Bacterial Meningitis after a Single Intravenous Dose. by Friedland IR, Sultan E, Lehr KH, Lenfant B. 1998 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105484
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Critical role for a high-affinity chemokine-binding protein in [gamma]-herpesvirus -induced lethal meningitis. by van Berkel V, Levine B, Kapadia SB, Goldman JE, Speck SH, IV HW. 2002 Apr 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=150927
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Critical Role for Alpha/Beta and Gamma Interferons in Persistence of Lymphocytic Choriomeningitis Virus by Clonal Exhaustion of Cytotoxic T Cells. by Ou R, Zhou S, Huang L, Moskophidis D. 2001 Sep 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=115086
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Critical Role for Glial Cells in the Propagation and Spread of Lymphocytic Choriomeningitis Virus in the Developing Rat Brain. by Bonthius DJ, Mahoney J, Buchmeier MJ, Karacay B, Taggard D. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=136288
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Decreased Virulence of a Pneumolysin-Deficient Strain of Streptococcus pneumoniae in Murine Meningitis. by Wellmer A, Zysk G, Gerber J, Kunst T, von Mering M, Bunkowski S, Eiffert H, Nau R. 2002 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=130334
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Detection by PCR of Enteroviruses in Cerebrospinal Fluid during a Summer Outbreak of Aseptic Meningitis in Switzerland. by Gorgievski-Hrisoho M, Schumacher JD, Vilimonovic N, Germann D, Matter L. 1998 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105134
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Detection of JC Virus in Cerebrospinal Fluid (CSF) Samples from Patients with Progressive Multifocal Leukoencephalopathy but Not in CSF Samples from Patients with Herpes Simplex Encephalitis, Enteroviral Meningitis, or Multiple Sclerosis. by Bogdanovic G, Priftakis P, Hammarin AL, Soderstrom M, Samuelson A, LewensohnFuchs I, Dalianis T. 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=104707
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Detection of Leptospira DNA in Patients with Aseptic Meningitis by PCR. by Romero EC, Billerbeck AE, Lando VS, Camargo ED, Souza CC, Yasuda PH. 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=104853
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Dexamethasone in adults with bacterial meningitis. by Suh KN. 2003 Mar 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=154925
•
Diagnosis of Meningococcal Meningitis by Broad-Range Bacterial PCR with Cerebrospinal Fluid. by Kotilainen P, Jalava J, Meurman O, Lehtonen OP, Rintala E, Seppala OP, Eerola E, Nikkari S. 1998 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105011
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Differences in Affinity of Binding of Lymphocytic Choriomeningitis Virus Strains to the Cellular Receptor [alpha]-Dystroglycan Correlate with Viral Tropism and Disease Kinetics. by Smelt SC, Borrow P, Kunz S, Cao W, Tishon A, Lewicki H, Campbell KP, Oldstone MB. 2001 Jan 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=113937
•
Dissemination of Lymphocytic Choriomeningitis Virus from the Gastric Mucosa Requires G Protein-Coupled Signaling. by Yin C, Djavani M, Schenkel AR, Schmidt DS, Pauza CD, Salvato MS. 1998 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=110272
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Effect of fluconazole on fungicidal activity of flucytosine in murine cryptococcal meningitis. by Larsen RA, Bauer M, Weiner JM, Diamond DM, Leal ME, Ding JC, Rinaldi MG, Graybill JR. 1996 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163494
•
Effect of severity of meningitis on fungicidal activity of flucytosine combined with fluconazole in a murine model of cryptococcal meningitis. by Ding JC, Bauer M,
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Diamond DM, Leal MA, Johnson D, Williams BK, Thomas AM, Najvar L, Graybill JR, Larsen RA. 1997 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163965 •
Effects of Polysaccharide Fucoidin on Cerebrospinal Fluid Interleukin-1 and Tumor Necrosis Factor Alpha in Pneumococcal Meningitis in the Rabbit. by Granert C, Raud J, Waage A, Lindquist L. 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=115939
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Efficacies of BMS 284756 against Penicillin-Sensitive, Penicillin-Resistant, and Quinolone-Resistant Pneumococci in Experimental Meningitis. by Cottagnoud P, Acosta F, Cottagnoud M, Pfister M, Tauber MG. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=126974
•
Efficacy of Gatifloxacin in Experimental Escherichia coli Meningitis. by Lutsar I, Friedland IR, Jafri HS, Wubbel L, Ng W, Ghaffar F, McCracken GH Jr. 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89371
•
Efficacy of Intravenous Liposomal Amphotericin B (AmBisome) against Coccidioidal Meningitis in Rabbits. by Clemons KV, Sobel RA, Williams PL, Pappagianis D, Stevens DA. 2002 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127346
•
Enhanced Virus Clearance by Early Inducible Lymphocytic Choriomeningitis VirusNeutralizing Antibodies in Immunoglobulin-Transgenic Mice. by Seiler P, Kalinke U, Rulicke T, Bucher EM, Bose C, Zinkernagel RM, Hengartner H. 1998 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=109522
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Enzyme Immunoassay Detecting Teichoic and Lipoteichoic Acids versus Cerebrospinal Fluid Culture and Latex Agglutination for Diagnosis of Streptococcus pneumoniae Meningitis. by Stuertz K, Merx I, Eiffert H, Schmutzhard E, Mader M, Nau R. 1998 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105046
•
Evaluation of an In-House-Developed Radioassay Kit for Antibody Detection in Cases of Pulmonary Tuberculosis and Tuberculous Meningitis. by Kameswaran M, Shetty K, Ray MK, Jaleel MA, Kadival GV. 2002 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=120075
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Evaluation of CP-99,219, a new fluoroquinolone, for treatment of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis. by Paris MM, Hickey SM, Trujillo M, Shelton S, McCracken GH Jr. 1995 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162720
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Evaluation of Moxifloxacin, a New 8-Methoxyquinolone, for Treatment of Meningitis Caused by a PenicillinResistant Pneumococcus in Rabbits. by Ostergaard C, Klitmoller Sorensen T, Dahl Knudsen J, Frimodt-Moller N. 1998 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105670
•
Evaluation of PCR Using TRC4 and IS6110 Primers in Detection of Tuberculous Meningitis. by Narayanan S, Parandaman V, Narayanan PR, Venkatesan P, Girish C, Mahadevan S, Rajajee S. 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88071
•
Evaluation of T-3811ME (BMS-284756), a New Des-F(6)-Quinolone, for Treatment of Meningitis Caused by Penicillin-Resistant Streptococcus pneumoniae in Rabbits. by Takahata M, Yamada H, Morita T, Furubou S, Minami S, Todo Y, Watanabe Y, Narita H. 2002 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127215
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Failure To Detect Muramic Acid in Normal Rat Tissues but Detection in Cerebrospinal Fluids from Patients with Pneumococcal Meningitis. by Kozar MP, Krahmer MT, Fox A, Gray BM. 2000 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=98412
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Fit genotypes and escape variants of subgroup III Neisseria meningitidis during three pandemics of epidemic meningitis. by Zhu P, van der Ende A, Falush D, Brieske N, Morelli G, Linz B, Popovic T, Schuurman IG, Adegbola RA, Zurth K, Gagneux S, Platonov AE, Riou JY, Caugant DA, Nicolas P, Achtman M. 2001 Apr 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33193
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Garenoxacin (BMS-284756) and Moxifloxacin in Experimental Meningitis Caused by Vancomycin-Tolerant Pneumococci. by Rodriguez-Cerrato V, McCoig CC, Saavedra J, Barton T, Michelow IC, Hardy RD, Bowlware K, Iglehart J, Katz K, McCracken GH Jr. 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=148949
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Gemifloxacin Is Effective in Experimental Pneumococcal Meningitis. by Smirnov A, Wellmer A, Gerber J, Maier K, Henne S, Nau R. 2000 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89762
•
Gemifloxacin Is Efficacious against Penicillin-Resistant and Quinolone-Resistant Pneumococci in Experimental Meningitis. by Cottagnoud P, Acosta F, Cottagnoud M, Tauber MG. 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127126
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Gentamicin Increases the Efficacy of Vancomycin against Penicillin-Resistant Pneumococci in the Rabbit Meningitis Model. by Cottagnoud P, Gerber CM, Cottagnoud M, Tauber MG. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127013
78 Meningitis
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Group B streptococcal [beta]-hemolysin/cytolysin activates neutrophil signaling pathways in brain endothelium and contributes to development of meningitis. by Doran KS, Liu GY, Nizet V. 2003 Sep 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=182187
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High doses of cefotaxime in treatment of adult meningitis due to Streptococcus pneumoniae with decreased susceptibilities to broad-spectrum cephalosporins. by Viladrich PF, Cabellos C, Pallares R, Tubau F, Martinez-Lacasa J, Linares J, Gudiol F. 1996 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163086
•
High Frequency of Virus-Specific Interleukin-2-Producing CD4 + T Cells and Th1 Dominance during Lymphocytic Choriomeningitis Virus Infection. by Varga SM, Welsh RM. 2000 May 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=111961
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Identification of Regions of the Escherichia coli Chromosome Specific for Neonatal Meningitis-Associated Strains. by Bonacorsi SP, Clermont O, Tinsley C, Le Gall I, Beaudoin JC, Elion J, Nassif X, Bingen E. 2000 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=97390
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Immunocytochemical Method for Early Laboratory Diagnosis of Tuberculous Meningitis. by Sumi MG, Mathai A, Reuben S, Sarada C, Radhakrishnan VV. 2002 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=119925
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Impaired responsiveness to gamma interferon of macrophages infected with lymphocytic choriomeningitis virus clone 13: susceptibility to histoplasmosis. by Villarete L, de Fries R, Kolhekar S, Howard D, Ahmed R, Wu-Hsieh B. 1995 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173176
•
Influence of dexamethasone on efficacy of ceftriaxone and vancomycin therapy in experimental pneumococcal meningitis. by Cabellos C, Martinez-Lacasa J, Martos A, Tubau F, Fernandez A, Viladrich PF, Gudiol F. 1995 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162903
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Inhibition of Escherichia coli-Induced Meningitis by Carboxyfullerence. by Tsao N, Kanakamma PP, Luh TY, Chou CK, Lei HY. 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89460
•
Inhibition of Leukocyte Entry into the Brain by the Selectin Blocker Fucoidin Decreases Interleukin-1 (IL-1) Levels but Increases IL-8 Levels in Cerebrospinal Fluid during Experimental Pneumococcal Meningitis in Rabbits. by Ostergaard C, YiengKow RV, Benfield T, Frimodt-Moller N, Espersen F, Lundgren JD. 2000 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=97550
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Interleukin-10 Negatively Regulates Local Cytokine and Chemokine Production but Does Not Influence Antibacterial Host Defense during Murine Pneumococcal Meningitis. by Zwijnenburg PJ, van der Poll T, Florquin S, Roord JJ, van Furth AM. 2003 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=152042
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Intrathecal Administration of Single-Chain Immunotoxin, LMB-7 [B3(Fv)- PE38], Produces Cures of Carcinomatous Meningitis in a Rat Model. by Pastan IH, Archer GE, McLendon RE, Friedman HS, Fuchs HE, Wang Q, Pai LH, Herndon J, Bigner DD. 1995 Mar 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=42299
•
Intrathecal production of interleukin-12 and gamma interferon in patients with bacterial meningitis. by Kornelisse RF, Hack CE, Savelkoul HF, van der Pouw Kraan TC, Hop WC, van Mierlo G, Suur MH, Neijens HJ, de Groot R. 1997 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=175063
•
Intrathecal synthesis of immunoglobulin G and Mycobacterium tuberculosis-specific humoral immune response in tuberculous meningitis. by Cho TY, Park SC, Cho SN, Lee HR, Kim SK, Kim SK, Lee BI. 1995 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=170160
•
Invasive Fungal Sinusitis and Meningitis Due to Arthrographis kalrae in a Patient with AIDS. by Chin-Hong PV, Sutton DA, Roemer M, Jacobson MA, Aberg JA. 2001 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=87827
•
Killing activity of cefpirome against penicillin-resistant Streptococcus pneumoniae isolates from patients with meningitis in a pharmacodynamic model simulating the cerebrospinal fluid concentration profile. by Fitoussi F, Doit C, Sandin A, Pechinot A, Kazmierczack A, Geslin P, Bingen E. 1995 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162984
•
Laboratory Diagnosis and Genetic Analysis of an Echovirus 30-Associated Outbreak of Aseptic Meningitis in Taiwan in 2001. by Wang JR, Tsai HP, Huang SW, Kuo PH, Kiang D, Liu CC. 2002 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=154609
•
Light eye colour linked to deafness after meningitis. by Cullington HE. 2001 Mar 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26552
•
Long-Term CD4 Th1 and Th2 Memory following Acute Lymphocytic Choriomeningitis Virus Infection. by Whitmire JK, Asano MS, Murali-Krishna K, Suresh M, Ahmed R. 1998 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=110189
80 Meningitis
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Management of meningitis caused by penicillin-resistant Streptococcus pneumoniae. by Paris MM, Ramilo O, McCracken GH Jr. 1995 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162908
•
Management of meningitis caused by penicillin-resistant Streptococcus pneumoniae. by Bhattacharya S. 1996 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163213
•
Matrix Metalloproteinases Contribute to Brain Damage in Experimental Pneumococcal Meningitis. by Leib SL, Leppert D, Clements J, Tauber MG. 2000 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=97183
•
Meningitis and cochlear implantation. by Papsin BC. 2003 Feb 4; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=140462
•
Meningitis Due to Mixed Infection with Penicillin-Resistant and PenicillinSusceptible Strains of Streptococcus pneumoniae. by Chaves F, Campelo C, Sanz F, Otero JR. 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=149642
•
Meningitis Due to Streptococcus salivarius. by Idigoras P, Valiente A, Iglesias L. 2001 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88286
•
Meningitis in infancy in England and Wales: follow up at age 5 years. by Bedford H, de Louvois J, Halket S, Peckham C, Hurley R, Harvey D. 2001 Sep 8; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=48156
•
Microscopic Examination and Broth Culture of Cerebrospinal Fluid in Diagnosis of Meningitis. by Dunbar SA, Eason RA, Musher DM, Clarridge JE III. 1998 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=104888
•
Modeling of Transfer Kinetics at the Serum-Cerebrospinal Fluid Barrier in Rabbits with Experimental Meningitis: Application to Grepafloxacin. by Pfister M, Zhang L, Hammarlund-Udenaes M, Sheiner LB, Gerber CM, Tauber MG, Cottagnoud P. 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=149016
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Modulation of Release of Proinflammatory Bacterial Compounds by Antibacterials: Potential Impact on Course of Inflammation and Outcome in Sepsis and Meningitis. by Nau R, Eiffert H. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=118062
•
Molecular and Functional Dissection of the H-2Db-Restricted Subdominant Cytotoxic T-Cell Response to Lymphocytic Choriomeningitis Virus. by Hudrisier D, Riond J, Gairin JE. 2001 Mar 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=114831
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Molecular Epidemiological Study of Haemophilus influenzae Serotype b Strains Obtained from Children with Meningitis in Japan. by Mitsuda T, Kuroki H, Ishikawa N, Imagawa T, Ito S, Miyamae T, Mori M, Uehara S, Yokota S. 1999 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=85279
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Molecular Identification and Epidemiological Tracing of Pasteurella multocida Meningitis in a Baby. by Boerlin P, Siegrist HH, Burnens AP, Kuhnert P, Mendez P, Pretat G, Lienhard R, Nicolet J. 2000 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=86385
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Molecular Identification of Staphylococcus lugdunensis in a Patient with Meningitis. by Kaabia N, Scauarda D, Lena G, Drancourt M. 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=130937
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Moxifloxacin in the Therapy of Experimental Pneumococcal Meningitis. by Schmidt H, Dalhoff A, Stuertz K, Trostdorf F, Chen V, Schneider O, Kohlsdorfer C, Bruck W, Nau R. 1998 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105611
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Multicenter Evaluation of the Amplicor Enterovirus PCR Test with Cerebrospinal Fluid from Patients with Aseptic Meningitis. by van Vliet KE, Glimaker M, Lebon P, Klapper PE, Taylor CE, Ciardi M, van der Avoort HG, Diepersloot RJ, Kurtz J, Peeters MF, Cleator GM, van Loon AM. 1998 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105179
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Neisseria meningitidis Serogroups W135 and A Were Equally Prevalent among Meningitis Cases Occurring at the End of the 2001 Epidemics in Burkina Faso and Niger. by Taha MK, Parent du Chatelet I, Schlumberger M, Sanou I, Djibo S, de Chabalier F, Alonso JM. 2002 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=120283
•
Neutralization of Macrophage Inflammatory Protein 2 (MIP-2) and MIP-1[alpha] Attenuates Neutrophil Recruitment in the Central Nervous System during Experimental Bacterial Meningitis. by Diab A, Abdalla H, Li HL, Shi FD, Zhu J, Hojberg B, Lindquist L, Wretlind B, Bakhiet M, Link H. 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=116008
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Once-daily gentamicin therapy for experimental Escherichia coli meningitis. by Ahmed A, Paris MM, Trujillo M, Hickey SM, Wubbel L, Shelton SL, McCracken GH Jr. 1997 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163658
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One Case Each of Recurrent Meningitis and Hemoperitoneum Infection with Ralstonia mannitolilytica. by Vaneechoutte M, De Baere T, Wauters G, Steyaert S, Claeys G, Vogelaers D, Verschraegen G. 2001 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88597
82 Meningitis
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PCR-Enzyme Immunoassay for Detection of Streptococcus pneumoniae DNA in Cerebrospinal Fluid Samples from Patients With Culture-Negative Meningitis. by Cherian T, Lalitha MK, Manoharan A, Thomas K, Yolken RH, Steinhoff MC. 1998 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105248
•
Persistent Virus Infection despite Chronic Cytotoxic T-Lymphocyte Activation in Gamma Interferon-Deficient Mice Infected with Lymphocytic Choriomeningitis Virus. by Bartholdy C, Christensen JP, Wodarz D, Thomsen AR. 2000 Nov 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=110904
•
Pharmacodynamics and bactericidal activity of ceftriaxone therapy in experimental cephalosporin-resistant pneumococcal meningitis. by Lutsar I, Ahmed A, Friedland IR, Trujillo M, Wubbel L, Olsen K, McCracken GH Jr. 1997 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=164137
•
Pharmacodynamics and Bactericidal Activity of Moxifloxacin in Experimental Escherichia coli Meningitis. by Rodriguez-Cerrato V, McCoig CC, Michelow IC, Ghaffar F, Jafri HS, Hardy RD, Patel C, Olsen K, McCracken GH Jr. 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90787
•
Pharmacodynamics of Gatifloxacin in Cerebrospinal Fluid in Experimental Cephalosporin-Resistant Pneumococcal Meningitis. by Lutsar I, Friedland IR, Wubbel L, McCoig CC, Jafri HS, Ng W, Ghaffar F, McCracken GH Jr. 1998 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105913
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Pharmacodynamics of Vancomycin for the Treatment of Experimental Penicillin- and Cephalosporin-Resistant Pneumococcal Meningitis. by Ahmed A, Jafri H, Lutsar I, McCoig CC, Trujillo M, Wubbel L, Shelton S, McCracken GH Jr. 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89220
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Pneumococcal pneumolysin and H2O2 mediate brain cell apoptosis during meningitis. by Braun JS, Sublett JE, Freyer D, Mitchell TJ, Cleveland JL, Tuomanen EI, Weber JR. 2002 Jan 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=150815
•
Population-Based Survey of Antimicrobial Susceptibility and Serotype Distribution of Streptococcus pneumoniae from Meningitis Patients in Salvador, Brazil. by Reis JN, Cordeiro SM, Coppola SJ, Salgado K, Carvalho MG, Teixeira LM, Thompson TA, Facklam RR, Reis MG, Ko AI. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=120107
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Postneurosurgical Meningitis Due to Proteus penneri with Selection of a CeftriaxoneResistant Isolate: Analysis of Chromosomal Class A [beta]-Lactamase HugA and its LysR-Type Regulatory Protein HugR. by Liassine N, Madec S, Ninet B, Metral C, Fouchereau-Peron M, Labia R, Auckenthaler R. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=126972
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•
Potential role of nitric oxide in the pathophysiology of experimental bacterial meningitis in rats. by Buster BL, Weintrob AC, Townsend GC, Scheld WM. 1995 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173539
•
Pretreatment with Granulocyte Colony-Stimulating Factor Attenuates the Inflammatory Response but Not the Bacterial Load in Cerebrospinal Fluid during Experimental Pneumococcal Meningitis in Rabbits. by Ostergaard C, Benfield T, Gesser B, Kharazmi A, Frimodt-Moller N, Espersen F, Lundgren JD. 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=116528
•
Prospective randomized comparison of cefepime and cefotaxime for treatment of bacterial meningitis in infants and children. by Saez-Llorens X, Castano E, Garcia R, Baez C, Perez M, Tejeira F, McCracken GH Jr. 1995 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162657
•
Quinolone antibiotics in therapy of experimental pneumococcal meningitis in rabbits. by Nau R, Schmidt T, Kaye K, Froula JL, Tauber MG. 1995 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162589
•
Randomized comparison of meropenem with cefotaxime for treatment of bacterial meningitis. Meropenem Meningitis Study Group. by Klugman KP, Dagan R. 1995 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162697
•
Rapid Diagnosis of Tuberculous Meningitis by a Dot Immunobinding Assay To Detect Mycobacterial Antigen in Cerebrospinal Fluid Specimens. by Sumi MG, Mathai A, Sarada C, Radhakrishnan VV. 1999 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=85846
•
Rapid Real-Time PCR for Determination of Penicillin Susceptibility in Pneumococcal Meningitis, Including Culture-Negative Cases. by Kearns AM, Graham C, Burdess D, Heatherington J, Freeman R. 2002 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=153399
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Recruitment Times, Proliferation, and Apoptosis Rates during the CD8 + T-Cell Response to Lymphocytic Choriomeningitis Virus. by De Boer RJ, Oprea M, Antia R, Murali-Krishna K, Ahmed R, Perelson AS. 2001 Nov 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=114648
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Rhodotorula glutinis-Related Meningitis. by Lanzafame M, De Checchi G, Parinello A. 2001 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=87748
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Rifampin Followed by Ceftriaxone for Experimental Meningitis Decreases Lipoteichoic Acid Concentrations in Cerebrospinal Fluid and Reduces Neuronal Damage in Comparison to Ceftriaxone Alone. by Gerber J, Pohl K, Sander V, Bunkowski S, Nau R. 2003 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=152510
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Role of an Intact Splenic Microarchitecture in Early Lymphocytic Choriomeningitis Virus Production. by Muller S, Hunziker L, Enzler S, Buhler-Jungo M, Di Santo JP, Zinkernagel RM, Mueller C. 2002 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=153806
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Role of IS6110-Targeted PCR, Culture, Biochemical, Clinical, and Immunological Criteria for Diagnosis of Tuberculous Meningitis. by Caws M, Wilson SM, Clough C, Drobniewski F. 2000 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=87341
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Roles of proinflammatory and anti-inflammatory cytokines in pathophysiology of bacterial meningitis and effect of adjunctive therapy. by van Furth AM, Roord JJ, van Furth R. 1996 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174464
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Selective Loss of Natural Killer T Cells by Apoptosis following Infection with Lymphocytic Choriomeningitis Virus. by Hobbs JA, Cho S, Roberts TJ, Sriram V, Zhang J, Xu M, Brutkiewicz RR. 2001 Nov 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=114656
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Severe community-acquired meningitis. by Boisson C, Arnaud S, Vialet R, Martin C. 1999; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=137234
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Simultaneous Detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in Suspected Cases of Meningitis and Septicemia Using Real-Time PCR. by Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB. 2001 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=87969
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Streptococcal Meningitis Resulting from Contact with an Infected Horse. by Downar J, Willey BM, Sutherland JW, Mathew K, Low DE. 2001 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88147
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Streptococcus bovis Meningitis in an Infant. by Grant RJ, Whitehead TR, Orr JE. 2000 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88753
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Streptococcus pneumoniae Causes Experimental Meningitis following Intranasal and Otitis Media Infections via a Nonhematogenous Route. by Marra A, Brigham D. 2001 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=98817
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Successful treatment of cryptococcal meningitis with amphotericin B colloidal dispersion: report of four cases. by Valero G, Graybill JR. 1995 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162993
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Synergy between Trovafloxacin and Ceftriaxone against Penicillin-Resistant Pneumococci in the Rabbit Meningitis Model and In Vitro. by Cottagnoud P, Acosta F, Cottagnoud M, Neftel K, Tauber MG. 2000 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90034
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Systemic Neutralization of Interleukin-8 Markedly Reduces Neutrophilic Pleocytosis during Experimental Lipopolysaccharide-Induced Meningitis in Rabbits. by Dumont RA, Car BD, Voitenok NN, Junker U, Moser B, Zak O, O'Reilly T. 2000 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=101534
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The 1998 Senegal Epidemic of Meningitis Was Due to the Clonal Expansion of A:4:P1.9, Clone III-1, Sequence Type 5 Neisseria meningitidis Strains. by Nicolas P, Raphenon G, Guibourdenche M, Decousset L, Stor R, Gaye AB. 2000 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88695
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The Cellular Form of Human Fibronectin as an Adhesion Target for the S Fimbriae of Meningitis-Associated Escherichia coli. by Saren A, Virkola R, Hacker J, Korhonen TK. 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=116024
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The Polysaccharide Fucoidin Inhibits the Antibiotic-Induced Inflammatory Cascade in Experimental Pneumococcal Meningitis. by Granert C, Raud J, Lindquist L. 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=104518
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The Three Major Spanish Clones of Penicillin-Resistant Streptococcus pneumoniae Are the Most Common Clones Recovered in Recent Cases of Meningitis in Spain. by Enright MC, Fenoll A, Griffiths D, Spratt BG. 1999 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=85530
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The Virus-Specific and Allospecific Cytotoxic T-Lymphocyte Response to Lymphocytic Choriomeningitis Virus Is Modified in a Subpopulation of CD8 + T Cells Coexpressing the Inhibitory Major Histocompatibility Complex Class I Receptor Ly49G2. by Peacock CD, Lin MY, Ortaldo JR, Welsh RM. 2000 Aug 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=112220
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Thymic Tolerance to Only One Viral Protein Reduces Lymphocytic Choriomeningitis Virus-Induced Immunopathology and Increases Survival in Perforin-Deficient Mice. by von Herrath M, Coon B, Homann D, Wolfe T, Guidotti LG. 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=112653
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Travel warning: eosinophilic meningitis caused by rat lungworm. by Weir E. 2002 Apr 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=102360
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Trovafloxacin in Combination with Vancomycin against Penicillin-Resistant Pneumococci in the Rabbit Meningitis Model. by Rodoni D, Hanni F, Gerber CM, Cottagnoud M, Neftel K, Tauber MG, Cottagnoud P. 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89237
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Trovafloxacin in treatment of rabbits with experimental meningitis caused by highlevel penicillin-resistant Streptococcus pneumoniae. by Kim YS, Liu Q, Chow LL, Tauber MG. 1997 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163879
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Use of IMiD3, a Thalidomide Analog, as an Adjunct to Therapy for Experimental Tuberculous Meningitis. by Tsenova L, Mangaliso B, Muller G, Chen Y, Freedman VH, Stirling D, Kaplan G. 2002 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127267
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Use of Lytic Bacteriophage for Control of Experimental Escherichia coli Septicemia and Meningitis in Chickens and Calves. by Barrow P, Lovell M, Berchieri A Jr. 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=104512
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Use of Roche AMPLICOR Mycobacterium tuberculosis PCR in Early Diagnosis of Tuberculous Meningitis. by Bonington A, Strang JI, Klapper PE, Hood SV, Rubombora W, Penny M, Willers R, Wilkins EG. 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=104809
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Variation in the structure of glucuronoxylomannan in isolates from patients with recurrent cryptococcal meningitis. by Cherniak R, Morris LC, Belay T, Spitzer ED, Casadevall A. 1995 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173241
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YKL-40 Is Elevated in Cerebrospinal Fluid from Patients with Purulent Meningitis. by Ostergaard C, Johansen JS, Benfield T, Price PA, Lundgren JD. 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=119997
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
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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text
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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with meningitis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “meningitis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for meningitis (hyperlinks lead to article summaries): •
A 10-week old infant with meningitis. Author(s): Colby CE, Steinbach WJ, Haiman AK. Source: Clinical Pediatrics. 2001 March; 40(3): 155-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11307961&dopt=Abstract
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A 35-year-old man with recurrent aseptic meningitis. Author(s): Chang DZ, Correia NG, Khurana P, Tuthill RJ, Taege AJ. Source: Cleve Clin J Med. 2001 March; 68(3): 199-201, 205-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11263848&dopt=Abstract
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A 59-year-old woman with tuberculous meningitis masked by hepatic encephalopathy. Author(s): Carmichael MG, Thompson JC, Buttolph TB, Hooke JA. Source: Military Medicine. 2003 March; 168(3): 266-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685697&dopt=Abstract
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A case of anthrax meningitis. Author(s): Albayrak F, Memikoglu O, Kurt O, Cokca F, Birengel S, Tekeli E. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(8): 627-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12238584&dopt=Abstract
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A case of non-O:1 Vibrio cholerae septicemia with meningitis, cerebral abscess and unilateral hydrocephalus in a preterm baby. Author(s): Ismail EA, Shafik MH, Al-Mutairi G. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 August; 20(8): 598600. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11681447&dopt=Abstract
journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A case of pneumococcal meningitis. Author(s): Crozier I, Morrow JD, Morgan H. Source: Tenn Med. 2000 October; 93(10): 379-80. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11026815&dopt=Abstract
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A case of rheumatoid meningitis positive for perinuclear antineutrophil cytoplasmic antibody. Author(s): Funauchi M, Yoo BS, Sugiyama M, Ikoma S, Ohno M, Kinoshito K, Hamada K, Kanamaru A. Source: Annals of the Rheumatic Diseases. 2000 December; 59(12): 1001-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11153479&dopt=Abstract
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A clinical manifestation of AIDS with cryptococcal meningitis in Equatorial Guinea. Author(s): Wang W, Carm AR. Source: Trop Doct. 2001 October; 31(4): 221-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11676062&dopt=Abstract
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A clinical study of chronic morbidity in children following pyogenic meningitis. Author(s): George CN, Letha S, Bai SS. Source: Indian Pediatrics. 2002 July; 39(7): 663-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147894&dopt=Abstract
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A cluster of children with lyme meningitis presenting to one emergency department in a Boston suburb. Author(s): Bowen AP. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2002 August; 28(4): 355-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12122414&dopt=Abstract
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A comparative evaluation of dot immunobinding assay (Dot-Iba) and polymerase chain reaction (PCR) for the laboratory diagnosis of tuberculous meningitis. Author(s): Sumi MG, Mathai A, Reuben S, Sarada C, Radhakrishnan VV, Indulakshmi R, Sathish M, Ajaykumar R, Manju YK. Source: Diagnostic Microbiology and Infectious Disease. 2002 January; 42(1): 35-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821169&dopt=Abstract
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A critical review of control strategies against meningococcal meningitis epidemics in sub-Saharan African countries. Author(s): Chippaux JP, Debois H, Saliou P. Source: Infection. 2002 August; 30(4): 216-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236565&dopt=Abstract
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A cryptic cause of cryptococcal meningitis. Author(s): Cheung MC, Rachlis AR, Shumak SL. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 February 18; 168(4): 451-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12591788&dopt=Abstract
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A hospital outbreak of aseptic meningitis due to echovirus type 30 in Antalya, Turkey. Author(s): Akman S, Ozkaya E, Colak D, Daloglu H. Source: Turk J Pediatr. 2002 July-September; 44(3): 237-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405436&dopt=Abstract
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A newer approach for the laboratory diagnosis of tuberculous meningitis. Author(s): Mathai A, Radhakrishnan VV, George SM, Sarada C. Source: Diagnostic Microbiology and Infectious Disease. 2001 April; 39(4): 225-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11404064&dopt=Abstract
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A novel, multiple drug-resistant, serotype 24F strain of Streptococcus pneumoniae that caused meningitis in patients in Naples, Italy. Author(s): Pantosti A, Gherardi G, Conte M, Faella F, Dicuonzo G, Beall B. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 July 15; 35(2): 205-8. Epub 2002 June 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12087529&dopt=Abstract
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A phase II trial of intra-cerebrospinal fluid alpha interferon in the treatment of neoplastic meningitis. Author(s): Chamberlain MC. Source: Cancer. 2002 May 15; 94(10): 2675-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173336&dopt=Abstract
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A prospective study of AIDS-associated cryptococcal meningitis in Thailand treated with high-dose amphotericin B. Author(s): Pitisuttithum P, Tansuphasawadikul S, Simpson AJ, Howe PA, White NJ. Source: The Journal of Infection. 2001 November; 43(4): 226-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869059&dopt=Abstract
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A randomized, double-blind, placebo-controlled trial of acetazolamide for the treatment of elevated intracranial pressure in cryptococcal meningitis. Author(s): Newton PN, Thai le H, Tip NQ, Short JM, Chierakul W, Rajanuwong A, Pitisuttithum P, Chasombat S, Phonrat B, Maek-A-Nantawat W, Teaunadi R, Lalloo DG, White NJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 September 15; 35(6): 769-72. Epub 2002 August 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12203177&dopt=Abstract
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A retrospective clinical, laboratory and outcome analysis in 43 cases of acute aseptic meningitis. Author(s): Nowak DA, Boehmer R, Fuchs HH. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2003 May; 10(3): 271-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752401&dopt=Abstract
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A revised clinical method for assessment of severity of acute bacterial meningitis. Author(s): Akpede GO, Jalo I, Dawodu SO. Source: Annals of Tropical Paediatrics. 2002 March; 22(1): 33-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11926048&dopt=Abstract
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A season of aseptic meningitis in Germany: epidemiologic, clinical and diagnostic aspects. Author(s): Bottner A, Daneschnejad S, Handrick W, Schuster V, Liebert UG, Kiess W. Source: The Pediatric Infectious Disease Journal. 2002 December; 21(12): 1126-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488662&dopt=Abstract
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A uropathogenicity island contributes to the pathogenicity of Escherichia coli strains that cause neonatal meningitis. Author(s): Houdouin V, Bonacorsi S, Brahimi N, Clermont O, Nassif X, Bingen E. Source: Infection and Immunity. 2002 October; 70(10): 5865-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12228319&dopt=Abstract
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Absolute neutrophil count in aseptic and bacterial meningitis related to time of lumbar puncture. Author(s): Straussberg R, Harel L, Nussinovitch M, Amir J. Source: Pediatric Neurology. 2003 May; 28(5): 365-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12878298&dopt=Abstract
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Actinomycotic meningitis: report of a case. Author(s): Chotmongkol V, Panthavasit J, Chuesakoolvanich K. Source: J Med Assoc Thai. 2002 June; 85(6): 739-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12322850&dopt=Abstract
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Acute bacterial meningitis as a complication of otitis media and related mortality factors. Author(s): Geyik MF, Kokoglu OF, Hosoglu S, Ayaz C. Source: Yonsei Medical Journal. 2002 October; 43(5): 573-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12402369&dopt=Abstract
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Acute bacterial meningitis in adults. A 12-year review. Author(s): Hussein AS, Shafran SD. Source: Medicine; Analytical Reviews of General Medicine, Neurology, Psychiatry, Dermatology, and Pediatrics. 2000 November; 79(6): 360-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11144034&dopt=Abstract
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Acute bacterial meningitis in children admitted to a rural Kenyan hospital: increasing antibiotic resistance and outcome. Author(s): Mwangi I, Berkley J, Lowe B, Peshu N, Marsh K, Newton CR. Source: The Pediatric Infectious Disease Journal. 2002 November; 21(11): 1042-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12442027&dopt=Abstract
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Acute community-acquired meningitis and encephalitis. Author(s): Saltman DC. Source: The Medical Journal of Australia. 2002 September 2; 177(5): 277; Author Reply 277. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197828&dopt=Abstract
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Acute disseminated encephalomyelitis associated with Pasteurella multocida meningitis. Author(s): Proulx NL, Freedman MS, Chan JW, Toye B, Code CC. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 2003 May; 30(2): 155-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12774957&dopt=Abstract
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Acute meningitis due to Toscana virus infection among patients from both the Spanish Mediterranean region and the region of Madrid. Author(s): Echevarria JM, de Ory F, Guisasola ME, Sanchez-Seco MP, Tenorio A, Lozano A, Cordoba J, Gobernado M. Source: Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology. 2003 January; 26(1): 79-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589837&dopt=Abstract
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Acute meningoencephalitis and meningitis due to primary HIV infection. Author(s): Newton PJ, Newsholme W, Brink NS, Manji H, Williams IG, Miller RF. Source: Bmj (Clinical Research Ed.). 2002 November 23; 325(7374): 1225-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12446542&dopt=Abstract
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Acute motor axonal Guillain-Barre syndrome after Salmonella typhimurium bacteremia and cryptococcal meningitis in AIDS. Author(s): Blanche P, Passeron A, Gombert B, Ginsburg C, Chapuis L, Salmon D, Sicard D. Source: Journal of Neurology. 2001 April; 248(4): 334-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11374102&dopt=Abstract
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Acute severe spinal cord dysfunction in bacterial meningitis in adults: MRI findings suggest extensive myelitis. Author(s): Roos KL. Source: Archives of Neurology. 2001 May; 58(5): 717-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346365&dopt=Abstract
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Acute severe spinal cord dysfunction in bacterial meningitis in adults: MRI findings suggest extensive myelitis. Author(s): Kastenbauer S, Winkler F, Fesl G, Schiel X, Ostermann H, Yousry TA, Pfister HW. Source: Archives of Neurology. 2001 May; 58(5): 806-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346376&dopt=Abstract
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Acute ST-segment elevation in Neisseria meningitis. Author(s): Gach O, Lancellotti P, Pierard LA. Source: Acta Cardiol. 2001 October; 56(5): 327-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11712830&dopt=Abstract
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Acute urinary retention as an unusual manifestation of aseptic meningitis. Author(s): Zenda T, Soma R, Muramoto H, Hayase H, Orito M, Okada T, Mabuchi H, Okino S. Source: Intern Med. 2002 May; 41(5): 392-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058890&dopt=Abstract
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Adenosine deaminase levels in cerebrospinal fluid and serum in the diagnosis of tubercular meningitis. Author(s): Chaturvedi P, Vaidya J, Harinath BC, Pramanick B. Source: Journal of Tropical Pediatrics. 2000 December; 46(6): 378-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191154&dopt=Abstract
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Adult community acquired bacterial meningitis in a Singaporean teaching hospital. A seven-year overview (1993-2000). Author(s): Chan YC, Wilder-Smith A, Ong BK, Kumarasinghe G, Wilder-Smith E. Source: Singapore Med J. 2002 December; 43(12): 632-6. Erratum In: Singapore Med J. 2003 January; 44(1): 50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12693768&dopt=Abstract
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Adult Enterobacter meningitis: a high incidence of coinfection with other pathogens and frequent association with neurosurgical procedures. Author(s): Huang CR, Lu CH, Chang WN. Source: Infection. 2001 March-April; 29(2): 75-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11339479&dopt=Abstract
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Adult onset spontaneous CSF otorrhea with oval window fistula and recurrent meningitis: MRI findings. Author(s): Rupa V, Job A, Rajshekhar V. Source: Otolaryngology and Head and Neck Surgery. 2001 March; 124(3): 344-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11241007&dopt=Abstract
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Adults with meningitis caused by viridans streptococci. Author(s): Lu CH, Chang WN, Chang HW. Source: Infection. 2001 December; 29(6): 305-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11787829&dopt=Abstract
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Amoxicillin-induced aseptic meningitis. Author(s): Wittmann A, Wooten GF. Source: Neurology. 2001 November 13; 57(9): 1734. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11706130&dopt=Abstract
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An epidemic of aseptic meningitis due to coxsackievirus B5 in Nara prefecture, Japan: an epidemiological analysis by PCR-RFLP. Author(s): Kitahori Y, Inoue Y, Maruhashi Y, Adachi O, Imai S. Source: Japanese Journal of Infectious Diseases. 2003 April; 56(2): 75-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824693&dopt=Abstract
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An indigenous leucocyte esterase test along with Pandy's test for the diagnosis of bacterial meningitis. Author(s): Locham KK, Sodhi M, Jindal G. Source: Indian Pediatrics. 2002 June; 39(6): 602-3; Author Reply 603-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12084964&dopt=Abstract
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An indigenous leucocyte esterase test along with Pandy's test for the diagnosis of bacterial meningitis. Author(s): Srivastava RK, Gupta S, Bhargava M, Kumar N, Upadhyay P, Puliyel JM. Source: Indian Pediatrics. 2001 November; 38(11): 1281-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11721069&dopt=Abstract
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An infant with group B streptococcal meningitis. Author(s): Listernick R. Source: Pediatric Annals. 2002 November; 31(11): 699-703. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455478&dopt=Abstract
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An infant with meningitis and unexplained coagulopathy. Author(s): Siegfried B. Source: Clinical Pediatrics. 2002 October; 41(8): 625-6; Discussion 626-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12403383&dopt=Abstract
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An open label trial of sustained-release cytarabine (DepoCyt) for the intrathecal treatment of solid tumor neoplastic meningitis. Author(s): Jaeckle KA, Batchelor T, O'Day SJ, Phuphanich S, New P, Lesser G, Cohn A, Gilbert M, Aiken R, Heros D, Rogers L, Wong E, Fulton D, Gutheil JC, Baidas S, Kennedy JM, Mason W, Moots P, Russell C, Swinnen LJ, Howell SB. Source: Journal of Neuro-Oncology. 2002 May; 57(3): 231-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12125986&dopt=Abstract
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An outbreak of Aseptic Meningitis due to echovirus type 30 in two cities of Turkey. Author(s): Ozkaya E, Hizel K, Uysal G, Akman S, Terzioglu S, Kuyucu N. Source: European Journal of Epidemiology. 2003; 18(8): 823-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12974559&dopt=Abstract
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An outbreak of echovirus 13 meningitis in central Israel. Author(s): Somekh E, Cesar K, Handsher R, Hanukoglu A, Dalal I, Ballin A, Shohat T. Source: Epidemiology and Infection. 2003 April; 130(2): 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729194&dopt=Abstract
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An outbreak of eosinophilic meningitis caused by Angiostrongylus cantonensis in travelers returning from the Caribbean. Author(s): Slom TJ, Cortese MM, Gerber SI, Jones RC, Holtz TH, Lopez AS, Zambrano CH, Sufit RL, Sakolvaree Y, Chaicumpa W, Herwaldt BL, Johnson S. Source: The New England Journal of Medicine. 2002 February 28; 346(9): 668-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11870244&dopt=Abstract
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An outbreak of meningitis caused by Angiostrongylus cantonensis in Kaohsiung. Author(s): Tsai TH, Liu YC, Wann SR, Lin WR, Lee SJ, Lin HH, Chen YS, Yen MY, Yen CM. Source: J Microbiol Immunol Infect. 2001 March; 34(1): 50-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321128&dopt=Abstract
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An unusual cause of acute bacterial meningitis. Author(s): Stephenson I, Wiselka MJ. Source: Postgraduate Medical Journal. 2001 December; 77(914): 791, 800-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11723327&dopt=Abstract
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An unusual serotype of Salmonella from a case of meningitis in a neonate. Author(s): Ghadage DP, Bal AM. Source: Indian J Pediatr. 2001 November; 68(11): 1088. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11770251&dopt=Abstract
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Anthrax meningitis: case report and review. Author(s): Tasyaran MA, Deniz O, Ertek M, Cetin K. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(1): 66-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874170&dopt=Abstract
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Anthrax meningitis: case report. Author(s): Yorgancigil B, Demirci M, Unlu M, Sevuk E, Doganay M. Source: International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases. 2001; 5(4): 220-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11953221&dopt=Abstract
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Antibiotic guidelines and antibiotic use in adult bacterial meningitis in The Netherlands. Author(s): van de Beek D, de Gans J, Spanjaard L, Vermeulen M, Dankert J. Source: The Journal of Antimicrobial Chemotherapy. 2002 April; 49(4): 661-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11909840&dopt=Abstract
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Antibiotic susceptibility and serotype distribution of 240 Streptococcus pneumoniae causing meningitis in Belgium 1997-2000. Author(s): Verhaegen J, Vandecasteele SJ, Vandeven J, Verbiest N, Lagrou K, Peetermans WE. Source: Acta Clin Belg. 2003 January-February; 58(1): 19-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12723258&dopt=Abstract
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Antifungal therapy for treatment of cryptococcal meningitis. Author(s): Yao Z, Liao W, Wen H. Source: Chin Med J (Engl). 2000 February; 113(2): 178-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775548&dopt=Abstract
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Antimicrobial resistance in Haemophilus influenzae isolated during populationbased surveillance for meningitis in Salvador, Brazil. Author(s): Reis JN, Lima JB, Ribeiro GS, Corderio SM, Salgado K, Reis MG, Ko AI. Source: Antimicrobial Agents and Chemotherapy. 2002 November; 46(11): 3641-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12384381&dopt=Abstract
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Antimicrobial resistance patterns of Haemophilus influenzae isolated from patients with meningitis in Sao Paulo, Brazil. Author(s): Casagrande ST, Vicente EJ, Landgraf IM, Kobata AM. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2000 March; 33(3): 295-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10719380&dopt=Abstract
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Approach to acute bacterial meningitis. Minireview. Author(s): Tabbarah ZA. Source: J Med Liban. 2001 January-February; 49(1): 18-21. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11910960&dopt=Abstract
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Appropriateness of a pneumococcal conjugate vaccine in Brazil: potential impact of age and clinical diagnosis, with emphasis on meningitis. Author(s): Brandileone MC, de Andrade AL, Di Fabio JL, Guerra ML, Austrian R. Source: The Journal of Infectious Diseases. 2003 April 15; 187(8): 1206-12. Epub 2003 March 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695999&dopt=Abstract
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Aseptic meningitis after intraventricular administration of gentamicin. Author(s): Haase KK, Lapointe M, Haines SJ. Source: Pharmacotherapy. 2001 January; 21(1): 103-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191728&dopt=Abstract
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Aseptic meningitis after spinal anesthesia in an infant. Author(s): Abouleish A, Nguyen NC, Mayhew JF. Source: Anesthesiology. 2000 April; 92(4): 1200-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10754646&dopt=Abstract
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Aseptic meningitis and optic neuritis preceding varicella-zoster progressive outer retinal necrosis in a patient with AIDS. Author(s): Franco-Paredes C, Bellehemeur T, Merchant A, Sanghi P, DiazGranados C, Rimland D. Source: Aids (London, England). 2002 May 3; 16(7): 1045-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11953471&dopt=Abstract
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Aseptic meningitis as a delayed neurologic complication of murine typhus. Author(s): Vallejo-Maroto I, Garcia-Morillo S, Wittel MB, Stiefel P, Miranda M, Pamies E, Aparicio R, Carneado J. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2002 December; 8(12): 826-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519359&dopt=Abstract
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Aseptic meningitis associated with rofecoxib. Author(s): Bonnel RA, Villalba ML, Karwoski CB, Beitz J. Source: Archives of Internal Medicine. 2002 March 25; 162(6): 713-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11911727&dopt=Abstract
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Aseptic meningitis due to administration of intravenous immunoglobulin with an unusually high number of leukocytes in cerebrospinal fluid. Author(s): Obando I, Duran I, Martin-Rosa L, Cano JM, Garcia-Martin FJ. Source: Pediatric Emergency Care. 2002 December; 18(6): 429-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488836&dopt=Abstract
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Aseptic meningitis in a child after systemic treatment with high dose cytarabine. Author(s): Pease CL, Horton TM, McClain KL, Kaplan SL. Source: The Pediatric Infectious Disease Journal. 2001 January; 20(1): 87-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11176579&dopt=Abstract
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Aseptic meningitis in a large MMR vaccine campaign (590,609 people) in Curitiba, Parana, Brazil, 1998. Author(s): Arruda WO, Kondageski C. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2001 SeptemberOctober; 43(5): 301-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11696855&dopt=Abstract
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Aseptic meningitis in children--the Singapore experience. Author(s): Tee WS, Choong CT, Lin RV, Ling AE. Source: Ann Acad Med Singapore. 2002 November; 31(6): 756-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520830&dopt=Abstract
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Aseptic meningitis in Germany associated with echovirus type 13. Author(s): Diedrich S, Schreier E. Source: Bmc Infectious Diseases [electronic Resource]. 2001; 1(1): 14. Epub 2001 September 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11591222&dopt=Abstract
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Aseptic meningitis related to valacyclovir. Author(s): Fobelo MJ, Corzo Delgado JE, Romero Alonso A, Gomez-Bellver MJ. Source: The Annals of Pharmacotherapy. 2001 January; 35(1): 128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11197578&dopt=Abstract
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Aseptic meningitis. Author(s): Narchi H. Source: Pediatrics. 2001 February; 107(2): 451. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11246643&dopt=Abstract
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Assessment of antibody responses to antigens of Mycobacterium tuberculosis and Cysticercus cellulosae in cerebrospinal fluid of chronic meningitis patients for definitive diagnosis as TBM/NCC by passive hemagglutination and immunoblot assays. Author(s): Katti MK. Source: Fems Immunology and Medical Microbiology. 2002 March 25; 33(1): 57-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11985970&dopt=Abstract
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Association of tumour necrosis factor alpha & malnutrition with outcome in children with acute bacterial meningitis. Author(s): Hemalatha R, Bhaskaram P, Balakrishna N, Saraswathi I. Source: The Indian Journal of Medical Research. 2002 February; 115: 55-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12138665&dopt=Abstract
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Atypical presentation of tuberculosis meningitis: a case report. Author(s): Souza RD, Franklin D, Simpson J, Kerr F. Source: Scott Med J. 2002 February; 47(1): 14-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980292&dopt=Abstract
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Audit of suspected meningitis in a district in 1996-1997 and in 1999. Author(s): Ejidokun OO, Linnane J, Ramaiah SR. Source: Commun Dis Public Health. 2002 March; 5(1): 27-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12070973&dopt=Abstract
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Bacillus cereus bacteremia and meningitis in immunocompromised children. Author(s): Gaur AH, Patrick CC, McCullers JA, Flynn PM, Pearson TA, Razzouk BI, Thompson SJ, Shenep JL. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 May 15; 32(10): 1456-62. Epub 2001 April 20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11317247&dopt=Abstract
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Bacillus cereus meningitis complicating cerebrospinal fluid fistula repair and spinal drainage. Author(s): Marshman LA, Hardwidge C, Donaldson PM. Source: British Journal of Neurosurgery. 2000 December; 14(6): 580-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11272043&dopt=Abstract
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Bacteremia and meningitis caused by a macrolide-sensitive strain of Streptococcus pneumoniae during treatment with azithromycin. Author(s): Lisby G, Brasholt MS, Teglbjerg MS. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 August 1; 33(3): 415-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11438918&dopt=Abstract
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Bacterial and mycobacterial meningitis in HIV-positive compared with HIV-negative patients in an internal medicine ward in Libreville, Gabon. Author(s): Nkoumou MO, Betha G, Kombila M, Clevenbergh P. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2003 March 1; 32(3): 345-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626897&dopt=Abstract
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Bacterial meningitis in aging adults. Author(s): Choi C. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 October 15; 33(8): 1380-5. Epub 2001 September 05. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11550119&dopt=Abstract
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Bacterial meningitis in Angola. Author(s): Bernardino L, Magalhaes J, Simoes MJ, Monteiro L. Source: Lancet. 2003 May 3; 361(9368): 1564-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12737901&dopt=Abstract
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Bacterial meningitis in childhood at the Children's Hospital of Pittsburgh: 1988-1998. Author(s): Neuman HB, Wald ER. Source: Clinical Pediatrics. 2001 November; 40(11): 595-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11758958&dopt=Abstract
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Bacterial meningitis in children. Author(s): Saez-Llorens X, McCracken GH Jr. Source: Lancet. 2003 June 21; 361(9375): 2139-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826449&dopt=Abstract
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Bacterial meningitis in children: critical care needs. Author(s): Singhi S, Singhi P, Baranwal AK. Source: Indian J Pediatr. 2001 August; 68(8): 737-47. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11563252&dopt=Abstract
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Bacterial meningitis in Malawian adults: pneumococcal disease is common, severe, and seasonal. Author(s): Gordon SB, Walsh AL, Chaponda M, Gordon MA, Soko D, Mbwvinji M, Molyneux ME, Read RC. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 July; 31(1): 53-7. Epub 2000 July 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10913396&dopt=Abstract
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Bacterial meningitis in Saudi Arabia: the impact of Haemophilus influenzae type b vaccination. Author(s): Almuneef M, Alshaalan M, Memish Z, Alalola S. Source: Journal of Chemotherapy (Florence, Italy). 2001 April; 13 Suppl 1: 34-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11434527&dopt=Abstract
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Bacterial meningitis of an infant with Currarino triad. Author(s): Chou IC, Mak SC, Lin TP, Chi CS, Pen HC. Source: Acta Paediatr Taiwan. 2002 September-October; 43(5): 288-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607487&dopt=Abstract
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Bacterial meningitis secondary to a transethmoidal encephalocele presenting to the emergency department. Author(s): Schwartz MD, Shaw GJ. Source: The Journal of Emergency Medicine. 2002 August; 23(2): 171-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359286&dopt=Abstract
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Bacterial meningitis. Appeal to thwart deadly outbreak. Author(s): Vogel G. Source: Science. 2002 October 11; 298(5592): 339. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376673&dopt=Abstract
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Bacterial meningitis: current controversies in approaches to treatment. Author(s): Williams AJ, Nadel S. Source: Cns Drugs. 2001; 15(12): 909-19. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11735611&dopt=Abstract
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Bacterial meningitis--problems on many fronts. Author(s): Ruef C. Source: Infection. 2000 January-February; 28(1): 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10697782&dopt=Abstract
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Bacterial penetration across the blood-brain barrier during the development of neonatal meningitis. Author(s): Huang SH, Stins MF, Kim KS. Source: Microbes and Infection / Institut Pasteur. 2000 August; 2(10): 1237-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11008113&dopt=Abstract
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Bactericidal activity in cerebrospinal fluid by treating meningitis caused by Stomatococcus mucilaginosus with rifampicin, cefotaxime and vancomycin in a neutropenic child. Author(s): Skogen PG, Kolmannskog S, Bergh K. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2001 January; 7(1): 39-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11284946&dopt=Abstract
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Bactericidal antibody response to Neisseria meningitidis serogroup B in patients with bacterial meningitis: effect of immunization with an outer membrane protein vaccine. Author(s): Milagres LG, Gorla MC, Rebelo MC, Barroso DE. Source: Fems Immunology and Medical Microbiology. 2000 August; 28(4): 319-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10891656&dopt=Abstract
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Bacteriologic outcome of children with cefotaxime- or ceftriaxone-susceptible and nonsusceptible Streptococcus pneumoniae meningitis. Author(s): Olivier C, Cohen R, Begue P, Floret D. Source: The Pediatric Infectious Disease Journal. 2000 October; 19(10): 1015-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11055609&dopt=Abstract
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Bacteriological diagnosis of Streptococcus suis meningitis. Author(s): Durand F, Perino CL, Recule C, Brion JP, Kobish M, Guerber F, Croize J. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 July; 20(7): 519-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11561816&dopt=Abstract
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Benefits of management strategy adjustments during an outbreak of enterovirus meningitis in adults. Author(s): Tattevin P, Minjolle S, Arvieux C, Clayessen V, Colimon R, Bouget J, Michelet C. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(5): 359-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069020&dopt=Abstract
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Bilateral basal ganglia infarctions in a patient with Streptococcus pneumoniae meningitis. Author(s): Johkura K, Nishiyama T, Kuroiwa Y. Source: European Neurology. 2002; 48(2): 123-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187007&dopt=Abstract
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Bilateral endogenous Klebsiella pneumoniae endophthalmitis associated with meningitis-useful vision regained after treatment: case report. Author(s): Liao SB, Yang KJ, Lai CC, Chen TL, Lee SC. Source: Changgeng Yi Xue Za Zhi. 2000 September; 23(9): 566-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11092147&dopt=Abstract
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Bilateral panophthalmitis as the initial presentation of meningococcal meningitis in an infant. Author(s): Gartaganis SP, Eliopoulou MJ, Georgakopoulos CD, Koliopoulos JX, Mela EK. Source: J Aapos. 2001 August; 5(4): 260-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11507588&dopt=Abstract
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Bilateral vestibular failure as a unique presenting sign in carcinomatous meningitis: case report. Author(s): Pollak L, Milo R, Kossych V, Rabey MJ, Shapira E. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2001 May; 70(5): 704-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11336037&dopt=Abstract
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Biofilm on ventriculo-peritoneal shunt tubing as a cause of treatment failure in coccidioidal meningitis. Author(s): Davis LE, Cook G, Costerton JW. Source: Emerging Infectious Diseases. 2002 April; 8(4): 376-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11971770&dopt=Abstract
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Bipolaris spicifera meningitis complicating a neurosurgerical procedure. Author(s): Latham RH. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(1): 102-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10716091&dopt=Abstract
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Brainstem auditory evoked potentials in tubercular meningitis and their correlation with radiological findings. Author(s): Kalita J, Misra UK. Source: Neurology India. 2001 March; 49(1): 51-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11303242&dopt=Abstract
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Breakthrough Streptococcus pneumoniae meningitis during clarithromycin therapy for acute otitis media. Author(s): Bochud PY, Calandra T, Moreillon P, Baumgartner JD, Yersin B. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 February; 20(2): 1367. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11305469&dopt=Abstract
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Breast cancer relapsing as carcinomatous meningitis. Author(s): Gaur S. Source: Southern Medical Journal. 2003 July; 96(7): 728. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940338&dopt=Abstract
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Broad-range bacterial polymerase chain reaction for early detection of bacterial meningitis. Author(s): Saravolatz LD, Manzor O, VanderVelde N, Pawlak J, Belian B. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 January 1; 36(1): 40-5. Epub 2002 December 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12491200&dopt=Abstract
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Burden of meningitis and other severe bacterial infections of children in africa: implications for prevention. Author(s): Peltola H. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 January; 32(1): 64-75. Epub 2000 December 11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11112673&dopt=Abstract
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Can a clinical decision rule decrease antibiotic use in viral meningitis? Author(s): Chitkara MB, Ryan LM, Stockwell D, Wiedermann BL. Source: Archives of Pediatrics & Adolescent Medicine. 2002 December; 156(12): 1195-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444829&dopt=Abstract
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Carcinomatous meningitis in a patient with metastatic breast cancer. Author(s): Lauby G. Source: Clin Lab Sci. 2001 Summer; 14(3): 141-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11517623&dopt=Abstract
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Carcinomatous meningitis: are surgeryand gamma knife radiosurgery treatment risk factors? Author(s): Mahajan A, Borden J, Tsai JS. Source: Journal of Neurosurgery. 2002 December; 97(5 Suppl): 441-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12507072&dopt=Abstract
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Carcinomatous Meningitis: it does not have to be a death sentence. Author(s): Sagar SM. Source: Oncology (Huntingt). 2002 February; 16(2): 237-43; Discussion 244, 249-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11866138&dopt=Abstract
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Case reports of viral meningitis/encephalitis. Author(s): Norwood C, Naponick JJ, Burton S, Varoqua S, Morris J, Kuizon D. Source: J La State Med Soc. 2003 May-June; 155(3): 154-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12873102&dopt=Abstract
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Case Reports. Chronic and acute Aspergillus meningitis. Author(s): Moling O, Lass-Floerl C, Verweij PE, Porte M, Boiron P, Prugger M, Gebert U, Corradini R, Vedovelli C, Rimenti G, Mian P. Source: Mycoses. 2002 December; 45(11-12): 504-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472730&dopt=Abstract
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Case Reports. Pulmonary cryptococcosis associated with cryptococcal meningitis in non-AIDS patients. Author(s): Zhu LP, Shi YZ, Weng XH, Muller FM. Source: Mycoses. 2002 April; 45(3-4): 111-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12000513&dopt=Abstract
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Caspase-3 mediates hippocampal apoptosis in pneumococcal meningitis. Author(s): Gianinazzi C, Grandgirard D, Imboden H, Egger L, Meli DN, Bifrare YD, Joss PC, Tauber MG, Borner C, Leib SL. Source: Acta Neuropathologica. 2003 May; 105(5): 499-507. Epub 2003 February 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677451&dopt=Abstract
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Cause and timing of death following meningitis in adults. Author(s): Vandecasteele SJ, Verhaegen J, Peetermans WE. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 March 15; 34(6): 878-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11850873&dopt=Abstract
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Cavernous sinus syndrome secondary to tuberculous meningitis. Author(s): Hui AC, Wong WS, Wong KS. Source: European Neurology. 2002; 47(2): 125-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11844904&dopt=Abstract
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Cefepime in the empiric treatment of meningitis in children. Author(s): Saez-Llorens X, O'Ryan M. Source: The Pediatric Infectious Disease Journal. 2001 March; 20(3): 356-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11303850&dopt=Abstract
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Cefepime is efficacious against penicillin- and quinolone-resistant pneumococci in experimental meningitis. Author(s): Cottagnoud P, Acosta F, Cottagnoud M, Tauber MG. Source: The Journal of Antimicrobial Chemotherapy. 2002 February; 49(2): 327-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11815575&dopt=Abstract
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Cerebral blood flow, oxidative metabolism and cerebrovascular carbon dioxide reactivity in patients with acute bacterial meningitis. Author(s): Moller K, Strauss GI, Thomsen G, Larsen FS, Holm S, Sperling BK, Skinhoj P, Knudsen GM. Source: Acta Anaesthesiologica Scandinavica. 2002 May; 46(5): 567-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12027852&dopt=Abstract
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Cerebrospinal fluid lysozyme level for the diagnosis of tuberculous meningitis in children. Author(s): Mishra OP, Batra P, Ali Z, Anupurba S, Das BK. Source: Journal of Tropical Pediatrics. 2003 February; 49(1): 13-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630714&dopt=Abstract
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Cerebrospinal fluid penetration and pharmacokinetic/pharmacodynamic parameters of intravenously administered colistin in a case of multidrug-resistant Acinetobacter baumannii meningitis. Author(s): Jimenez-Mejias ME, Pichardo-Guerrero C, Marquez-Rivas FJ, Martin-Lozano D, Prados T, Pachon J. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 March; 21(3): 212-4. Epub 2002 March 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11957024&dopt=Abstract
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Characterization of a laboratory-derived, high-level ampicillin-resistant Salmonella enterica serovar Typhimurium strain that caused meningitis in an infant. Author(s): Chiu CH, Chu C, Su LH, Wu WY, Wu TL. Source: Antimicrobial Agents and Chemotherapy. 2002 May; 46(5): 1604-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11959613&dopt=Abstract
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Characterization of Mycobacterium tuberculosis complex isolates from the cerebrospinal fluid of meningitis patients at six fever hospitals in Egypt. Author(s): Cooksey RC, Abbadi SH, Woodley CL, Sikes D, Wasfy M, Crawford JT, Mahoney F. Source: Journal of Clinical Microbiology. 2002 May; 40(5): 1651-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980936&dopt=Abstract
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Childhood bacterial meningitis in Bulgaria: a population-based retrospective study in six regions during 1992-96. Author(s): Kojouharova M, Gatcheva N, Setchanova L, Mechandjieva V; Bulgarian Hib Study Team. Source: International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases. 2003 June; 7(2): 109-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839711&dopt=Abstract
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Chip-based diagnostics for meningitis and food poisoning. Author(s): Clayton J. Source: Drug Discovery Today. 2002 June 15; 7(12): 637-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12110234&dopt=Abstract
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Chloramphenicol or ceftriaxone, or both, as treatment for meningitis in developing countries? Author(s): Duke T, Michael A, Mokela D, Wal T, Reeder J. Source: Archives of Disease in Childhood. 2003 June; 88(6): 536-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765927&dopt=Abstract
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Chronic meningitis presenting with acute obstructive hydrocephalus. Author(s): Birkhahn RH, Sweeny AH, Lopez O. Source: The Journal of Emergency Medicine. 2002 February; 22(2): 175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858923&dopt=Abstract
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Chronic meningitis. Author(s): Tan TQ. Source: Seminars in Pediatric Infectious Diseases. 2003 April; 14(2): 131-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881801&dopt=Abstract
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Chronic meningitis: still a diagnostic challenge. Author(s): Hildebrand J, Aoun M. Source: Journal of Neurology. 2003 June; 250(6): 653-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796824&dopt=Abstract
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Chronicle of an outbreak foretold: meningococcal meningitis W135 in Burkina Faso. Author(s): Decosas J, Koama JB. Source: The Lancet Infectious Diseases. 2002 December; 2(12): 763-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467693&dopt=Abstract
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Citrobacter koseri (diversus) meningitis in an otherwise healthy adolescent. Author(s): Prais D, Nussinovitch M, Harel L, Amir J. Source: Scandinavian Journal of Infectious Diseases. 2003; 35(3): 202-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751719&dopt=Abstract
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Citrobacter koseri pneumonia and meningitis in an infant. Author(s): Aller SC, Chusid MJ. Source: The Journal of Infection. 2002 July; 45(1): 65-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217738&dopt=Abstract
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Cladosporium bantianum meningitis in a neonate. Author(s): Banerjee TK, Patwari AK, Dutta R, Anand VK, Chabra A. Source: Indian J Pediatr. 2002 August; 69(8): 721-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356227&dopt=Abstract
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Claims of equivalence in randomized controlled trials of the treatment of bacterial meningitis in children. Author(s): Krysan DJ, Kemper AR. Source: The Pediatric Infectious Disease Journal. 2002 August; 21(8): 753-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12192164&dopt=Abstract
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Classification of Ralstonia pickettii biovar 3/'thomasii' strains (Pickett 1994) and of new isolates related to nosocomial recurrent meningitis as Ralstonia mannitolytica sp. nov. Author(s): De Baere T, Steyaert S, Wauters G, Des Vos P, Goris J, Coenye T, Suyama T, Verschraegen G, Vaneechoutte M. Source: International Journal of Systematic and Evolutionary Microbiology. 2001 March; 51(Pt 2): 547-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321101&dopt=Abstract
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Clearance of 14-3-3 protein from cerebrospinal fluid heralds the resolution of bacterial meningitis. Author(s): Bonora S, Zanusso G, Raiteri R, Monaco S, Rossati A, Ferrari S, Boffito M, Audagnotto S, Sinicco A, Rizzuto N, Concia E, Di Perri G. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 June 1; 36(11): 1492-5. Epub 2003 May 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766846&dopt=Abstract
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Clinical data and cerebrospinal fluid findings in Lyme meningitis versus aseptic meningitis. Author(s): Tuerlinckx D, Bodart E, Garrino MG, de Bilderling G. Source: European Journal of Pediatrics. 2003 March; 162(3): 150-3. Epub 2003 January 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655417&dopt=Abstract
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Clinical outcomes of meningitis caused by Streptococcus pneumoniae in the era of antibiotic resistance. Author(s): Fiore AE, Moroney JF, Farley MM, Harrison LH, Patterson JE, Jorgensen JH, Cetron M, Kolczak MS, Breiman RF, Schuchat A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 January; 30(1): 71-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619736&dopt=Abstract
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Clinical predictors of bacterial meningitis in infants and young children in The Gambia. Author(s): Weber MW, Herman J, Jaffar S, Usen S, Oparaugo A, Omosigho C, Adegbola RA, Greenwood BM, Mulholland EK. Source: Tropical Medicine & International Health : Tm & Ih. 2002 September; 7(9): 72231. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225501&dopt=Abstract
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Clinical study of 44 cases of Staphylococcus aureus meningitis. Author(s): Pintado V, Meseguer MA, Fortun J, Cobo J, Navas E, Quereda C, Corral I, Moreno S. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 December; 21(12): 864-8. Epub 2002 December 10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525921&dopt=Abstract
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Clonally related penicillin-nonsusceptible Streptococcus pneumoniae serotype 14 from cases of meningitis in Salvador, Brazil. Author(s): Ko AI, Reis JN, Coppola SJ, Gouveia EL, Cordeiro SM, Lobo TS, Pinheiro RM, Salgado K, Ribeiro Dourado CM, Tavares-Neto J, Rocha H, Galvao Reis M, Johnson WD Jr, Riley LW. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 January; 30(1): 78-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619737&dopt=Abstract
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Coccidioidal meningitis: incidental diagnosis 3 y after ventriculo-peritoneal shunt placement for hydrocephalus. Author(s): Almoujahed MO, Johnson LB, Gehring R, Khatib R. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(2): 142-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11928851&dopt=Abstract
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Coccidioidomycosis meningitis and syndrome of inappropriate antidiuretic hormone. Author(s): Webb M, Ziauddin A, Okusa MD. Source: The American Journal of the Medical Sciences. 2002 September; 324(3): 155-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240713&dopt=Abstract
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Cochlear implant recipients at risk for meningitis. Author(s): Wooltorton E. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 September 17; 167(6): 670. Erratum In: Cmaj. 2003 February 4; 168(3): 257. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358204&dopt=Abstract
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Cochlear implants and meningitis: update and recommendations for prevention. Author(s): Bluestone CD. Source: The Pediatric Infectious Disease Journal. 2003 May; 22(5): 477-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792395&dopt=Abstract
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Cochlear implants carry risk of meningitis, agencies warn. Author(s): Josefson D. Source: Bmj (Clinical Research Ed.). 2002 August 10; 325(7359): 298. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12169502&dopt=Abstract
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Cochlear malformations, meningitis, and cochlear implants: what have we learned? Author(s): Bluestone CD. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 March; 24(2): 349-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621357&dopt=Abstract
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Cognitive impairment in adults with good recovery after bacterial meningitis. Author(s): van de Beek D, Schmand B, de Gans J, Weisfelt M, Vaessen H, Dankert J, Vermeulen M. Source: The Journal of Infectious Diseases. 2002 October 1; 186(7): 1047-52. Epub 2002 September 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12232850&dopt=Abstract
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Comamonas testosteroni meningitis in a patient with recurrent cholesteatoma. Author(s): Arda B, Aydemir S, Yamazhan T, Hassan A, Tunger A, Serter D. Source: Apmis : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. 2003 April; 111(4): 474-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780521&dopt=Abstract
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Community-acquired bacterial meningitis in adults: the epidemiology, timing of appropriate antimicrobial therapy, and prognostic factors. Author(s): Lu CH, Huang CR, Chang WN, Chang CJ, Cheng BC, Lee PY, Lin MW, Chang HW. Source: Clinical Neurology and Neurosurgery. 2002 September; 104(4): 352-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140104&dopt=Abstract
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Community-acquired spontaneous bacterial meningitis in adult diabetic patients: an analysis of clinical characteristics and prognostic factors. Author(s): Huang CR, Lu CH, Chang HW, Lee PY, Lin MW, Chang WN. Source: Infection. 2002 December; 30(6): 346-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478323&dopt=Abstract
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Community-acquired spontaneous Klebsiella pneumoniae meningitis in adult cirrhotic patients with and without diabetes. Author(s): Chang WN, Lu CH, Wu JJ, Lei CB, Huang CR. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2003 April; 22(4): 271-3. Epub 2003 March 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12687413&dopt=Abstract
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Comparative genomics identifies the genetic islands that distinguish Neisseria meningitidis, the agent of cerebrospinal meningitis, from other Neisseria species. Author(s): Perrin A, Bonacorsi S, Carbonnelle E, Talibi D, Dessen P, Nassif X, Tinsley C. Source: Infection and Immunity. 2002 December; 70(12): 7063-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438387&dopt=Abstract
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Comparison of mixed cell culture containing genetically engineered BGMK and CaCo-2 cells (Super E-Mix) with RT-PCR and conventional cell culture for the diagnosis of enterovirus meningitis. Author(s): Buck GE, Wiesemann M, Stewart L. Source: Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology. 2002 July; 25 Suppl 1: S13-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091077&dopt=Abstract
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Computerised tomographic study of tuberculous meningitis in children. Author(s): De JK, Bagchi S, Bhadra UK, Chatterjee SN, Munshi AK. Source: J Indian Med Assoc. 2002 October; 100(10): 603-4, 606. Erratum In: J Indian Med Assoc. 2002 November; 100(11): 678. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452514&dopt=Abstract
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Concurrent meningitis/serious bacterial infection in an infant hospitalized with respiratory syncytial virus. Author(s): McGregor RS, Tung J. Source: Archives of Pediatrics & Adolescent Medicine. 2002 October; 156(10): 1055; Author Reply 1056-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361455&dopt=Abstract
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Corticosteroid treatment of eosinophilic meningitis. Author(s): Chotmongkol V, Sawanyawisuth K, Thavornpitak Y. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 September; 31(3): 660-2. Epub 2000 September 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11017811&dopt=Abstract
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Corticosteroids for everyone with meningitis? Author(s): Tunkel AR, Scheld WM. Source: The New England Journal of Medicine. 2002 November 14; 347(20): 1613-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432049&dopt=Abstract
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Corticosteroids in acute bacterial meningitis. Author(s): van de Beek D, de Gans J, McIntyre P, Prasad K. Source: Cochrane Database Syst Rev. 2003; (3): Cd004305. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12918010&dopt=Abstract
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Cranial CT before lumbar puncture in suspected meningitis. Author(s): Segal S. Source: The New England Journal of Medicine. 2002 April 18; 346(16): 1248-51; Author Reply 1248-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11963944&dopt=Abstract
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Cranial CT before lumbar puncture in suspected meningitis. Author(s): Kastenbauer S, Winkler F, Pfister HW. Source: The New England Journal of Medicine. 2002 April 18; 346(16): 1248-51; Author Reply 1248-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11961158&dopt=Abstract
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Cranial CT before lumbar puncture in suspected meningitis. Author(s): Tokuda Y, Nakazato N. Source: The New England Journal of Medicine. 2002 April 18; 346(16): 1248-51; Author Reply 1248-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11963943&dopt=Abstract
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Cranial CT before lumbar puncture in suspected meningitis. Author(s): Tattevin P, Bruneel F, Regnier B. Source: The New England Journal of Medicine. 2002 April 18; 346(16): 1248-51; Author Reply 1248-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11963945&dopt=Abstract
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Cranial CT before lumbar puncture in suspected meningitis. Author(s): Bruzzi JF, Brennan DD. Source: The New England Journal of Medicine. 2002 April 18; 346(16): 1248-51; Author Reply 1248-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11963942&dopt=Abstract
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Cranial Doppler ultrasonography as a predictor of neurologic sequelae in infants with bacterial meningitis. Author(s): Okten A, Ahmetoglu A, Dilber E, Dinc H, Kalyoncu M, Ciftcibais K, Yaris N. Source: Investigative Radiology. 2002 February; 37(2): 86-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799332&dopt=Abstract
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C-reactive protein concentrations in cerebral spinal fluid in gram-positive and gramnegative bacterial meningitis. Author(s): Rajs G, Finzi-Yeheskel Z, Rajs A, Mayer M. Source: Clinical Chemistry. 2002 March; 48(3): 591-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11861461&dopt=Abstract
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Cryptococcal lymphadenitis and meningitis in human immunodeficiency virus infection--a case report. Author(s): Das BP, Panda PL, Mallik RN, Das B. Source: Indian J Pathol Microbiol. 2002 July; 45(3): 349-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785184&dopt=Abstract
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Cryptococcal meningitis and sarcoidosis. Author(s): Ross JJ, Katz JD. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(12): 937-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587633&dopt=Abstract
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Cryptococcal meningitis caused by Cryptococcus neoformans var. gattii, serotype C, in AIDS patients in Soweto, South Africa. Author(s): Karstaedt AS, Crewe-Brown HH, Dromer F. Source: Medical Mycology : Official Publication of the International Society for Human and Animal Mycology. 2002 February; 40(1): 7-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11860015&dopt=Abstract
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Cryptococcal meningitis during front-line chemotherapy for acute lymphoblastic leukemia. Author(s): Urbini B, Castellini C, Rondelli R, Prete A, Pierinelli S, Pession A. Source: Haematologica. 2000 October; 85(10): 1103-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11025610&dopt=Abstract
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Cryptococcal meningitis following autologous stem cell transplantation in a patient with multiple myeloma. Author(s): Mendpara SD, Ustun C, Kallab AM, Mazzella FM, Bilodeau PA, Jillella AP. Source: Bone Marrow Transplantation. 2002 August; 30(4): 259-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12203144&dopt=Abstract
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Cryptococcal meningitis in a child with acute lymphoblastic leukemia. Author(s): Mavinkurve-Groothuis AM, Bokkerink JP, Verweij PE, Veerman AJ, Hoogerbrugge PM. Source: The Pediatric Infectious Disease Journal. 2003 June; 22(6): 576. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799518&dopt=Abstract
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Cryptococcal meningitis in a neonate. Author(s): Kaur R, Mittal N, Rawat D, Mathur MD. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(7): 542-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195885&dopt=Abstract
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Cryptococcal meningitis in a patient with systemic immunosuppression 13 years after liver transplantation. Author(s): Hermann W, Gunther P, Berrouschot J, Kuhn HJ, Wagner A. Source: Intensive Care Medicine. 2002 October; 28(10): 1500. Epub 2002 August 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12373479&dopt=Abstract
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Cryptococcal meningitis in pediatric AIDS. Author(s): Kaur R, Rawat D, Kakkar M, Monga R, Sharma VK. Source: Journal of Tropical Pediatrics. 2003 April; 49(2): 124-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729297&dopt=Abstract
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Cryptococcal meningitis in pediatric systemic lupus erythematosus. Author(s): Liou J, Chiu C, Tseng C, Chi C, Fu L. Source: Mycoses. 2003 April; 46(3-4): 153-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870207&dopt=Abstract
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Cryptococcal meningitis: an analysis among 5,521 consecutive organ transplant recipients. Author(s): Wu G, Vilchez RA, Eidelman B, Fung J, Kormos R, Kusne S. Source: Transplant Infectious Disease : an Official Journal of the Transplantation Society. 2002 December; 4(4): 183-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535260&dopt=Abstract
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Cryptococcal meningitis: implications for the otologist. Author(s): Low WK. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 January-February; 64(1): 35-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11891396&dopt=Abstract
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Cryptococcus neoformans causing meningitis in AIDS patients. Author(s): Menezes EA, Monteiro MN, Angelo MR, Santos CD, Freire CC, Cunha FA. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2002 September-October; 35(5): 537-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621679&dopt=Abstract
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Cryptococcus neoformans var. gattii meningitis in Singapore. Author(s): Koh TH, Tan AL, Lo YL, Oh H. Source: Medical Mycology : Official Publication of the International Society for Human and Animal Mycology. 2002 April; 40(2): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058737&dopt=Abstract
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Current concepts in the pathogenesis of meningitis caused by Streptococcus pneumoniae. Author(s): Meli DN, Christen S, Leib SL, Tauber MG. Source: Current Opinion in Infectious Diseases. 2002 June; 15(3): 253-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12015459&dopt=Abstract
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Current options for the treatment of neoplastic meningitis. Author(s): Cokgor I, Friedman AH, Friedman HS. Source: Journal of Neuro-Oncology. 2002 October; 60(1): 79-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416549&dopt=Abstract
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Current pharmacotherapy of pneumococcal meningitis. Author(s): Aronin SI. Source: Expert Opinion on Pharmacotherapy. 2002 February; 3(2): 121-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11829726&dopt=Abstract
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Current treatment approaches for neoplastic meningitis: nursing management of patients receiving intrathecal DepoCyt. Author(s): Craig C. Source: Oncology Nursing Forum. 2000 September; 27(8): 1225-30; Quiz 1231-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11013903&dopt=Abstract
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Cytokine profiles in HIV seropositive patients with tuberculous meningitis. Author(s): Patel VB, Bhigjee AI, Bill PL, Connolly CA. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2002 November; 73(5): 598-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397163&dopt=Abstract
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D- and L-lactate in rabbit and human bacterial meningitis. Author(s): Wellmer A, Prange J, Gerber J, Zysk G, Lange P, Michel U, Eiffert H, Nau R. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(12): 909-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868764&dopt=Abstract
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Decreased susceptibility to extended-spectrum cephalosporins of a penicillinsusceptible Streptococcus pneumoniae in meningitis. Author(s): De Champs C, Constantin JM, Bonnet R, Guelon D, Goldstein F, Sirot J. Source: Infection. 2000 January-February; 28(1): 58-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10697797&dopt=Abstract
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Delayed diagnosis of meningitis caused by beta-haemolytic group G. Streptococcus in an older woman. Author(s): Luyx C, Vanpee D, Glupczynski Y, Swine C, Gillet JB. Source: The Journal of Emergency Medicine. 2001 November; 21(4): 393-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11728766&dopt=Abstract
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Dependency of cerebral blood flow on mean arterial pressure in patients with acute bacterial meningitis. Author(s): Moller K, Larsen FS, Qvist J, Wandall JH, Knudsen GM, Gjorup IE, Skinhoj P. Source: Critical Care Medicine. 2000 April; 28(4): 1027-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10809277&dopt=Abstract
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Dermal sinus presenting as group B streptococcal meningitis. Author(s): Reimer CM, Sharma G, Grelinger BA. Source: Archives of Neurology. 2001 May; 58(5): 820-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346379&dopt=Abstract
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Designing meningitis vaccines. Author(s): Buttery JP, Moxon ER. Source: Journal of the Royal College of Physicians of London. 2000 March-April; 34(2): 163-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10816873&dopt=Abstract
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Detection of antibody to Mycobacterium tuberculosis protein antigens in the cerebrospinal fluid of patients with tuberculous meningitis. Author(s): Chandramuki A, Lyashchenko K, Kumari HB, Khanna N, Brusasca P, Gourie-Devi M, Satishchandra P, Shankar SK, Ravi V, Alcabes P, Kanaujia GV, Gennaro ML. Source: The Journal of Infectious Diseases. 2002 September 1; 186(5): 678-83. Epub 2002 August 05. Erratum In: J Infect Dis. 2003 January 1; 187(1): 163. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195355&dopt=Abstract
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Detection of Neisseria meningitidis in cerebrospinal fluid samples from suspicious cases of meningococcal meningitis using polymerase chain reaction and counterimmunoelectrophoresis. Author(s): De Gaspari EN. Source: Rev Argent Microbiol. 2000 April-June; 32(2): 97-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10885010&dopt=Abstract
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Development and evaluation of a broad-range PCR-ELISA assay with Borrelia burgdorferi and Streptococcus pneumoniae as model organisms for reactive arthritis and bacterial meningitis. Author(s): Fischer-Romero C, Luthy-Hottenstein J, Altwegg M. Source: Journal of Microbiological Methods. 2000 March; 40(1): 79-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10739346&dopt=Abstract
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Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Author(s): Nigrovic LE, Kuppermann N, Malley R. Source: Pediatrics. 2002 October; 110(4): 712-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359784&dopt=Abstract
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Dexamethasone in acute bacterial meningitis. Author(s): Principi N, Esposito S. Source: Lancet. 2002 November 16; 360(9345): 1610; Author Reply 1610-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12443642&dopt=Abstract
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Dexamethasone in acute bacterial meningitis. Author(s): Obaro SK. Source: Lancet. 2002 November 16; 360(9345): 1609-10; Author Reply 1610-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12443641&dopt=Abstract
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Dexamethasone in adults with bacterial meningitis. Author(s): Tancredi DN, Binder WD. Source: The New England Journal of Medicine. 2003 March 6; 348(10): 954-7; Author Reply 954-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622125&dopt=Abstract
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Dexamethasone in adults with bacterial meningitis. Author(s): Tabas JA, Chambers HF. Source: The New England Journal of Medicine. 2003 March 6; 348(10): 954-7; Author Reply 954-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621141&dopt=Abstract
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Dexamethasone in adults with bacterial meningitis. Author(s): Joffe AR. Source: The New England Journal of Medicine. 2003 March 6; 348(10): 954-7; Author Reply 954-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622128&dopt=Abstract
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Dexamethasone in adults with bacterial meningitis. Author(s): Abril V, Ortega E. Source: The New England Journal of Medicine. 2003 March 6; 348(10): 954-7; Author Reply 954-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622126&dopt=Abstract
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Dexamethasone in adults with bacterial meningitis. Author(s): Poshkus M, Obaro S. Source: The New England Journal of Medicine. 2003 March 6; 348(10): 954-7; Author Reply 954-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622127&dopt=Abstract
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Dexamethasone in adults with bacterial meningitis. Author(s): de Gans J, van de Beek D; European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. Source: The New England Journal of Medicine. 2002 November 14; 347(20): 1549-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432041&dopt=Abstract
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Dexamethasone therapy for bacterial meningitis in adults: a double blind placebo control study. Author(s): Gijwani D, Kumhar MR, Singh VB, Chadda VS, Soni PK, Nayak KC, Gupta BK. Source: Neurology India. 2002 March; 50(1): 63-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11960154&dopt=Abstract
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Dexamethasone treatment in childhood bacterial meningitis in Malawi: a randomised controlled trial. Author(s): Molyneux EM, Walsh AL, Forsyth H, Tembo M, Mwenechanya J, Kayira K, Bwanaisa L, Njobvu A, Rogerson S, Malenga G. Source: Lancet. 2002 July 20; 360(9328): 211-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133656&dopt=Abstract
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Dexamethasone use in adult meningococcal meningitis. Author(s): Hui L, Tokeshi J. Source: Hawaii Med J. 2000 July; 59(7): 308-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10961042&dopt=Abstract
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Diabetes insipidus as a complication of cryptococcal meningitis in an HIV-infected patient. Author(s): Juffermans NP, Verbon A, Van der Poll T. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(5): 397-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069031&dopt=Abstract
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Diabetes insipidus due to Streptococcus pneumoniae meningitis. Author(s): Franco-Paredes C, Evans J, Jurado R. Source: Archives of Internal Medicine. 2001 April 23; 161(8): 1114-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11322848&dopt=Abstract
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Diagnosing and prognosticating acute meningitis in young infants within 24 hours of admission. Author(s): See KC, Tay SK, Low PS. Source: Ann Acad Med Singapore. 2001 September; 30(5): 503-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11603134&dopt=Abstract
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Diagnosing bacterial meningitis after the Haemophilus influenzae vaccine: still a challenge. Author(s): Frohna JG, Park SM, Gopal S. Source: Archives of Pediatrics & Adolescent Medicine. 2001 December; 155(12): 1307-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732948&dopt=Abstract
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Diagnosing postneurosurgical meningitis. Author(s): Johnson JR. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 May; 30(5): 836-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10816158&dopt=Abstract
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Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups. Author(s): Graybill JR, Sobel J, Saag M, van Der Horst C, Powderly W, Cloud G, Riser L, Hamill R, Dismukes W. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 January; 30(1): 47-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619732&dopt=Abstract
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Diagnosis and outcome of acute bacterial meningitis in early childhood. Author(s): Chinchankar N, Mane M, Bhave S, Bapat S, Bavdekar A, Pandit A, Niphadkar KB, Dutta A, Leboulleux D. Source: Indian Pediatrics. 2002 October; 39(10): 914-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428036&dopt=Abstract
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Diagnosis and treatment of bacterial meningitis. Author(s): El Bashir H, Laundy M, Booy R. Source: Archives of Disease in Childhood. 2003 July; 88(7): 615-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12818910&dopt=Abstract
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Diagnosis of acute bacterial meningitis in children at a district hospital in subSaharan Africa. Author(s): Berkley JA, Mwangi I, Ngetsa CJ, Mwarumba S, Lowe BS, Marsh K, Newton CR. Source: Lancet. 2001 June 2; 357(9270): 1753-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11403812&dopt=Abstract
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Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Author(s): Thwaites GE, Chau TT, Stepniewska K, Phu NH, Chuong LV, Sinh DX, White NJ, Parry CM, Farrar JJ. Source: Lancet. 2002 October 26; 360(9342): 1287-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12414204&dopt=Abstract
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Diagnosis of bacterial meningitis. Author(s): Enwere G, Obaro S. Source: Lancet. 2001 November 3; 358(9292): 1549-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11705597&dopt=Abstract
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Diagnostic criteria for Tuberculous Meningitis. Author(s): Seth R, Sharma U. Source: Indian J Pediatr. 2002 April; 69(4): 299-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019549&dopt=Abstract
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Diagnostic performance of amplified Mycobacterium Tuberculosis direct test in the cerebrospinal fluid of children with tuberculosis meningitis. Author(s): Yaramis A. Source: Pediatrics. 2000 July; 106(1 Pt 1): 162. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10939912&dopt=Abstract
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Diagnostic utility of cerebrospinal fluid studies in patients with clinically suspected tuberculous meningitis. Author(s): Hooker JA, Muhindi DW, Amayo EO, Mc'ligeyo SO, Bhatt KM, Odhiambo JA. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2003 August; 7(8): 787-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12921156&dopt=Abstract
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Diagnostic value of cytokine assays in cerebrospinal fluid in culture-negative, polymerase chain reaction-positive bacterial meningitis. Author(s): Lorino G, Angeletti S, Gherardi G, De Cesaris M, Gherardi L, Battistoni F, Filadoro F, Dicuonzo G. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2000 May; 19(5): 388-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10898144&dopt=Abstract
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Differences in laboratory findings for cerebrospinal fluid specimens obtained from patients with meningitis or encephalitis due to herpes simplex virus (HSV) documented by detection of HSV DNA. Author(s): Simko JP, Caliendo AM, Hogle K, Versalovic J. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 August 15; 35(4): 414-9. Epub 2002 July 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145725&dopt=Abstract
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Diffuse meningeal involvement in tubercular meningitis. Author(s): Roy J, Paul S, Mitra S, Gangopadhyay PK. Source: Neurology India. 2001 June; 49(2): 216. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11447455&dopt=Abstract
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Diplopia in a patient with carcinomatous meningitis: a case report and review of the literature. Author(s): Chang AK. Source: The Journal of Emergency Medicine. 2002 November; 23(4): 351-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480013&dopt=Abstract
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Discontinuation of secondary prophylaxis for cryptococcal meningitis in HIVinfected patients responding to highly active antiretroviral therapy. Author(s): Martinez E, Garcia-Viejo MA, Marcos MA, Perez-Cuevas JB, Blanco JL, Mallolas J, Miro JM, Gatell JM. Source: Aids (London, England). 2000 November 10; 14(16): 2615-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11101078&dopt=Abstract
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Discontinuation of secondary prophylaxis for cryptococcal meningitis in human immunodeficiency virus-infected patients treated with highly active antiretroviral therapy: a prospective, multicenter, randomized study. Author(s): Vibhagool A, Sungkanuparph S, Mootsikapun P, Chetchotisakd P, Tansuphaswaswadikul S, Bowonwatanuwong C, Ingsathit A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 May 15; 36(10): 1329-31. Epub 2003 May 02. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746781&dopt=Abstract
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Discrepancies between brain CT imaging and severely raised intracranial pressure proven by ventriculostomy in adults with pneumococcal meningitis. Author(s): Winkler F, Kastenbauer S, Yousry TA, Maerz U, Pfister HW. Source: Journal of Neurology. 2002 September; 249(9): 1292-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12242556&dopt=Abstract
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Disseminated gonococcal infection and meningitis. Author(s): Mofredj A, Baraka D, Madec Y, Lemaitre P. Source: The American Journal of Medicine. 2000 July; 109(1): 71-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10991742&dopt=Abstract
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Distinguishing between chemical and bacterial meningitis in patients who have undergone neurosurgery. Author(s): Brown EM, de Louvois J, Bayston R, Lees PD, Pople IK; British Society for Antimicrobial Chemotherapy Working Party on Neurosurgical Infections. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 February 15; 34(4): 556-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11797188&dopt=Abstract
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Does dexamethasone affect ceftriazone penetration into cerebrospinal fluid in adult bacterial meningitis. Author(s): Buke AC, Cavusoglu C, Karasulu E, Karakartal G. Source: International Journal of Antimicrobial Agents. 2003 May; 21(5): 452-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727079&dopt=Abstract
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Double blind placebo-controlled trial of pleconaril in infants with enterovirus meningitis. Author(s): Abzug MJ, Cloud G, Bradley J, Sanchez PJ, Romero J, Powell D, Lepow M, Mani C, Capparelli EV, Blount S, Lakeman F, Whitley RJ, Kimberlin DW; National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Source: The Pediatric Infectious Disease Journal. 2003 April; 22(4): 335-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690273&dopt=Abstract
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Drug companies asked to deliver on a low-cost meningitis vaccine. Author(s): Ahmad K. Source: The Lancet Infectious Diseases. 2002 November; 2(11): 650. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409033&dopt=Abstract
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Drug-induced aseptic meningitis. Author(s): Nettis E, Calogiuri G, Colanardi MC, Ferrannini A, Tursi A. Source: Current Drug Targets. Immune, Endocrine and Metabolic Disorders. 2003 June; 3(2): 143-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12769786&dopt=Abstract
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Drug-induced aseptic meningitis: diagnosis and management. Author(s): Jolles S, Sewell WA, Leighton C. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2000 March; 22(3): 215-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10738845&dopt=Abstract
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Duodenal ulcer perforation in a twenty-month-old: an unusual complication of Haemophilus influenzae type B meningitis. Author(s): Sykora J, Jana T, Renata P, Frantisek S, Vladimir S, Jana V, Petr H. Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 September; 35(3): 3668. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352530&dopt=Abstract
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Duration of echovirus 30 excretion in stools from patients with aseptic meningitis. Author(s): Takao S, Komazawa Y, Fukuda S, Shimazu Y, Noda M, Tokumoto S. Source: Japanese Journal of Infectious Diseases. 2000 June; 53(3): 132-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10957714&dopt=Abstract
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Dutch consider following UK on vaccines after meningitis scare. Author(s): Sheldon T. Source: Bmj (Clinical Research Ed.). 2001 September 1; 323(7311): 470. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11532831&dopt=Abstract
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E. coli invasion of brain microvascular endothelial cells as a pathogenetic basis of meningitis. Author(s): Kim KS. Source: Subcell Biochem. 2000; 33: 47-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10804851&dopt=Abstract
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Early management of suspected bacterial meningitis and meningococcal septicaemia in adults. Author(s): Heyderman RS, Lambert HP, O'Sullivan I, Stuart JM, Taylor BL, Wall RA. Source: The Journal of Infection. 2003 February; 46(2): 75-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634067&dopt=Abstract
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Early prediction of neurological sequelae or death after bacterial meningitis. Author(s): Oostenbrink R, Moons KG, Derksen-Lubsen G, Grobbee DE, Moll HA. Source: Acta Paediatrica (Oslo, Norway : 1992). 2002; 91(4): 391-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12061353&dopt=Abstract
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Echovirus 30 meningitis: a new cause for cerebral venous thrombosis? Author(s): Rabaud Ch, Ghiringelli CB, Dauendorffer JN, May T. Source: The Journal of Infection. 2002 January; 44(1): 53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11972424&dopt=Abstract
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Echovirus 30 outbreak of aseptic meningitis in Turkey. Author(s): Uysal G, Ozkaya E, Guven A. Source: The Pediatric Infectious Disease Journal. 2000 May; 19(5): 490. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10819358&dopt=Abstract
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Efavirenz-based regimen as treatment of advanced AIDS with cryptococcal meningitis. Author(s): Sungkanuparph S, Vibhagool A, Mootsikapun P, Chetchotisakd P, Tansuphaswaswadikul S, Bowonwatanuwong C, Chantratita W. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2003 May 1; 33(1): 118-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792366&dopt=Abstract
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Effect of methyl prednisolone on sensory motor functions in tuberculous meningitis. Author(s): Kalita J, Misra UK. Source: Neurology India. 2001 September; 49(3): 267-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11593244&dopt=Abstract
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Effect of short-term hyperventilation on cerebral blood flow autoregulation in patients with acute bacterial meningitis. Author(s): Moller K, Skinhoj P, Knudsen GM, Larsen FS. Source: Stroke; a Journal of Cerebral Circulation. 2000 May; 31(5): 1116-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797174&dopt=Abstract
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Effectiveness of incidence thresholds for detection and control of meningococcal meningitis epidemics in northern Togo. Author(s): Kaninda AV, Belanger F, Lewis R, Batchassi E, Aplogan A, Yakoua Y, Paquet C. Source: International Journal of Epidemiology. 2000 October; 29(5): 933-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11034981&dopt=Abstract
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Efficiency of cefepime in postoperative meningitis attributable to Enterobacter aerogenes. Author(s): Rousseau JM, Soullie B, Villevielle T, Koeck JL. Source: The Journal of Trauma. 2001 May; 50(5): 971. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11379596&dopt=Abstract
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Electroencephalographic abnormalities in aseptic meningitis and noninfectious headache. A comparative study. Author(s): Pollak L, Klein C, Schiffer J, Flechter S, Rabey J. Source: Headache. 2001 January; 41(1): 79-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168607&dopt=Abstract
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Elevated cerebrospinal fluid levels of glutamate in children with bacterial meningitis as a predictor of the development of seizures or other adverse outcomes. Author(s): Ma W, Shang-Feaster G, Okada PJ, Kernie SG. Source: Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2003 April; 4(2): 170-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749647&dopt=Abstract
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Eleven-month-old with recurrent bacterial and aseptic meningitis. Author(s): Slavin KA, Kohl S. Source: The Pediatric Infectious Disease Journal. 2000 February; 19(2): 175, 178-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10694015&dopt=Abstract
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Emergency management of meningitis. Author(s): Charlton R. Source: Journal of the Royal Society of Medicine. 2000 August; 93(8): 450. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10983518&dopt=Abstract
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Emergency management of meningitis. Author(s): Heyderman RS, Klein NJ. Source: Journal of the Royal Society of Medicine. 2000 May; 93(5): 225-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10884763&dopt=Abstract
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Emergency vaccination against epidemic meningitis in Ghana: implications for the control of meningococcal disease in West Africa. Author(s): Woods CW, Armstrong G, Sackey SO, Tetteh C, Bugri S, Perkins BA, Rosenstein NE. Source: Lancet. 2000 January 1; 355(9197): 30-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10615888&dopt=Abstract
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Empirical treatment of adult postsurgical nosocomial meningitis. Author(s): De Bels D, Korinek AM, Bismuth R, Trystram D, Coriat P, Puybasset L. Source: Acta Neurochirurgica. 2002 October; 144(10): 989-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382127&dopt=Abstract
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Employment of broad-range 16S rRNA PCR to detect aetiological agents of infection from clinical specimens in patients with acute meningitis--rapid separation of 16S rRNA PCR amplicons without the need for cloning. Author(s): Xu J, Millar BC, Moore JE, Murphy K, Webb H, Fox AJ, Cafferkey M, Crowe MJ. Source: Journal of Applied Microbiology. 2003; 94(2): 197-206. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534811&dopt=Abstract
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Encephalitis without meningitis due to sandfly fever virus serotype toscana. Author(s): Dionisio D, Valassina M, Ciufolini MG, Vivarelli A, Esperti F, Cusi MG, Marchi A, Mazzoli F, Lupi C. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 April 15; 32(8): 1241-3. Epub 2001 March 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11283818&dopt=Abstract
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Endoscopic lamina terminalis fenestration for treatment of hydrocephalus due to tuberculous meningitis. Case illustration. Author(s): Nakao N, Itakura T. Source: Journal of Neurosurgery. 2003 July; 99(1): 187. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854766&dopt=Abstract
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Endoscopic third ventriculostomy in tuberculous meningitis. Author(s): Figaji AA, Fieggen AG, Peter JC. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2003 April; 19(4): 217-25. Epub 2003 April 05. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682756&dopt=Abstract
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Endoscopic third ventriculostomy in tuberculous meningitis. Author(s): Siomin V, Constantini S. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2003 June; 19(5-6): 269. Epub 2003 May 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12774170&dopt=Abstract
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Enterococcal meningitis in an infant complicating congenital cutis aplasia. Author(s): Suara RO, Dermody TS. Source: The Pediatric Infectious Disease Journal. 2000 July; 19(7): 668-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10917233&dopt=Abstract
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Enterococcal nosocomial meningitis in children. Author(s): Krcmery V Jr, Filka J, Krupova Y, Mateicka F. Source: Journal of Chemotherapy (Florence, Italy). 2000 February; 12(1): 109-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10768523&dopt=Abstract
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Enterococcus faecalis meningitis after spinal anesthesia. Author(s): Tortosa JA, Hernandez-Palazon J. Source: Anesthesiology. 2000 March; 92(3): 909. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10719988&dopt=Abstract
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Enterococcus faecalis: an unusual cause of meningitis in HIV-infected patients. Author(s): Sharma A, Mong MS, Minamoto G. Source: Aids Read. 2002 December; 12(12): 540-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521008&dopt=Abstract
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Enteroviral meningitis in Northern Jordan: prevalence and association with clinical findings. Author(s): Meqdam MM, Khalousi MM, Al-Shurman A. Source: Journal of Medical Virology. 2002 February; 66(2): 224-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11782931&dopt=Abstract
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Enteroviral meningitis with a petechial rash in three children. Author(s): Sukhai RN, Munneke R. Source: European Journal of Pediatrics. 2002 April; 161(4): 226-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12014394&dopt=Abstract
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Enteroviral meningitis. Cost of illness and considerations for the economic evaluation of potential therapies. Author(s): Parasuraman TV, Frenia K, Romero J. Source: Pharmacoeconomics. 2001 January; 19(1): 3-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11252544&dopt=Abstract
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Enterovirus meningitis in adults in 1999-2000 and evaluation of clinical management. Author(s): Peigue-Lafeuille H, Croquez N, Laurichesse H, Clavelou P, Aumaitre O, Schmidt J, Maillet-Vioud M, Henquell C, Archimbaud C, Bailly JL, Chambon M. Source: Journal of Medical Virology. 2002 May; 67(1): 47-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11920817&dopt=Abstract
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Enzootic Angiostrongylus cantonensis in rats and snails after an outbreak of human eosinophilic meningitis, Jamaica. Author(s): Lindo JF, Waugh C, Hall J, Cunningham-Myrie C, Ashley D, Eberhard ML, Sullivan JJ, Bishop HS, Robinson DG, Holtz T, Robinson RD. Source: Emerging Infectious Diseases. 2002 March; 8(3): 324-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927033&dopt=Abstract
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Eosinophilic meningitis caused by Angiostrongylus cantonensis associated with eating raw snails: correlation of brain magnetic resonance imaging scans with clinical findings. Author(s): Tsai HC, Liu YC, Kunin CM, Lai PH, Lee SS, Chen YS, Wann SR, Lin WR, Huang CK, Ger LP, Lin HH, Yen MY. Source: Am J Trop Med Hyg. 2003 March; 68(3): 281-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685630&dopt=Abstract
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Eosinophilic meningitis caused by Angiostrongylus cantonensis: report of 17 cases. Author(s): Tsai HC, Liu YC, Kunin CM, Lee SS, Chen YS, Lin HH, Tsai TH, Lin WR, Huang CK, Yen MY, Yen CM. Source: The American Journal of Medicine. 2001 August; 111(2): 109-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11498063&dopt=Abstract
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Eosinophilic meningitis due to Angiostrongylus cantonensis in a returned traveler: case report and review of the literature. Author(s): Lo Re V 3rd, Gluckman SJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 November 1; 33(9): E112-5. Epub 2001 September 24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11568860&dopt=Abstract
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Eosinophilic meningitis due to Angiostrongylus cantonensis. Author(s): Ellis-Pegler R, Parry G. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 September 15; 35(6): 777-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12203184&dopt=Abstract
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Eosinophilic meningitis due to Gnathostoma spinigerum. Author(s): Lo Re V 3rd, Gluckman SJ. Source: The Journal of Infection. 2002 August; 45(2): 117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217718&dopt=Abstract
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Eosinophilic meningitis in a neonate. Author(s): Hewett FA 2nd, Hendley JO. Source: Clinical Pediatrics. 2002 May; 41(4): 269-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12043718&dopt=Abstract
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Eosinophilic meningitis. Author(s): Lo Re V 3rd, Gluckman SJ. Source: The American Journal of Medicine. 2003 February 15; 114(3): 217-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637136&dopt=Abstract
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Epidemic typhus meningitis in the southwestern United States. Author(s): Massung RF, Davis LE, Slater K, McKechnie DB, Puerzer M. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 March 15; 32(6): 979-82. Epub 2001 Mar 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11247722&dopt=Abstract
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Epidemiology and diagnosis of meningitis: results of a five-year prospective, population-based study. Author(s): Jolly K, Stewart G. Source: Commun Dis Public Health. 2001 June; 4(2): 124-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525000&dopt=Abstract
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Epidemiology of bacterial meningitis among children in Brazil, 1997-1998. Author(s): Weiss DP, Coplan P, Guess H. Source: Revista De Saude Publica. 2001 June; 35(3): 249-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11486147&dopt=Abstract
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Epidemiology of childhood bacterial meningitis in Poland. Incidence of bacterial meningitis with special reference to Haemophilus influenzae type b among children 0-59 months old in the former Kielce and Bydgoszcz districts in Poland in 1998-1999. Author(s): Zielinski A, Tomaszunas-Blaszczyk J, Kuklinska D. Source: European Journal of Epidemiology. 2001; 17(8): 779-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12086097&dopt=Abstract
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Epidemiology of Haemophilus influenzae type b meningitis in Manila, Philippines, 1994 to 1996. Author(s): Limcangco MR, Salole EG, Armour CL. Source: The Pediatric Infectious Disease Journal. 2000 January; 19(1): 7-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10643843&dopt=Abstract
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Epidemiology of meningitis and bacteraemia due to Streptococcus pneumoniae in The Netherlands. Author(s): Spanjaard L, van der Ende A, Rumke H, Dankert J, van Alphen L. Source: Acta Paediatr Suppl. 2000 December; 89(435): 22-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11194792&dopt=Abstract
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Epidemiology of meningitis due to Haemophilus influenzae type b in children in Bulgaria: a prospective, population-based surveillance study. Author(s): Kojouharova M, Gatcheva N, Setchanova L, Robertson SE, Wenger JD. Source: Bulletin of the World Health Organization. 2002; 80(9): 690-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378285&dopt=Abstract
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Epidemiology of meningococcal meningitis in Angola, 1994-2000. Author(s): Gaspar M, Leite F, Brumana L, Felix B, Stella AA. Source: Epidemiology and Infection. 2001 December; 127(3): 421-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11811874&dopt=Abstract
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Epidemiology of neonatal meningitis in Qatar. Author(s): El-Said MF, Bessisso MS, Janahi MA, Habob LH, El-Shafie SS. Source: Saudi Med J. 2002 July; 23(7): 789-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174226&dopt=Abstract
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Erythema migrans after ceftriaxone treatment of aseptic meningitis caused by Borrelia burgdorferi. Author(s): Jhaveri R, Cherry JD, Phillips S, Korb J. Source: The Pediatric Infectious Disease Journal. 2001 October; 20(10): 1010-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11642622&dopt=Abstract
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Escherichia coli O18:K1:H7 isolates from patients with acute cystitis and neonatal meningitis exhibit common phylogenetic origins and virulence factor profiles. Author(s): Johnson JR, Delavari P, O'Bryan TT. Source: The Journal of Infectious Diseases. 2001 February 1; 183(3): 425-34. Epub 2000 December 20. Erratum In: J Infect Dis 2001 May 15; 183(10): 1546. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11133374&dopt=Abstract
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Estimating incidence of bacterial meningitis with capture-recapture method, Lazio Region, Italy. Author(s): Faustini A, Fano V, Sangalli M, Ferro S, Celesti L, Contegiacomo P, Renzini V, Perucci CA. Source: European Journal of Epidemiology. 2000; 16(9): 843-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11297227&dopt=Abstract
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Etiologic spectrum and pattern of antimicrobial drug susceptibility in bacterial meningitis in Sokoto, Nigeria. Author(s): Emele FE. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 August; 89(8): 942-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10976835&dopt=Abstract
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Evaluation of an in-house-developed radioassay kit for antibody detection in cases of pulmonary tuberculosis and tuberculous meningitis. Author(s): Kameswaran M, Shetty K, Ray MK, Jaleel MA, Kadival GV. Source: Clinical and Diagnostic Laboratory Immunology. 2002 September; 9(5): 987-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204948&dopt=Abstract
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Evaluation of brainstem auditory evoked response audiometry findings in children with tuberculous meningitis at admission. Author(s): Topcu I, Cureoglu S, Yaramis A, Tekin M, Oktay F, Osma U, Meric F, Katar S. Source: Auris, Nasus, Larynx. 2002 January; 29(1): 11-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772484&dopt=Abstract
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Evaluation of enterovirus serological tests IgM-EIA and complement fixation in patients with meningitis, confirmed by detection of enteroviral RNA by RT-PCR in cerebrospinal fluid. Author(s): Terletskaia-Ladwig E, Metzger C, Schalasta G, Enders G. Source: Journal of Medical Virology. 2000 June; 61(2): 221-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797378&dopt=Abstract
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Evaluation of free radical status in CSF in childhood meningitis. Author(s): Ray G, Aneja S, Jain M, Batra S. Source: Annals of Tropical Paediatrics. 2000 June; 20(2): 115-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10945061&dopt=Abstract
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Evaluation of PCR using TRC(4) and IS6110 primers in detection of tuberculous meningitis. Author(s): Narayanan S, Parandaman V, Narayanan PR, Venkatesan P, Girish C, Mahadevan S, Rajajee S. Source: Journal of Clinical Microbiology. 2001 May; 39(5): 2006-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11326036&dopt=Abstract
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Evaluation of polymerase chain reaction (PCR) for diagnosing Haemophilus influenzae b meningitis. Author(s): Singhi SC, Mohankumar D, Singhi PD, Sapru S, Ganguly NK. Source: Annals of Tropical Paediatrics. 2002 December; 22(4): 347-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530285&dopt=Abstract
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Evaluation of surveillance thresholds for prediction of meningitis epidemics using ongoing surveillance data at the district level, in Niger. Author(s): de Chabalier F, Hassane A, Chippaux JP. Source: Trans R Soc Trop Med Hyg. 2000 May-June; 94(3): 251-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10974990&dopt=Abstract
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Experimental meningitis in the rat: protection by uric acid at human physiological blood concentrations. Author(s): Kastenbauer S, Koedel U, Becker BF, Pfister HW. Source: European Journal of Pharmacology. 2001 August 10; 425(2): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502281&dopt=Abstract
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Expression of death-related proteins in dentate granule cells in human bacterial meningitis. Author(s): Gerber J, Bruck W, Stadelmann C, Bunkowski S, Lassmann H, Nau R. Source: Brain Pathology (Zurich, Switzerland). 2001 October; 11(4): 422-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11556687&dopt=Abstract
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Expression of matrix metalloproteinases, sICAM-1 and IL-8 in CSF from children with meningitis. Author(s): Shapiro S, Miller A, Lahat N, Sobel E, Lerner A. Source: Journal of the Neurological Sciences. 2003 January 15; 206(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480084&dopt=Abstract
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Expression of vascular endothelial growth factor in tuberculous meningitis. Author(s): Matsuyama W, Hashiguchi T, Umehara F, Matsuura E, Kawabata M, Arimura K, Maruyama I, Osame M. Source: Journal of the Neurological Sciences. 2001 May 1; 186(1-2): 75-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11412875&dopt=Abstract
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Failure of cefotaxime and meropenem to eradicate meningitis caused by an intermediately susceptible Streptococcus pneumoniae strain. Author(s): Vandecasteele SJ, Verhaegen J, Colaert J, Van Caster A, Devlieger H. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 October; 20(10): 7512. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11757981&dopt=Abstract
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Failure of treatment for chronic Mycobacterium abscessus meningitis despite adequate clarithromycin levels in cerebrospinal fluid. Author(s): Maniu CV, Hellinger WC, Chu SY, Palmer R, Alvarez-Elcoro S. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 September 1; 33(5): 745-8. Epub 2001 August 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11486298&dopt=Abstract
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Failure To detect muramic acid in normal rat tissues but detection in cerebrospinal fluids from patients with Pneumococcal meningitis. Author(s): Kozar MP, Krahmer MT, Fox A, Gray BM. Source: Infection and Immunity. 2000 August; 68(8): 4688-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10899874&dopt=Abstract
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False-positive pneumococcal antigen test in meningitis diagnosis. Author(s): Alonso-Tarres C, Cortes-Lletget C, Casanova T, Domenech A. Source: Lancet. 2001 October 13; 358(9289): 1273-4. Erratum In: Lancet 2002 July 27; 360(9329): 344. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11675095&dopt=Abstract
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Familial outbreak of disseminated multidrug-resistant tuberculosis and meningitis. Author(s): Sofia M, Maniscalco M, Honore N, Molino A, Mormile M, Heym B, Cole ST. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2001 June; 5(6): 551-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11409583&dopt=Abstract
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Fast duplex one-step RT-PCR for rapid differential diagnosis of entero- or toscana virus meningitis. Author(s): Valassina M, Valentini M, Valensin PE, Cusi MG. Source: Diagnostic Microbiology and Infectious Disease. 2002 July; 43(3): 201-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12106953&dopt=Abstract
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Fatal meningitis and encephalitis due to Bartonella henselae bacteria. Author(s): Gerber JE, Johnson JE, Scott MA, Madhusudhan KT. Source: J Forensic Sci. 2002 May; 47(3): 640-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12051353&dopt=Abstract
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Fatal septicemia and meningitis due to Morganella morganii in a patient with Hodgkin's disease. Author(s): Samonis G, Anatoliotaki M, Apostolakou H, Souglakos J, Georgoulias V. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(7): 553-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11515771&dopt=Abstract
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Fatal subarachnoid hemorrhage complicating actinomycotic meningitis. Author(s): Koda Y, Seto Y, Takeichi S, Kimura H. Source: Forensic Science International. 2003 July 8; 134(2-3): 169-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850413&dopt=Abstract
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Feculent meningitis: polymicrobial meningitis in colorectal surgery. Author(s): Garcia-Lechuz JM, Hernangomez S, San Juan R, Bouza E. Source: Diagnostic Microbiology and Infectious Disease. 2000 November; 38(3): 169-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11109015&dopt=Abstract
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Fever interval before diagnosis, prior antibiotic treatment, and clinical outcome for young children with bacterial meningitis. Author(s): Bonsu BK, Harper MB. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 February 15; 32(4): 566-72. Epub 2001 Feb 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11181119&dopt=Abstract
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Findings in a patient with herpes simplex viral meningitis associated with acute retinal necrosis syndrome. Author(s): Tada Y, Negoro K, Morimatsu M, Makino H, Nishida T. Source: Ajnr. American Journal of Neuroradiology. 2001 August; 22(7): 1300-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11498417&dopt=Abstract
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First epidemic of aseptic meningitis due to echovirus type 13 among Spanish children. Author(s): Trallero G, Casas I, Avellon A, Perez C, Tenorio A, De La Loma A. Source: Epidemiology and Infection. 2003 April; 130(2): 251-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729193&dopt=Abstract
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First epidemic of echovirus 16 meningitis in Cuba. Author(s): Sarmiento L, Mas P, Goyenechea A, Palomera R, Morier L, Capo V, Quintana I, Santin M. Source: Emerging Infectious Diseases. 2001 September-October; 7(5): 887-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11747705&dopt=Abstract
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Fit genotypes and escape variants of subgroup III Neisseria meningitidis during three pandemics of epidemic meningitis. Author(s): Zhu P, van der Ende A, Falush D, Brieske N, Morelli G, Linz B, Popovic T, Schuurman IG, Adegbola RA, Zurth K, Gagneux S, Platonov AE, Riou JY, Caugant DA, Nicolas P, Achtman M. Source: Proceedings of the National Academy of Sciences of the United States of America. 2001 April 24; 98(9): 5234-9. Epub 2001 Apr 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11287631&dopt=Abstract
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Flaccid quadriplegia from tonsillar herniation in pneumococcal meningitis. Author(s): Ropper AH, Kanis KB. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2000 July; 7(4): 339-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10938617&dopt=Abstract
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Fluconazole treatment of coccidioidal meningitis in children: two case reports and a review of the literature. Author(s): Saitoh A, Homans J, Kovacs A. Source: The Pediatric Infectious Disease Journal. 2000 December; 19(12): 1204-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11144385&dopt=Abstract
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Fluconazole-resistant cryptococcal meningitis. Author(s): Momoff N, Parrish A. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2003 June; 93(6): 444. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12916384&dopt=Abstract
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Fluid-attenuated inversion-recovery imaging of cerebral infarction associated with tuberculous meningitis. Author(s): Nogami K, Nomura S, Kashiwagi S, Kato S, Yamashita K, Ito H. Source: Computerized Medical Imaging and Graphics : the Official Journal of the Computerized Medical Imaging Society. 2000 September-October; 24(5): 333-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10940611&dopt=Abstract
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Follistatin (FS) in human cerebrospinal fluid and regulation of FS expression in a mouse model of meningitis. Author(s): Michel U, Ebert S, Schneider O, Shintani Y, Bunkowski S, Smirnov A, Stringaris A, Gerber J, Bruck W, Nau R. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2000 December; 143(6): 809-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11124865&dopt=Abstract
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Frequent association with neurosurgical conditions in adult Proteus mirabilis meningitis: report of five cases. Author(s): Chang WN, Tsai YC, Chien CC, Huang CR, Lu CH. Source: Clinical Neurology and Neurosurgery. 2002 May; 104(2): 121-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932041&dopt=Abstract
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Frosted branch angitis associated with aseptic meningitis. Author(s): Johkura K, Hara A, Hattori T, Hasegawa O, Kuroiwa Y. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2000 March; 7(2): 241. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10809950&dopt=Abstract
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Fungal meningitis. Author(s): Gottfredsson M, Perfect JR. Source: Seminars in Neurology. 2000; 20(3): 307-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11051295&dopt=Abstract
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Fusobacterium necrophorum: a rare cause of meningitis in children. Author(s): Voie H, Turid M, Wathne KO. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(7): 543-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195886&dopt=Abstract
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Gastric linitis adenocarcinoma and carcinomatous meningitis: an infrequent but aggressive association--report of four cases. Author(s): Delaunoit T, Boige V, Belloc J, Elias D, Lasser P, Duvillard P, Ducreux M. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2001 June; 12(6): 869-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11484967&dopt=Abstract
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Gemifloxacin is efficacious against penicillin-resistant and quinolone-resistant pneumococci in experimental meningitis. Author(s): Cottagnoud P, Acosta F, Cottagnoud M, Tauber MG. Source: Antimicrobial Agents and Chemotherapy. 2002 May; 46(5): 1607-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11959614&dopt=Abstract
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Genetic diversity of echovirus 30 during a meningitis outbreak, demonstrated by direct molecular typing from cerebrospinal fluid. Author(s): Bailly JL, Brosson D, Archimbaud C, Chambon M, Henquell C, PeigueLafeuille H. Source: Journal of Medical Virology. 2002 December; 68(4): 558-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376964&dopt=Abstract
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Genetic predisposition and sensorineural hearing loss following bacterial meningitis: is there a link? Author(s): Jayarajan V, Patton MA, Rajenderkumar D. Source: The Journal of Infection. 2002 April; 44(3): 210. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12099760&dopt=Abstract
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Gonococcal meningitis and intra-abdominal abscess in the presence of a ventriculoperitoneal shunt. Author(s): Lin MF, Lau YJ, Hu BS, Shi ZY, Lin YH. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(5): 567-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11055670&dopt=Abstract
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Gram negative meningitis resulting from rupture of a spinal epidural abscess into the subarachnoid space. Author(s): Lodhi S, Mozaffar T, Sarwari AR. Source: J Pak Med Assoc. 2000 November; 50(11): 393-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126818&dopt=Abstract
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Group a streptococcal meningitis in adults: report of 41 cases and a review of the literature. Author(s): van de Beek D, de Gans J, Spanjaard L, Sela S, Vermeulen M, Dankert J. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 May 1; 34(9): E32-6. Epub 2002 April 04. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11941569&dopt=Abstract
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Group A streptococcal meningitis with an infected BCG scar. Author(s): Melzer M, Joashi U, Murdoch I, Gransden W. Source: Journal of the Royal Society of Medicine. 2000 December; 93(12): 641. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11193065&dopt=Abstract
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Group A streptococcal meningitis: report of a case and review of literature since 1976. Author(s): Shetty AK, Frankel LR, Maldonado Y, Falco DA, Lewis DB. Source: Pediatric Emergency Care. 2001 December; 17(6): 430-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11753187&dopt=Abstract
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Group B streptococcal beta-hemolysin/cytolysin activates neutrophil signaling pathways in brain endothelium and contributes to development of meningitis. Author(s): Doran KS, Liu GY, Nizet V. Source: The Journal of Clinical Investigation. 2003 September; 112(5): 736-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12952922&dopt=Abstract
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Group B streptococcal meningitis complicating elective abortion: report of 2 cases. Author(s): Deziel PJ, McGuire N, Brown PD. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 November; 31(5): E23-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11073784&dopt=Abstract
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Group B streptococcal meningitis in adults: recent increase in Southeast Asia. Author(s): Wilder-Smith E, Chow KM, Kay R, Ip M, Tee N. Source: Aust N Z J Med. 2000 August; 30(4): 462-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10985511&dopt=Abstract
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Group B streptococcus meningitis in an HIV-positive adult: case report and review. Author(s): Guerin JM, Mofredj A, Leibinger F, Ekherian JM, Raskine L. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(2): 215-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10826913&dopt=Abstract
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Group C streptococcal meningitis in infancy. Author(s): Jenkins EL, McGuire W. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 September; 89(9): 1141-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11071100&dopt=Abstract
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Group C streptococcal meningitis: case report and review of the literature. Author(s): Shah SS, Matthews RP, Cohen C. Source: The Pediatric Infectious Disease Journal. 2001 April; 20(4): 445-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332674&dopt=Abstract
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Group-A streptococcal meningitis in an adult, secondary to purulent otitis media. Author(s): Cohen-Kerem R, Lavon H. Source: The Journal of Laryngology and Otology. 2002 July; 116(7): 541-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12238676&dopt=Abstract
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Guidelines for managing acute bacterial meningitis. Author(s): Moller K, Skinhoj P. Source: Bmj (Clinical Research Ed.). 2000 May 13; 320(7245): 1290. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10807603&dopt=Abstract
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Haemophilus influenzae meningitis in Catalonia, Spain: epidemiology and bacteriologic characteristics. Author(s): Latorre C, Pineda V, Juncosa T, Munoz C, Dominguez A, Bou R, Fontanals D, Sanfeliu I, Pons I, Margall N, Sanchez F, Pericas R, Lobera E; H. influenzae invasive disease working group. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2000 May; 6(5): 279-82. Erratum In: Clin Microbiol Infect 2000 October; 6(10): 573. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168129&dopt=Abstract
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Haemophilus influenzae type b meningitis in a fully immunized 2-year-old. Author(s): McCann WA, Frank MM, Cox F, Ownby DR. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2002 June; 88(6): 551-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12086360&dopt=Abstract
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Haemophilus influenzae type b meningitis with subdural effusion: a case report. Author(s): Chan PC, Lu CY, Lee PI, Yang TY, Chen RT, Ho YH, Yang SC, Lee CY, Huang L. Source: J Microbiol Immunol Infect. 2002 March; 35(1): 61-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11950123&dopt=Abstract
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Haemophilus influenzae type b meningitis: how much better is prevention than cure? Author(s): Duke T. Source: P N G Med J. 2002 September-December; 45(3-4): 213-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12968792&dopt=Abstract
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Haemophilus influenzae type b still remains a leading cause of meningitis among unvaccinated children--a prospective CSF analysis study. Author(s): Uduman SA, Adeyemi E, El-Khadir A, Jose K, Benedict S, Bener A. Source: Journal of Tropical Pediatrics. 2000 December; 46(6): 331-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191142&dopt=Abstract
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Hearing in children after meningococcal meningitis. Author(s): Drake R, Dravitski J, Voss L. Source: Journal of Paediatrics and Child Health. 2000 June; 36(3): 240-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10849224&dopt=Abstract
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Hearing preservation mastoidectomy in otogenic meningitis secondary to an enlarged vestibular aqueduct. Case report. Author(s): Saliba I, Moukheiber A, Wanna G, Moukarzel N, Nehme A, Mansour S. Source: J Med Liban. 2000 September-October; 48(5): 327-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12489589&dopt=Abstract
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Henoch-Schonlein purpura following meningitis C vaccination. Author(s): Courtney PA, Patterson RN, Lee RJ. Source: Rheumatology (Oxford, England). 2001 March; 40(3): 345-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11285387&dopt=Abstract
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Hepatocyte growth factor levels in cerebrospinal fluid: a comparison between acute bacterial and nonbacterial meningitis. Author(s): Nayeri F, Nilsson I, Hagberg L, Brudin L, Roberg M, Soderstrom C, Forsberg P. Source: The Journal of Infectious Diseases. 2000 June; 181(6): 2092-4. Epub 2000 May 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10837201&dopt=Abstract
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Herpes zoster and aseptic meningitis in a previously healthy child. Author(s): Szinnai G, Farron F, Bar G, Heininger U. Source: European Journal of Pediatrics. 2003 June; 162(6): 434-5. Epub 2003 April 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684902&dopt=Abstract
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Hospital-acquired meningitis in patients undergoing craniotomy: incidence, evolution, and risk factors. Author(s): Reichert MC, Medeiros EA, Ferraz FA. Source: American Journal of Infection Control. 2002 May; 30(3): 158-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11988710&dopt=Abstract
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How college nurses managed the meningitis C campaign. Author(s): Halligan E. Source: Nurs Times. 2000 November 30-December 6; 96(48): 38-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11965995&dopt=Abstract
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Human herpesvirus 7-associated meningitis and optic neuritis in a patient after allogeneic stem cell transplantation. Author(s): Yoshikawa T, Yoshida J, Hamaguchi M, Kubota T, Akimoto S, Ihira M, Nishiyama Y, Asano Y. Source: Journal of Medical Virology. 2003 July; 70(3): 440-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767008&dopt=Abstract
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Hydrocephalus in coccidioidal meningitis: case report and review of the literature. Author(s): Romeo JH, Rice LB, McQuarrie IG. Source: Neurosurgery. 2000 September; 47(3): 773-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10981768&dopt=Abstract
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Hydrocephalus internus--first manifestation of chronic meningitis due to Listeria monocytogenes. Author(s): Grafe G, Handrik W, Geyer C. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S46-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11848049&dopt=Abstract
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Hypothermia attenuates beta1 integrin expression on extravasated neutrophils in an animal model of meningitis. Author(s): Rowin ME, Xue V, Irazuzta J. Source: Inflammation. 2001 June; 25(3): 137-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11403204&dopt=Abstract
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Iatrogenic meningitis: an increasing role for resistant viridans streptococci? Case report and review of the last 20 years. Author(s): Yaniv LG, Potasman I. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(6): 693-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11200384&dopt=Abstract
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Iatrogenic meningitis: the case for face masks. Author(s): Baer ET. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 August; 31(2): 519-21. Epub 2000 August 28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987715&dopt=Abstract
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Iatrogenic Streptococcus salivarius meningitis after spinal anaesthesia: need for strict application of standard precautions. Author(s): Couzigou C, Vuong TK, Botherel AH, Aggoune M, Astagneau P. Source: The Journal of Hospital Infection. 2003 April; 53(4): 313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660130&dopt=Abstract
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ICD-10 mild cognitive disorder following meningitis due to neurosarcoidosis. Author(s): Pruter C, Kunert HJ, Hoff P. Source: Psychopathology. 2001 November-December; 34(6): 326-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11847493&dopt=Abstract
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Identification of resource use and associated costs for viral meningitis. Author(s): Parasuraman TV, Deverka PA, Toscani MR. Source: Manag Care. 2000 January; 9(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10977664&dopt=Abstract
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Identification of viridans streptococcal species causing bacterial meningitis in adults in Taiwan. Author(s): Chang WN, Wu JJ, Huang CR, Tsai YC, Chien CC, Lu CH. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 May; 21(5): 393-6. Epub 2002 May 07. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072926&dopt=Abstract
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IL-6 may be the key mediator in trimethoprim-induced systemic adverse reaction and aseptic meningitis: a reply to Muller et al. Author(s): Antonen JA, Saha HH, Hurme M, Pasternack AI. Source: Clinical Nephrology. 2001 June; 55(6): 489-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11434363&dopt=Abstract
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Images in clinical medicine. Neoplastic meningitis. Author(s): Grossman SA, Celano P. Source: The New England Journal of Medicine. 2001 February 15; 344(7): 494. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11172191&dopt=Abstract
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Imaging of cranial meningitis and ventriculitis. Author(s): Kanamalla US, Ibarra RA, Jinkins JR. Source: Neuroimaging Clin N Am. 2000 May; 10(2): 309-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10775954&dopt=Abstract
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Immunisation. School nurses burnt out by meningitis C campaign. Author(s): Coombes R. Source: Nurs Times. 2000 June 22-28; 96(25): 13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11962968&dopt=Abstract
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Immunization campaign targets influenza, meningitis, tetanus. Author(s): Traynor K. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2001 September 15; 58(18): 1685-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11571808&dopt=Abstract
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Immunocytochemical method for early laboratory diagnosis of tuberculous meningitis. Author(s): Sumi MG, Mathai A, Reuben S, Sarada C, Radhakrishnan VV. Source: Clinical and Diagnostic Laboratory Immunology. 2002 March; 9(2): 344-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874875&dopt=Abstract
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Immunodiagnosis of human eosinophilic meningitis using an antigen of Angiostrongylus cantonensis L5 with molecular weight 204 kD. Author(s): Chye SM, Chang JH, Yen CM. Source: Acta Tropica. 2000 February 25; 75(1): 9-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10708002&dopt=Abstract
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Immunodiagnosis of tuberculous meningitis: rapid detection of mycobacterial antigens in cerebrospinal fluid by reverse passive hemagglutination assay and their characterization by Western blotting. Author(s): Katti MK. Source: Fems Immunology and Medical Microbiology. 2001 July; 31(1): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476983&dopt=Abstract
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Impact of Haemophilus influenzae type b (Hib) conjugate vaccines on Haemophilus influenzae meningitis in Wisconsin. Author(s): Enders PJ, Trepka MJ, Davis JP. Source: Wmj. 2000 August; 99(5): 45-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043070&dopt=Abstract
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Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients. Author(s): Hakim JG, Gangaidzo IT, Heyderman RS, Mielke J, Mushangi E, Taziwa A, Robertson VJ, Musvaire P, Mason PR. Source: Aids (London, England). 2000 July 7; 14(10): 1401-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10930155&dopt=Abstract
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Impact of human immunodeficiency virus type 1 infection on the epidemiology and outcome of bacterial meningitis in South African children. Author(s): Madhi SA, Madhi A, Petersen K, Khoosal M, Klugman KP. Source: International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases. 2001; 5(3): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11724667&dopt=Abstract
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Impact of rapid polymerase chain reaction results on management of pediatric patients with enteroviral meningitis. Author(s): Robinson CC, Willis M, Meagher A, Gieseker KE, Rotbart H, Glode MP. Source: The Pediatric Infectious Disease Journal. 2002 April; 21(4): 283-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075757&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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In vivo therapy of neoplastic meningitis with methotrexate and 5. Author(s): Kassis AI, Dahman BA, Adelstein SJ. Source: Acta Oncologica (Stockholm, Sweden). 2000; 39(6): 731-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11130012&dopt=Abstract
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Incidence of Haemophilus influenzae type b meningitis in Mie prefecture, Japan. Author(s): Nakano T, Ihara T, Kamiya H, Yabu Y, Kuwabara H, Iwade Y, Sugiyama A. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2001 June; 43(3): 323-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11380936&dopt=Abstract
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Increase of in vitro amoxycillin bactericidal activity by clavulanic acid against Neisseria meningitis using time-kill curves. Author(s): Anta ML, Gimenez MJ, Alou L, Gomez-Lus ML, Laguna B, Aguilar L, Prieto J. Source: International Journal of Antimicrobial Agents. 2002 March; 19(3): 249-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932151&dopt=Abstract
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Increased serum concentrations of tissue plasminogen activator correlate with an adverse clinical outcome in patients with bacterial meningitis. Author(s): Winkler F, Kastenbauer S, Koedel U, Pfister HW. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2002 October; 73(4): 456. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235321&dopt=Abstract
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Index of suspicion. Case 1. Diagnosis: TB meningitis. Author(s): Alshaar M. Source: Pediatrics in Review / American Academy of Pediatrics. 2001 July; 22(7): 245-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11435626&dopt=Abstract
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Indications for the immunological evaluation of patients with meningitis. Author(s): Overturf GD. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 January 15; 36(2): 189-94. Epub 2002 December 31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522751&dopt=Abstract
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Infantile Salmonella meningitis associated with gecko-keeping. Author(s): Cyriac J, Wozniak ER. Source: Commun Dis Public Health. 2000 March; 3(1): 66-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10743325&dopt=Abstract
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Infected cephalohematoma complicated with meningitis: report of one case. Author(s): Huang CS, Cheng KJ, Huang CB. Source: Acta Paediatr Taiwan. 2002 July-August; 43(4): 217-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12238911&dopt=Abstract
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Infectious disease. Shortage of meningitis vaccine forces triage in Burkina Faso. Author(s): Vogel G. Source: Science. 2003 March 7; 299(5612): 1499-501. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624241&dopt=Abstract
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Infliximab-induced aseptic meningitis. Author(s): Kashyap AS, Kashyap S. Source: Lancet. 2002 April 6; 359(9313): 1252. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11955573&dopt=Abstract
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Infliximab-induced aseptic meningitis. Author(s): Marotte H, Charrin JE, Miossec P. Source: Lancet. 2001 November 24; 358(9295): 1784. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11734240&dopt=Abstract
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Initial presentation of systemic lupus erythematosus masquerading as bacterial meningitis. Author(s): Dong J, Suwanvecho S, Chen L, Keung YK. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 2001 November-December; 14(6): 470-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11757892&dopt=Abstract
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Initial treatment with amphotericin B plus rifampin in the acute treatment of cryptococcal meningitis in aids. Author(s): Chotmongkol V, Methawasin K. Source: Southeast Asian J Trop Med Public Health. 2001 December; 32(4): 776-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12041553&dopt=Abstract
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Interleukin 6 may be an important mediator of trimethoprim-induced systemic adverse reaction resembling aseptic meningitis. Author(s): Antonen J, Hulkkonen J, Pasternack A, Hurme M. Source: Archives of Internal Medicine. 2000 July 10; 160(13): 2066-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10888991&dopt=Abstract
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Interleukin-1beta and tumor necrosis factor-alpha in cerebrospinal fluid of children with bacterial meningitis. Author(s): Tang RB, Lee BH, Chung RL, Chen SJ, Wong TT. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2001 August; 17(8): 453-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11508533&dopt=Abstract
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Interleukin-8 levels in children with bacterial, tuberculous and aseptic meningitis. Author(s): Yilmaz E, Gurgoze MK, Ilhan N, Dogan Y, Aydinoglu H. Source: Indian J Pediatr. 2002 March; 69(3): 219-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003295&dopt=Abstract
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Interventricular methotrexate therapy for carcinomatous meningitis due to breast cancer: a case with leukoencephalopathy. Author(s): Hara H, Igarashi A, Yano Y, Yashiro T, Ueno E, Aiyoshi Y. Source: Breast Cancer. 2000; 7(3): 247-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11029806&dopt=Abstract
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Intracranial Salmonella infections: meningitis, subdural collections and brain abscess. A series of six surgically managed cases with follow-up results. Author(s): Mahapatra AK, Pawar SJ, Sharma RR. Source: Pediatric Neurosurgery. 2002 January; 36(1): 8-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11818740&dopt=Abstract
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Intradural, eextramedullary tuberculoma of the spinal cord as a complication of tuberculous meningitis. Author(s): Skendros P, Kamaria F, Kontopoulos V, Tsitouridis I, Sidiropoulos L. Source: Infection. 2003 March; 31(2): 115-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682818&dopt=Abstract
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Intramuscular ceftriaxone in the treatment of childhood meningitis due to Haemophilus influenzae type F. Author(s): Ratka A, Erramouspe J. Source: The Annals of Pharmacotherapy. 2001 January; 35(1): 36-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11197583&dopt=Abstract
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Intraoperative intracranial pressure monitoring in pneumococcal meningitis. Author(s): Vavilala MS, Lam AM. Source: Anesthesia and Analgesia. 2000 January; 90(1): 107-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10624987&dopt=Abstract
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Intrathecal administration of vancomycin for coagulase-negative staphylococcal meningitis in a patient with blunt head injury: case report. Author(s): Kawamoto H, Inagawa T, Ikawa F, Sakamoto S, Urabe S. Source: The Journal of Trauma. 2002 November; 53(5): 1010-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435961&dopt=Abstract
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Intrathecal amphotericin in the management of coccidioidal meningitis. Author(s): Stevens DA, Shatsky SA. Source: Seminars in Respiratory Infections. 2001 December; 16(4): 263-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740828&dopt=Abstract
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Intrathecal chemotherapy in carcinomatous meningitis from breast cancer. Author(s): Orlando L, Curigliano G, Colleoni M, Fazio N, Nole F, Martinelli G, Cinieri S, Graffeo R, Peruzzotti G, Goldhirsch A. Source: Anticancer Res. 2002 September-October; 22(5): 3057-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530042&dopt=Abstract
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Intrathecal synthesis of complement components C3c and C4 in the central nervous system infections with signs of the acute serous meningitis syndrome. Author(s): Tatomirovic Z, Bokun R, Bokonjic D. Source: Vojnosanit Pregl. 2002 May-June; 59(3): 265-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132240&dopt=Abstract
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Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine. Author(s): Jaeckle KA, Phuphanich S, Bent MJ, Aiken R, Batchelor T, Campbell T, Fulton D, Gilbert M, Heros D, Rogers L, O'Day SJ, Akerley W, Allen J, Baidas S, Gertler SZ, Greenberg HS, LaFollette S, Lesser G, Mason W, Recht L, Wong E, Chamberlain MC, Cohn A, Glantz MJ, Gutheil JC, Maria B, Moots P, New P, Russell C, Shapiro W, Swinnen L, Howell SB. Source: British Journal of Cancer. 2001 January; 84(2): 157-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11161370&dopt=Abstract
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Intravenous methylprednisolone for aseptic meningitis in Vogt-Koyanagi-Harada syndrome. Author(s): Solaro C, Messmer Uccelli M. Source: European Neurology. 2000; 44(2): 129-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10965172&dopt=Abstract
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Intraventricular haemorrhage due to ruptured posterior inferior cerebellar artery aneurysm in tuberculous meningitis. Author(s): Griffiths SJ, Sgouros S, James G, John P. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2000 December; 16(12): 872-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11156304&dopt=Abstract
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Intussusception associated with bacterial meningitis. Author(s): Crushell E, Flanagan O, Devins M, Dunne K, Gleeson J. Source: Archives of Disease in Childhood. 2001 July; 85(1): 56-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11420203&dopt=Abstract
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Invasive fungal sinusitis and meningitis due to Arthrographis kalrae in a patient with AIDS. Author(s): Chin-Hong PV, Sutton DA, Roemer M, Jacobson MA, Aberg JA. Source: Journal of Clinical Microbiology. 2001 February; 39(2): 804-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11158158&dopt=Abstract
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Is vaccination against meningitis useful? The findings of an investigation in the Sherbrooke region, Quebec. Author(s): De Wals P, Allard MA, Guindon K, Mayrand L, Simard S, Black R. Source: Can Commun Dis Rep. 2002 April 15; 28(8): 61-3. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11974427&dopt=Abstract
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Isolated cerebrospinal fluid eosinophilia due to Streptococcus bovis meningitis in an infant. Author(s): Al-Arishi H, Frayha HH, Yaneza AL, Al Hifzi IS. Source: International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases. 2002 December; 6(4): 323-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12725215&dopt=Abstract
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Isolated cryptococcal sphenoid sinusitis with septicemia, meningitis, and subsequent skull base osteomyelitis in an immunocompetent patient. Author(s): Prendiville S, Bielamowicz SA, Hawrych A, Deeb ZE. Source: Otolaryngology and Head and Neck Surgery. 2000 September; 123(3): 277-9. Erratum In: Otolaryngol Head Neck Surg 2000 November; 123(5): 668. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10964305&dopt=Abstract
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Isolated vestibular ossification after meningitis associated with sensorineural hearing loss. Author(s): Reeck JB, Lalwani AK. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 July; 24(4): 576-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851548&dopt=Abstract
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Isolation and characterization of vancomycin-tolerant Streptococcus pneumoniae from the cerebrospinal fluid of a patient who developed recrudescent meningitis. Author(s): McCullers JA, English BK, Novak R. Source: The Journal of Infectious Diseases. 2000 January; 181(1): 369-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10608791&dopt=Abstract
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Isolation of echovirus type 13 from patients of aseptic meningitis. Author(s): Keino M, Kanno M, Hirasawa K, Watari T, Mikawa M, Saito K, Kato K, Katayose M, Yoshida H. Source: Japanese Journal of Infectious Diseases. 2001 December; 54(6): 249-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11862012&dopt=Abstract
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Isoniazid resistance, mycobacterial genotype and outcome in Vietnamese adults with tuberculous meningitis. Author(s): Thwaites GE, Chau TT, Caws M, Phu NH, Chuong LV, Sinh DX, Drobniewski F, White NJ, Parry CM, Farrar JJ. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2002 October; 6(10): 865-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365572&dopt=Abstract
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Issues arising from two related cases of childhood tuberculous meningitis. Author(s): Leung WC, Tregoning D. Source: Public Health. 2000 January; 114(1): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10787028&dopt=Abstract
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JMM, past and present. Meningitis cerebro-spinalis epidemica. Author(s): Ganten D, Weber JR. Source: Journal of Molecular Medicine (Berlin, Germany). 2001 May; 79(4): 159-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11409705&dopt=Abstract
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Kingella endocarditis and meningitis in a patient with SLE and associated antiphospholipid syndrome. Author(s): Wolak T, Abu-Shakra M, Flusser D, Liel-Cohen N, Buskila D, Sukenik S. Source: Lupus. 2000; 9(5): 393-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10878736&dopt=Abstract
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Klebsiella meningitis in adults: clinical features, prognostic factors and therapeutic outcomes. Author(s): Lu CH, Chang WN, Chang HW. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2002 September; 9(5): 533-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383410&dopt=Abstract
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Klebsiella pneumoniae meningitis in thalassemia major patients. Author(s): Li CK, Shing MM, Chik KW, Lee V, Yuen PM. Source: Pediatric Hematology and Oncology. 2001 April-May; 18(3): 229-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293293&dopt=Abstract
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Klebsiella pneumoniae meningitis: timing of antimicrobial therapy and prognosis. Author(s): Fang CT, Chen YC, Chang SC, Sau WY, Luh KT. Source: Qjm : Monthly Journal of the Association of Physicians. 2000 January; 93(1): 4553. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10623782&dopt=Abstract
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Laboratory diagnosis and genetic analysis of an echovirus 30-associated outbreak of aseptic meningitis in Taiwan in 2001. Author(s): Wang JR, Tsai HP, Huang SW, Kuo PH, Kiang D, Liu CC. Source: Journal of Clinical Microbiology. 2002 December; 40(12): 4439-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12454133&dopt=Abstract
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Labyrinthine dysplasia, meningitis, and sensorineural deafness: a complex relationship. Author(s): Rashad UM, Flood LM, El-Hmd KA, Hawthorne MR. Source: The Journal of Otolaryngology. 2000 April; 29(2): 110-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10819110&dopt=Abstract
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Lack of sensitivity of the latex agglutination test to detect bacterial antigen in the cerebrospinal fluid of patients with culture-negative meningitis. Author(s): Tarafdar K, Rao S, Recco RA, Zaman MM. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 August 1; 33(3): 406-8. Epub 2001 June 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11438913&dopt=Abstract
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Late-developing cerebral arteropathy after pyogenic meningitis. Author(s): Palacio S, Hart RG, Vollmer DG, Kagan-Hallet K. Source: Archives of Neurology. 2003 March; 60(3): 431-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633156&dopt=Abstract
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Legacy of bacterial meningitis in infancy. Many children continue to suffer functionally important deficits. Author(s): Grimwood K. Source: Bmj (Clinical Research Ed.). 2001 September 8; 323(7312): 523-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11546680&dopt=Abstract
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Lesson of the week: Recurrent bacterial meningitis: the need for sensitive imaging. Author(s): Carrol ED, Latif AH, Misbah SA, Flood TJ, Abinun M, Clark JE, Pugh RE, Cant AJ. Source: Bmj (Clinical Research Ed.). 2001 September 1; 323(7311): 501-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11532847&dopt=Abstract
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Leukemic meningitis in B-cell chronoc lymphocytic leukemia: resolution following intrathecal methotrexate. Author(s): Marmont AM. Source: Blood. 2000 July 15; 96(2): 776-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10950515&dopt=Abstract
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Leukocyte aggregation score in meningitis and its relationship with cerebrospinal fluid soluble selectin and soluble ICAM-1 levels. Author(s): Uysal G, Tulek N, Ozhan B. Source: Journal of Tropical Pediatrics. 2000 December; 46(6): 381-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191156&dopt=Abstract
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Levels of matrix metalloproteinase-9 within cerebrospinal fluid in a rabbit model of coccidioidal meningitis and vasculitis. Author(s): Williams PL, Leib SL, Kamberi P, Leppert D, Sobel RA, Bifrare YD, Clemons KV, Stevens DA. Source: The Journal of Infectious Diseases. 2002 December 1; 186(11): 1692-5. Epub 2002 November 01. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12447750&dopt=Abstract
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Levels of three inflammation markers, C-reactive protein, serum amyloid A protein and procalcitonin, in the serum and cerebrospinal fluid of patients with meningitis. Author(s): Shimetani N, Shimetani K, Mori M. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 2001; 61(7): 56774. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763415&dopt=Abstract
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Light eye colour linked to deafness after meningitis. Author(s): Cullington HE. Source: Bmj (Clinical Research Ed.). 2001 March 10; 322(7286): 587. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11238154&dopt=Abstract
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Limits of detection of Mycobacterium tuberculosis in spiked cerebrospinal fluid using the polymerase chain reaction in tuberculous meningitis. Author(s): Baran J Jr, Riederer KM, Khatib R. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2000 January; 19(1): 47-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10706180&dopt=Abstract
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Listeria meningitis after treatment with infliximab. Author(s): Kamath BM, Mamula P, Baldassano RN, Markowitz JE. Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 April; 34(4): 410-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11930099&dopt=Abstract
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Listeria meningitis in children: report of two cases. Author(s): Economou M, Karyda S, Kansouzidou A, Kavaliotis J. Source: Infection. 2000 March-April; 28(2): 121-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782402&dopt=Abstract
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Listeria monocytogenes meningitis during the incubation period of hepatitis A disease. Author(s): Boga AS, Montero RB, Garcia FS, Valcarcel GR. Source: The Pediatric Infectious Disease Journal. 2000 March; 19(3): 265-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10749478&dopt=Abstract
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Listeria monocytogenes meningitis in a patient with chronic hepatitis C infection, treated by interferon alfa and ribavirin. Author(s): Vander T, Medvedovsky M, Hallevy C, Golzman G, Herishanu Y. Source: The Journal of Infection. 2003 January; 46(1): 70-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504615&dopt=Abstract
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Listeria monocytogenes meningitis: serotype distribution and patient characteristics in The Netherlands, 1976-95. Author(s): Aouaj Y, Spanjaard L, van Leeuwen N, Dankert J. Source: Epidemiology and Infection. 2002 June; 128(3): 405-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113484&dopt=Abstract
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Long term follow up after meningitis in infancy: behaviour of teenagers. Author(s): Halket S, de Louvois J, Holt DE, Harvey D. Source: Archives of Disease in Childhood. 2003 May; 88(5): 395-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716708&dopt=Abstract
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Long term outcome of neonatal meningitis. Author(s): Stevens JP, Eames M, Kent A, Halket S, Holt D, Harvey D. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2003 May; 88(3): F179-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719389&dopt=Abstract
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Long term response in a patient with neoplastic meningitis secondary to melanoma treated with (131)I-radiolabeled antichondroitin proteoglycan sulfate Mel-14 F(ab')(2): a case study. Author(s): Cokgor I, Akabani G, Friedman HS, Friedman AH, Zalutsky MR, Zehngebot LM, Provenzale JM, Guy CD, Wikstrand CJ, Bigner DD. Source: Cancer. 2001 May 1; 91(9): 1809-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11335907&dopt=Abstract
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Longitudinal outcomes of Haemophilus influenzae meningitis in school-age children. Author(s): Taylor HG, Schatschneider C, Minich NM. Source: Neuropsychology. 2000 October; 14(4): 509-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11055253&dopt=Abstract
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Long-term follow up of childhood tuberculous meningitis. Author(s): Schoeman J, Wait J, Burger M, van Zyl F, Fertig G, van Rensburg AJ, Springer P, Donald P. Source: Developmental Medicine and Child Neurology. 2002 August; 44(8): 522-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206617&dopt=Abstract
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Long-term follow-up of children with bacterial meningitis with emphasis on behavioural characteristics. Author(s): Berg S, Trollfors B, Hugosson S, Fernell E, Svensson E. Source: European Journal of Pediatrics. 2002 June; 161(6): 330-6. Epub 2002 April 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12029452&dopt=Abstract
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Long-Term outcome of neonatal Citrobacter koseri (diversus) meningitis treated with imipenem/meropenem and surgical drainage. Author(s): Straussberg R, Harel L, Amir J. Source: Infection. 2001 October; 29(5): 280-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11688908&dopt=Abstract
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Long-term outcomes of childhood meningitis. Author(s): Fellick JM, Thomson AP. Source: Hosp Med. 2002 May; 63(5): 274-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12066345&dopt=Abstract
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Low cerebrospinal fluid beta-amyloid 42 in patients with acute bacterial meningitis and normalization after treatment. Author(s): Sjogren M, Gisslen M, Vanmechelen E, Blennow K. Source: Neuroscience Letters. 2001 November 13; 314(1-2): 33-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11698140&dopt=Abstract
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Low sensitivity of polymerase chain reaction for diagnosis of tuberculous meningitis in southeastern Brazil. Author(s): Brienze VM, Tonon AP, Pereira FJ, Liso E, Tognola WA, dos Santos MA, Ferreira MU. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2001 July-August; 34(4): 389-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11562736&dopt=Abstract
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Low sensitivity of serum procalcitonin in bacterial meningitis in adults. Author(s): Hoffmann O, Reuter U, Masuhr F, Holtkamp M, Kassim N, Weber JR. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(3): 215-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11303813&dopt=Abstract
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Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment. Author(s): Kanegaye JT, Soliemanzadeh P, Bradley JS. Source: Pediatrics. 2001 November; 108(5): 1169-74. Erratum In: Pediatrics 2002 September; 110(3): 651. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11694698&dopt=Abstract
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Lumbar punctures and meningitis. Author(s): Kvalsvig AJ, Unsworth DJ. Source: Pediatrics. 2002 November; 110(5): 1028; Author Reply 1028. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415049&dopt=Abstract
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Lumbar punctures and meningitis. Author(s): Arkava T, Luszczak M. Source: Pediatrics. 2002 November; 110(5): 1028; Author Reply 1028. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415048&dopt=Abstract
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Lymphomatous meningitis of the Burkitt type presenting with multiple cranial neuropathies. Author(s): Grassi MA, Lee AG. Source: American Journal of Ophthalmology. 2002 March; 133(3): 424-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11860991&dopt=Abstract
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Malignant meningitis secondary to ovarian carcinoma: an unusual occurrence. Author(s): Chung P, Allerton R. Source: Clin Oncol (R Coll Radiol). 2001; 13(2): 112-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11373871&dopt=Abstract
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Management of an outbreak of meningococcal meningitis in a Sudanese refugee camp in Northern Uganda. Author(s): Santaniello-Newton A, Hunter PR. Source: Epidemiology and Infection. 2000 February; 124(1): 75-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10722133&dopt=Abstract
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Management of bacterial meningitis in adults. Author(s): Cohen J. Source: Bmj (Clinical Research Ed.). 2003 May 10; 326(7397): 996-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742897&dopt=Abstract
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Management of meningitis in children with oral fluid restriction or intravenous fluid at maintenance volumes: a randomised trial. Author(s): Duke T, Mokela D, Frank D, Michael A, Paulo T, Mgone J, Kurubi J. Source: Annals of Tropical Paediatrics. 2002 June; 22(2): 145-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12070950&dopt=Abstract
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Management of pneumococcal meningitis. Author(s): Kaplan SL. Source: The Pediatric Infectious Disease Journal. 2002 June; 21(6): 589-91; Discussion 613-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182395&dopt=Abstract
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Markers of oxidative injury in the cerebrospinal fluid of a premature infant with meningitis and periventricular leukomalacia. Author(s): Inder T, Mocatta T, Darlow B, Spencer C, Senthilmohan R, Winterbourn CC, Volpe JJ. Source: The Journal of Pediatrics. 2002 May; 140(5): 617-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032532&dopt=Abstract
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Maternal group B streptococcal meningitis in the postpartum period. Author(s): Ravindranth NT, O'Driscoll J. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 January; 23(1): 79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12647708&dopt=Abstract
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Matrix metalloproteinase (MMP)-8 and MMP-9 in cerebrospinal fluid during bacterial meningitis: association with blood-brain barrier damage and neurological sequelae. Author(s): Leppert D, Leib SL, Grygar C, Miller KM, Schaad UB, Hollander GA. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 July; 31(1): 80-4. Epub 2000 July 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10913401&dopt=Abstract
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Matrix metalloproteinase-9 in pneumococcal meningitis: activation via an oxidative pathway. Author(s): Meli DN, Christen S, Leib SL. Source: The Journal of Infectious Diseases. 2003 May 1; 187(9): 1411-5. Epub 2003 April 15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12717622&dopt=Abstract
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Matrix metalloproteinases: multifunctional effectors of inflammation in multiple sclerosis and bacterial meningitis. Author(s): Leppert D, Lindberg RL, Kappos L, Leib SL. Source: Brain Research. Brain Research Reviews. 2001 October; 36(2-3): 249-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11690622&dopt=Abstract
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Media management of a community outbreak of meningococcal meningitis. Author(s): Singleton CD, Fey R, Appleby C. Source: Commun Dis Public Health. 2000 December; 3(4): 267-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280256&dopt=Abstract
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Meningeal carcinomatosis in lung cancer. Case 2. Carcinomatous meningitis. Author(s): Janne PA, Janicek MJ, Brown F. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2000 August; 18(15): 2927-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10920142&dopt=Abstract
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Meningitis A conjugate vaccine comes on stream. Author(s): Ahmad K. Source: The Lancet Infectious Diseases. 2003 May; 3(5): 263. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12726961&dopt=Abstract
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Meningitis after spinal anaesthesia. Author(s): Whiteside J. Source: Anesthesia and Analgesia. 2000 September; 91(3): 763-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10960420&dopt=Abstract
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Meningitis and cochlear implantation. Author(s): Papsin BC. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 February 4; 168(3): 256-7; Author Reply 257. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566326&dopt=Abstract
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Meningitis and cochlear implantation. Author(s): O'Donoghue G, Balkany T, Cohen N, Lenarz T, Lustig L, Niparko J. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 November; 23(6): 823-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438839&dopt=Abstract
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Meningitis and encephalitis in children. An update. Author(s): Bonthius DJ, Karacay B. Source: Neurologic Clinics. 2002 November; 20(4): 1013-38, Vi-Vii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616679&dopt=Abstract
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Meningitis and endocarditis caused by group B streptococcus in a human immunodeficiency virus (HIV) infected patient. Author(s): Civljak R, Lisic M, Begovac J, Maretic T, Planinc D. Source: Croatian Medical Journal. 2001 October; 42(5): 572-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11596176&dopt=Abstract
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Meningitis and septicaemia in a child caused by non-typable Haemophilus influenzae biotype III. Author(s): Kay SE, Nack Z, Jenner BM. Source: The Medical Journal of Australia. 2001 November 5; 175(9): 484-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11758078&dopt=Abstract
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Meningitis and shunt infection caused by anaerobic bacteria in children. Author(s): Brook I. Source: Pediatric Neurology. 2002 February; 26(2): 99-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11897473&dopt=Abstract
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Meningitis articles spark painful memories. Author(s): Andrews J. Source: Nurs N Z. 2001 August; 7(7): 4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12012840&dopt=Abstract
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Meningitis C immunisation is low among young people who are not in education. Author(s): Booth L, Naracott E, Greenslade J. Source: Bmj (Clinical Research Ed.). 2000 March 18; 320(7237): 805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10720386&dopt=Abstract
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Meningitis C vaccine (North American vaccine). Author(s): Lattanzi M, Del Giudice G. Source: Curr Opin Investig Drugs. 2002 January; 3(1): 51-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12054072&dopt=Abstract
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Meningitis C vaccine uptake by British undergraduates. Author(s): Thirlaway K, Lukman H. Source: Commun Dis Public Health. 2003 June; 6(2): 157-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12889298&dopt=Abstract
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Meningitis carcinomatosa originating from an alpha fetoprotein-producing gastric cancer. Author(s): Tsujikawa T, Tsukamoto H, Itoh A, Andoh A, Sasaki M, Koyama S, Fujiyama Y, Bamba T. Source: Intern Med. 2000 March; 39(3): 223-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10772124&dopt=Abstract
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Meningitis caused by Streptococcus pyogenes in an intravenous drug user. Author(s): Robson D, Cadwgan AM, Laing RB. Source: The Journal of Infection. 2002 November; 45(4): 276-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12423620&dopt=Abstract
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Meningitis complicating an occult infected nasal epidermoid cyst in a child. Author(s): Hsu ML, Chen CY, Lien YH, Wang CC, Yuh YS, Chen SJ. Source: Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging. 2002 April; 12(2): 187-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11977917&dopt=Abstract
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Meningitis concerns. Immunization recommended for group C type among children under five, teens and young adults. Author(s): Fletcher M. Source: Can Nurse. 2002 January; 98(1): 10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11845548&dopt=Abstract
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Meningitis due to acute otitis media and arachnoid granulations. Author(s): Perry BP, Rubinstein JT. Source: The Annals of Otology, Rhinology, and Laryngology. 2000 September; 109(9): 877-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11007094&dopt=Abstract
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Meningitis due to Capnocytophaga canimorsus after receipt of a dog bite: case report and review of the literature. Author(s): Le Moal G, Landron C, Grollier G, Robert R, Burucoa C. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 February 1; 36(3): E42-6. Epub 2003 January 13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12539089&dopt=Abstract
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Meningitis due to mixed infection with penicillin-resistant and penicillin-susceptible strains of Streptococcus pneumoniae. Author(s): Chaves F, Campelo C, Sanz F, Otero JR. Source: Journal of Clinical Microbiology. 2003 January; 41(1): 512-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517910&dopt=Abstract
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Meningitis due to Neisseria subflava: case report and review. Author(s): Baraldes MA, Domingo P, Barrio JL, Pericas R, Gurgui M, Vazquez G. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 March; 30(3): 615-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10722463&dopt=Abstract
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Meningitis due to penicillin-resistant Neisseria meningitidis in a 20-year-old man. Author(s): Ben RJ, Wang CC, Chu ML. Source: J Formos Med Assoc. 2001 October; 100(10): 696-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11760376&dopt=Abstract
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Meningitis due to Salmonella in preterm neonates. Author(s): Totan M, Kucukoduk S, Dagdemir A, Dilber C. Source: Turk J Pediatr. 2002 January-March; 44(1): 45-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858379&dopt=Abstract
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Meningitis due to Streptococcus salivarius. Author(s): Idigoras P, Valiente A, Iglesias L, Trieu-Cout P, Poyart C. Source: Journal of Clinical Microbiology. 2001 August; 39(8): 3017. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11499393&dopt=Abstract
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Meningitis due to viridans streptococci. Author(s): Watanakunakorn C. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 January; 30(1): 238-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619783&dopt=Abstract
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Meningitis following cochlear implantation: pathomechanisms, clinical symptoms, conservative and surgical treatments. Author(s): Arnold W, Bredberg G, Gstottner W, Helms J, Hildmann H, Kiratzidis T, Muller J, Ramsden RT, Roland P, Walterspiel JN. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 November-December; 64(6): 382-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12499760&dopt=Abstract
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Meningitis following stapedotomy: a rare and early complication. Author(s): Nielsen TR, Thomsen J. Source: The Journal of Laryngology and Otology. 2000 October; 114(10): 781-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11127151&dopt=Abstract
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Meningitis four years after treatment of macroprolactinoma. Author(s): Wood R, Sandeman DD, Gawne-Cain ML, Holt RI. Source: Journal of the Royal Society of Medicine. 2002 October; 95(10): 501-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356971&dopt=Abstract
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Meningitis in a girl with recurrent otitis media caused by Streptococcus pyogenes-otitis media has to be treated appropriately. Author(s): Steppberger K, Adams I, Deutscher J, Muller H, Kiess W. Source: Infection. 2001 October; 29(5): 286-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11688910&dopt=Abstract
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Meningitis in Africa--tackling W135. Author(s): Chonghaile CN. Source: Lancet. 2002 December 21-28; 360(9350): 2054-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504411&dopt=Abstract
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Meningitis in infancy in England and Wales: follow up at age 5 years. Author(s): Bedford H, de Louvois J, Halket S, Peckham C, Hurley R, Harvey D. Source: Bmj (Clinical Research Ed.). 2001 September 8; 323(7312): 533-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11546697&dopt=Abstract
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Meningitis in pediatric patients. Author(s): Lozon MM. Source: Air Medical Journal. 2002 March-April; 21(2): 9-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11896364&dopt=Abstract
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Meningitis propagation in southern Tanzania: the role of a village video show. Author(s): Jahn A, Kudzala A, Kitundu H, Lyamuya E, Razum O. Source: Tropical Medicine & International Health : Tm & Ih. 2001 October; 6(10): 839-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11679132&dopt=Abstract
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Meningitis seasonal pattern in Africa and detection of epidemics: a retrospective study in Niger, 1990-98. Author(s): de Chabalier F, Djingarey MH, Hassane A, Chippaux JP. Source: Trans R Soc Trop Med Hyg. 2000 November-December; 94(6): 664-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198652&dopt=Abstract
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Meningitis vaccination programme prompts needless scare. Author(s): Dixon B. Source: Current Biology : Cb. 2000 October 19; 10(20): R726. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11069092&dopt=Abstract
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Meningitis, life and death, and why we do what we do. Author(s): Nice RA. Source: Journal of American College Health : J of Ach. 2002 May; 50(6): 313. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701658&dopt=Abstract
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Meningitis, pathogenicity near criticality: the epidemiology of meningococcal disease as a model for accidental pathogens. Author(s): Stollenwerk N, Jansen VA. Source: Journal of Theoretical Biology. 2003 June 7; 222(3): 347-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732481&dopt=Abstract
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Meningitis. Outcome of a complex interaction. Author(s): Vogel U. Source: Lancet. 2001 December; 358 Suppl: S43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11784592&dopt=Abstract
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Meningitis. The fears, the facts. Author(s): Myers F. Source: Rn. 2000 November; 63(11): 52-7; Quiz 58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11147011&dopt=Abstract
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Meningitis. The worst days of my life. Author(s): Schwarzbeck D, Reng CM. Source: Lancet. 2001 December; 358 Suppl: S44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11784593&dopt=Abstract
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Meningitis: a rash diagnosis. Author(s): Glennie L. Source: Nurs Times. 2000 March 23-29; 96(12): 44-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11310020&dopt=Abstract
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Meningitis--viral versus bacterial. Author(s): Haruda FD. Source: Pediatrics. 2003 August; 112(2): 447-8; Author Reply 447-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897308&dopt=Abstract
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Meningococcal disease in Slovenia (1993-1999): serogroups and susceptibility to antibiotics. Slovenian Meningitis Study Group. Author(s): Cizman M, Gubina M, Paragi M, Beovic B, Lesnicar G. Source: International Journal of Antimicrobial Agents. 2001 January; 17(1): 27-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137645&dopt=Abstract
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Meningococcal infections and meningitis: what is new? Author(s): Kumar RK. Source: The Australian Journal of Rural Health. 2000 December; 8(6): 318-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11894791&dopt=Abstract
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Meningococcal meningitis epidemic. A new role for single-dose oily chloramphenicol. Author(s): Hussein AA, Abdel Rahman SI. Source: Saudi Med J. 2002 July; 23(7): 797-801. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174228&dopt=Abstract
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Meningococcal meningitis in Africa. Author(s): Fonkoua MC. Source: The American Journal of Nursing. 2002 December; 102(12): 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12489542&dopt=Abstract
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Meningococcal meningitis outbreak control strategies. Author(s): Ahlawat S, Kumar R, Roy P, Varma S, Sharma BK. Source: J Commun Dis. 2000 December; 32(4): 264-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11668937&dopt=Abstract
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Meningococcus-not just meningitis. Author(s): Matich MD. Source: N Z Med J. 2000 June 23; 113(1112): 260. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914517&dopt=Abstract
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Methicillin-resistant Staphylococcus aureus meningitis: has the time come for an alternative to vancomycin? Author(s): Pagani L, Petrosillo N, Viale P. Source: Infection. 2002 June; 30(3): 181-2; Author Reply 183. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12120949&dopt=Abstract
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Microbiologic features of adult community-acquired bacterial meningitis in Taiwan. Author(s): Fang CT, Chang SC, Hsueh PR, Chen YC, Sau WY, Luh KT. Source: J Formos Med Assoc. 2000 April; 99(4): 300-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10870313&dopt=Abstract
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Migraine-like headache in bacterial meningitis. Author(s): Lampl C, Yazdi K, Buzath A, Klingler D. Source: Cephalalgia : an International Journal of Headache. 2000 October; 20(8): 738-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11167904&dopt=Abstract
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Mild cognitive impairment after viral meningitis in adults. Author(s): Sittinger H, Muller M, Schweizer I, Merkelbach S. Source: Journal of Neurology. 2002 May; 249(5): 554-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12021945&dopt=Abstract
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Mixed infection in adult bacterial meningitis. Author(s): Chang WN, Lu CH, Huang CR, Chuang YC. Source: Infection. 2000 January-February; 28(1): 8-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10697784&dopt=Abstract
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Modulation of nuclear factor-kappaB activation and decreased markers of neurological injury associated with hypothermic therapy in experimental bacterial meningitis. Author(s): Irazuzta JE, Pretzlaff RK, Zingarelli B, Xue V, Zemlan F. Source: Critical Care Medicine. 2002 November; 30(11): 2553-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441769&dopt=Abstract
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Modulation of release of proinflammatory bacterial compounds by antibacterials: potential impact on course of inflammation and outcome in sepsis and meningitis. Author(s): Nau R, Eiffert H. Source: Clinical Microbiology Reviews. 2002 January; 15(1): 95-110. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11781269&dopt=Abstract
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Molecular analysis and experimental virulence of French and North American Escherichia coli neonatal meningitis isolates: identification of a new virulent clone. Author(s): Bonacorsi S, Clermont O, Houdouin V, Cordevant C, Brahimi N, Marecat A, Tinsley C, Nassif X, Lange M, Bingen E. Source: The Journal of Infectious Diseases. 2003 June 15; 187(12): 1895-906. Epub 2003 May 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792866&dopt=Abstract
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Molecular analysis of the CDR3 encoding region of the immunoglobulin heavy chain locus in cerebrospinal fluid cells as a diagnostic tool in lymphomatous meningitis. Author(s): Storch-Hagenlocher B, Haas J, Vogt-Schaden ME, Bentz M, Hoffmann LA, Biessmann A, Wildemann B. Source: Annals of Neurology. 2000 February; 47(2): 211-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10665492&dopt=Abstract
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Molecular detection and identification of an enterovirus during an outbreak of aseptic meningitis. Author(s): Siafakas N, Georgopoulou A, Markoulatos P, Spyrou N, Stanway G. Source: Journal of Clinical Laboratory Analysis. 2001; 15(2): 87-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11291111&dopt=Abstract
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Molecular epidemiology of serogroup a meningitis in Moscow, 1969 to 1997. Author(s): Achtman M, van der Ende A, Zhu P, Koroleva IS, Kusecek B, Morelli G, Schuurman IG, Brieske N, Zurth K, Kostyukova NN, Platonov AE. Source: Emerging Infectious Diseases. 2001 May-June; 7(3): 420-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11384519&dopt=Abstract
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Molecular evolution of human echovirus 9 isolated from patients with aseptic meningitis in northern Kyushu during the summer of 1997. Author(s): Hara K, Kashiwagi T, Ohtsu Y, Masunaga K, Akasu-Tsuji Y, Tsumura N, Kato H, Iwahashi J, Hamada N, Toyoda M, Toyoda T. Source: Microbiol Immunol. 2001; 45(10): 717-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11762754&dopt=Abstract
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Molecular identification and epidemiological tracing of Pasteurella multocida meningitis in a baby. Author(s): Boerlin P, Siegrist HH, Burnens AP, Kuhnert P, Mendez P, Pretat G, Lienhard R, Nicolet J. Source: Journal of Clinical Microbiology. 2000 March; 38(3): 1235-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10699029&dopt=Abstract
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Molecular identification of Staphylococcus lugdunensis in a patient with meningitis. Author(s): Kaabia N, Scauarda D, Lena G, Drancourt M. Source: Journal of Clinical Microbiology. 2002 May; 40(5): 1824-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980968&dopt=Abstract
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Molecular typing and epidemiology of enteroviruses identified from an outbreak of aseptic meningitis in Belgium during the summer of 2000. Author(s): Thoelen I, Lemey P, Van Der Donck I, Beuselinck K, Lindberg AM, Van Ranst M. Source: Journal of Medical Virology. 2003 July; 70(3): 420-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767006&dopt=Abstract
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Mononuclear cells and cytokines in the cerebrospinal fluid of echovirus 30 meningitis patients. Author(s): Matsubara T, Matsuoka T, Katayama K, Yoshitomi T, Nishikawa M, Ichiyama T, Furukawa S. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(5): 471-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11055648&dopt=Abstract
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Moraxella catarrhalis meningitis: a case report. Author(s): Jin Y. Source: Chin Med J (Engl). 2000 April; 113(4): 381-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775241&dopt=Abstract
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MRI demonstration of unsuspected intraventricular rupture of pyogenic cerebral abscesses in patients being treated for meningitis. Author(s): Kamra P, Vatsal DK, Husain M, Pradhan S, Venkatesh SK, Gupta RK. Source: Neuroradiology. 2002 February; 44(2): 114-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11942361&dopt=Abstract
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Multidrug-resistant tuberculous meningitis in patients with AIDS. Author(s): Daikos GL, Cleary T, Rodriguez A, Fischl MA. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2003 April; 7(4): 3948. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729347&dopt=Abstract
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Multiple myeloma following an episode of community-acquired pneumococcal bacteraemia or meningitis. Author(s): Gregersen H, Pedersen G, Svendsen N, Thulstrup AM, Sorensen HT, Schonheyder HC. Source: Apmis : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. 2001 November; 109(11): 797-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11900061&dopt=Abstract
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Mycobacterium tuberculosis meningitis and other etiologies of the aseptic meningitis syndrome. Author(s): Roos KL. Source: Seminars in Neurology. 2000; 20(3): 329-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11051297&dopt=Abstract
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Naegleria meningitis: a rare survival. Author(s): Jain R, Prabhakar S, Modi M, Bhatia R, Sehgal R. Source: Neurology India. 2002 December; 50(4): 470-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577098&dopt=Abstract
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Neisseria meningitidis serogroups W135 and A were equally prevalent among meningitis cases occurring at the end of the 2001 epidemics in Burkina Faso and Niger. Author(s): Taha MK, Parent Du Chatelet I, Schlumberger M, Sanou I, Djibo S, de Chabalier F, Alonso JM. Source: Journal of Clinical Microbiology. 2002 March; 40(3): 1083-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880446&dopt=Abstract
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Neisseria sicca meningitis in a woman with nascent pernicious anemia. Author(s): Sartin JS. Source: The American Journal of Medicine. 2000 August 1; 109(2): 175-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11032571&dopt=Abstract
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Neonatal bacterial meningitis. Author(s): Polin RA, Harris MC. Source: Seminars in Neonatology : Sn. 2001 April; 6(2): 157-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11483021&dopt=Abstract
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Neonatal Candida meningitis. Author(s): Moylett EH. Source: Seminars in Pediatric Infectious Diseases. 2003 April; 14(2): 115-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881799&dopt=Abstract
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Neonatal coagulase-negative staphylococcal meningitis: a report of two cases. Author(s): Drinkovic D, Pottumarthy S, Knight D, Morris AJ. Source: Pathology. 2002 December; 34(6): 586-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556001&dopt=Abstract
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Neonatal meningitis in England and Wales: 10 years on. Author(s): Holt DE, Halket S, de Louvois J, Harvey D. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2001 March; 84(2): F85-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207221&dopt=Abstract
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Neonatal meningitis. Author(s): Heath PT, Nik Yusoff NK, Baker CJ. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2003 May; 88(3): F173-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719388&dopt=Abstract
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Neonatal meningitis. Author(s): Al-Harthi AA, Dagriri KA, Asindi AA, Bello CS. Source: Saudi Med J. 2000 June; 21(6): 550-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11500704&dopt=Abstract
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Neonatal meningitis: mortality, cerebrospinal fluid, and microbiological findings. Author(s): Nel E. Source: Journal of Tropical Pediatrics. 2000 August; 46(4): 237-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10996987&dopt=Abstract
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Neonatal salmonella meningitis. Author(s): Nabi G, Khan M. Source: Saudi Med J. 2001 January; 22(1): 78. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255620&dopt=Abstract
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Neonatal salmonella meningitis. Author(s): Matthew L, Chandran U. Source: Saudi Med J. 2000 May; 21(5): 498-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11500693&dopt=Abstract
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Neonatal Salmonella meningitis. Author(s): Manzar S. Source: Saudi Med J. 2000 October; 21(10): 989. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11369975&dopt=Abstract
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Neonatal Salmonella typhimurium meningitis. Author(s): Totan M. Source: Indian J Pediatr. 2001 November; 68(11): 1079-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11770247&dopt=Abstract
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Neonate with late onset Streptococcus bovis meningitis: case report and review of the literature. Author(s): Cheung M, Pelot M, Nadarajah R, Kohl S. Source: The Pediatric Infectious Disease Journal. 2000 September; 19(9): 891-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11001118&dopt=Abstract
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Neoplastic meningitis. Author(s): Aparicio A, Chamberlain MC. Source: Curr Neurol Neurosci Rep. 2002 May; 2(3): 225-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11937001&dopt=Abstract
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Neoplastic meningitis. Author(s): Kim L, Glantz MJ. Source: Curr Treat Options Oncol. 2001 December; 2(6): 517-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12057097&dopt=Abstract
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Neoplastic meningitis: a guide to diagnosis and treatment. Author(s): Chamberlain MC. Source: Current Opinion in Neurology. 2000 December; 13(6): 641-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11148663&dopt=Abstract
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Neoplastic meningitis: diagnosis and treatment considerations. Author(s): Blaney SM, Poplack DG. Source: Medical Oncology (Northwood, London, England). 2000 August; 17(3): 151-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10962524&dopt=Abstract
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Neurocysticercosis presenting as chronic meningitis. Author(s): Hassan KM, Mathew I. Source: J Assoc Physicians India. 2000 September; 48(9): 940. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198809&dopt=Abstract
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Neurogenic pulmonary oedema induced by bacterial meningitis: a case report. Author(s): D'Souza R, Kerr F. Source: Scott Med J. 2001 August; 46(4): 115-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11676042&dopt=Abstract
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Neurologic morbidity after herpes simplex virus type 2 meningitis: a retrospective study of 40 patients. Author(s): Aurelius E, Forsgren M, Gille E, Skoldenberg B. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(4): 278-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064691&dopt=Abstract
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Neuronal injury in bacterial meningitis: mechanisms and implications for therapy. Author(s): Nau R, Bruck W. Source: Trends in Neurosciences. 2002 January; 25(1): 38-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11801337&dopt=Abstract
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Neuron-specific enolase, nucleotides, nucleosides, purine bases, oxypurines and uric acid concentrations in cerebrospinal fluid of children with meningitis. Author(s): Rodriguez-Nunez A, Cid E, Rodriguez-Garcia J, Camina F, Rodriguez-Segade S, Castro-Gago M. Source: Brain & Development. 2003 March; 25(2): 102-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581805&dopt=Abstract
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Neurotoxicity of carbapenem antibiotics: consequences for their use in bacterial meningitis. Author(s): Norrby SR. Source: The Journal of Antimicrobial Chemotherapy. 2000 January; 45(1): 5-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10629006&dopt=Abstract
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Neurotrophin-3 levels in cerebrospinal fluid from children with bacterial meningitis, viral meningitis, or encephalitis. Author(s): Mizuno Y, Takada H, Urakami K, Ihara K, Kira R, Suminoe A, Ohga S, Aoki T, Hara T. Source: Journal of Child Neurology. 2000 January; 15(1): 19-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10641604&dopt=Abstract
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Neurotrophin-4 and glial cell line-derived neurotrophic factor in cerebrospinal fluid from meningitis/encephalitis patients. Author(s): Tokunaga Y, Kira R, Takahata Y, Gondo K, Mizuno Y, Aoki T, Hara T. Source: Pediatric Neurology. 2002 August; 27(2): 102-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213609&dopt=Abstract
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New and old diagnostic markers of meningitis in cerebrospinal fluid (CSF). Author(s): Kleine TO, Zwerenz P, Zofel P, Shiratori K. Source: Brain Research Bulletin. 2003 August 15; 61(3): 287-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12909299&dopt=Abstract
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New onset seizures in HIV-infected patients without intracranial mass lesions or meningitis--a clinical, radiological and SPECT scan study. Author(s): Modi G, Modi M, Martinus I, Vangu M. Source: Journal of the Neurological Sciences. 2002 October 15; 202(1-2): 29-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12220689&dopt=Abstract
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New perspectives on pneumococcal meningitis. Author(s): Aronin SI, Quagliarello VJ. Source: Hosp Pract (Off Ed). 2001 February 15; 36(2): 43-6, 49-50, 51. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11220360&dopt=Abstract
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New rapid antigen test for diagnosis of pneumococcal meningitis. Author(s): Marcos MA, Martinez E, Almela M, Mensa J, Jimenez de Anta MT. Source: Lancet. 2001 May 12; 357(9267): 1499-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11377604&dopt=Abstract
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New therapies and vaccines for bacterial meningitis. Author(s): Foster C, Nadel S. Source: Expert Opinion on Investigational Drugs. 2002 August; 11(8): 1051-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150701&dopt=Abstract
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NF-kappaB activation in cerebrospinal fluid cells from patients with meningitis. Author(s): Ichiyama T, Isumi H, Yoshitomi T, Nishikawa M, Matsubara T, Furukawa S. Source: Neurological Research. 2002 October; 24(7): 709-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392210&dopt=Abstract
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Nitric oxide production during bacterial and viral meningitis in children. Author(s): Murawska-Cialowicz E, Szychowska Z, Tr busiewicz B. Source: International Journal of Clinical & Laboratory Research. 2000; 30(3): 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11196070&dopt=Abstract
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No evidence of type 1 or type 3 hypersensitivity mechanism in amoxicillin/clavulanic acid induced aseptic meningitis. Author(s): Kastenbauer S, Pfister HW, Wick M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 May; 74(5): 690-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700328&dopt=Abstract
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No funds to control meningitis outbreak in Africa. Author(s): Ahmad K. Source: The Lancet Infectious Diseases. 2003 March; 3(3): 119. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614713&dopt=Abstract
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Non-01 Vibrio cholerae septicemia and meningitis in a neonate. Author(s): Kerketta JA, Paul AC, Kirubakaran VB, Jesudason MV, Moses PD. Source: Indian J Pediatr. 2002 October; 69(10): 909-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450305&dopt=Abstract
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Nontraditional dosing of ampicillin-sulbactam for multidrug-resistant Acinetobacter baumannii meningitis. Author(s): Cawley MJ, Suh C, Lee S, Ackerman BH. Source: Pharmacotherapy. 2002 April; 22(4): 527-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939689&dopt=Abstract
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Nosocomial Acinetobacter meningitis. Author(s): Kralinsky K, Krcmeryova T, Tuharsky J, Krcmery V. Source: The Pediatric Infectious Disease Journal. 2000 March; 19(3): 270-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10749482&dopt=Abstract
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Nosocomial bacterial and fungal meningitis in children; an eight year national survey reporting 101 cases. Pediatric Nosocomial Meningitis Study Group. Author(s): Krcmery V, Paradisi F. Source: International Journal of Antimicrobial Agents. 2000 July; 15(2): 143-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10854811&dopt=Abstract
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Nosocomial enterobacter meningitis: risk factors, management, and treatment outcomes. Author(s): Parodi S, Lechner A, Osih R, Vespa P, Pegues D. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 July 15; 37(2): 159-66. Epub 2003 Jul 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856206&dopt=Abstract
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Nosocomial meningitis due to Acinetobacter calcoaceticus in 10 children after ventriculoperitoneal shunt insertion. Author(s): Filka J, Huttova M, Schwartzova D, Kurak M, Krcmeryova T, Tuharsky J, Kralinsky K, Sagat T, Krcmery V Jr. Source: The Journal of Hospital Infection. 2000 January; 44(1): 76-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10633059&dopt=Abstract
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Nosocomial meningitis due to Pseudomonas aeruginosa in children. Author(s): Kralinsky K, Svetlansky I, Kovacicova G, Filka J, Huttova M, Krcmery V Jr. Source: Journal of Chemotherapy (Florence, Italy). 2000 December; 12(6): 538-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11154042&dopt=Abstract
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Novel treatment of meningitis caused by multidrug-resistant Mycobacterium tuberculosis with intrathecal levofloxacin and amikacin: case report. Author(s): Berning SE, Cherry TA, Iseman MD. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 February 15; 32(4): 643-6. Epub 2001 Feb 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11181130&dopt=Abstract
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Ocular angiostrongyliasis without meningitis symptoms in Okinawa, Japan. Author(s): Toma H, Matsumura S, Oshiro C, Hidaka T, Sato Y. Source: J Parasitol. 2002 February; 88(1): 211-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053973&dopt=Abstract
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One case each of recurrent meningitis and hemoperitoneum infection with Ralstonia mannitolilytica. Author(s): Vaneechoutte M, De Baere T, Wauters G, Steyaert S, Claeys G, Vogelaers D, Verschraegen G. Source: Journal of Clinical Microbiology. 2001 December; 39(12): 4588-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11724893&dopt=Abstract
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Optic neuritis complicating west nile virus meningitis in a young adult. Author(s): Gilad R, Lampl Y, Sadeh M, Paul M, Dan M. Source: Infection. 2003 January; 31(1): 55-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590335&dopt=Abstract
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Oral wooden stick injury complicated by meningitis and brain abscess. Author(s): Chang CJ, Huang LT, Lui CC, Huang SC. Source: Chang Gung Med J. 2002 April; 25(4): 266-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12079161&dopt=Abstract
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Organ donation from children with meningitis. Author(s): Mirza D, Hastings M, Reyes J, Green M, Healey PJ, Stock P. Source: The Pediatric Infectious Disease Journal. 2003 May; 22(5): 475. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792392&dopt=Abstract
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Organ donors with adequately treated bacterial meningitis may be suitable for successful transplantation. Author(s): Paig i JM, Lopez-Navidad A, Lloveras J, Mir M, Orfila A, Quintana S, Vazquez-Sanchez A, Inigo V, Masramon J. Source: Transplantation Proceedings. 2000 February; 32(1): 75-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10700977&dopt=Abstract
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Osteomyelitis of the odontoid process associated with meningitis and retropharyngeal abscess--case report. Author(s): Kubo S, Takimoto H, Hosoi K, Toyota S, Karasawa J, Yoshimine T. Source: Neurol Med Chir (Tokyo). 2002 October; 42(10): 447-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416570&dopt=Abstract
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Otogenic meningitis caused by the pneumococci that had acquired resistance to cephalosporins. Author(s): Sakamoto M, Ito K, Sugasawa M, Taniguchi M. Source: Otolaryngology and Head and Neck Surgery. 2001 March; 124(3): 350-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11241009&dopt=Abstract
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Outbreak of aseptic meningitis and mumps after mass vaccination with MMR vaccine using the Leningrad-Zagreb mumps strain. Author(s): da Cunha SS, Rodrigues LC, Barreto ML, Dourado I. Source: Vaccine. 2002 January 15; 20(7-8): 1106-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803071&dopt=Abstract
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Outbreak of aseptic meningitis associated with echovirus 13. Author(s): Kirschke DL, Jones TF, Buckingham SC, Craig AS, Schaffner W. Source: The Pediatric Infectious Disease Journal. 2002 November; 21(11): 1034-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12442025&dopt=Abstract
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Outbreak of aseptic meningitis associated with mass vaccination with a urabecontaining measles-mumps-rubella vaccine: implications for immunization programs. Author(s): Dourado I, Cunha S, Teixeira MG, Farrington CP, Melo A, Lucena R, Barreto ML. Source: American Journal of Epidemiology. 2000 March 1; 151(5): 524-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10707922&dopt=Abstract
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Outbreak of aseptic meningitis by echo 4: prevalence of clinical cases among adults. Author(s): Portolani M, Pecorari M, Pietrosemoli P, Bartoletti A, Sabbatini AM, Meacci M, Gennari W, Bazzani E, Beretti F, Guaraldi G. Source: New Microbiol. 2001 January; 24(1): 11-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11209838&dopt=Abstract
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Outbreak of echovirus 30 meningitis in Wingecarribee Shire, New South Wales. Author(s): Gosbell I, Robinson D, Chant K, Crone S. Source: Commun Dis Intell. 2000 May; 24(5): 121-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11085017&dopt=Abstract
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Outbreaks of aseptic meningitis associated with echoviruses 9 and 30 and preliminary surveillance reports on enterovirus activity--United States, 2003. Author(s): Centers for Disease Control and Prevention (CDC). Source: Mmwr. Morbidity and Mortality Weekly Report. 2003 August 15; 52(32): 761-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917581&dopt=Abstract
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Outbreaks of meningococcal meningitis during Hajj: changing face of an old enemy. Author(s): Khan MA. Source: J Pak Med Assoc. 2003 January; 53(1): 1-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666842&dopt=Abstract
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Outcome of meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae type b in children in The Gambia. Author(s): Goetghebuer T, West TE, Wermenbol V, Cadbury AL, Milligan P, LloydEvans N, Adegbola RA, Mulholland EK, Greenwood BM, Weber MW. Source: Tropical Medicine & International Health : Tm & Ih. 2000 March; 5(3): 207-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10747284&dopt=Abstract
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Outcome of penicillin-nonsusceptible Streptococcus pneumoniae meningitis: a nested case-control study. Author(s): Kellner JD, Scheifele DW, Halperin SA, Lebel MH, Moore D, Le Saux N, Ford-Jones EL, Law B, Vaudry W; Canadian Paediatric Society/Centre for Infectious Disease Prevention and Control Immunization Monitoring Program. Source: The Pediatric Infectious Disease Journal. 2002 October; 21(10): 903-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394810&dopt=Abstract
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Overwhelming S. pneumonia meningitis after basilar skull fracture: a case report. Author(s): Severyn FA, Fenn J. Source: Air Medical Journal. 2000 July-September; 19(3): 102-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11184480&dopt=Abstract
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Oxidant and antioxidant activities in childhood meningitis. Author(s): Tsukahara H, Haruta T, Todoroki Y, Hiraoka M, Noiri E, Maeda M, Mayumi M. Source: Life Sciences. 2002 October 25; 71(23): 2797-806. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383885&dopt=Abstract
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Oxidative stress in bacterial meningitis in humans. Author(s): Kastenbauer S, Koedel U, Becker BF, Pfister HW. Source: Neurology. 2002 January 22; 58(2): 186-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11805243&dopt=Abstract
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Oxidative stress in childhood meningitis: measurement of 8-hydroxy-2'deoxyguanosine concentration in cerebrospinal fluid. Author(s): Tsukahara H, Haruta T, Ono N, Kobata R, Fukumoto Y, Hiraoka M, Mayumi M. Source: Redox Report : Communications in Free Radical Research. 2000; 5(5): 295-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11145104&dopt=Abstract
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Paediatric nursing. A brush with meningitis that showed NHS at its best. Author(s): Gaskell C. Source: Nurs Times. 2000 November 23-29; 96(47): 9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11965785&dopt=Abstract
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Palmoplantar pustulosis with pustulotic arthroosteitis involving temporal osteomyelitis and meningitis. Author(s): Seno A, Arata J, Matsuura Y, Suemitsu I. Source: The Journal of Dermatology. 2000 April; 27(4): 269-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10824492&dopt=Abstract
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Papilloedema with peripapillary retinal haemorrhages in an acquired immunodeficiency syndrome (AIDS) patient with cryptococcal meningitis. Author(s): Battu RR, Biswas J, Jayakumar N, Madhavan HN, Kumarsamy N, Solomon S. Source: Indian J Ophthalmol. 2000 March; 48(1): 47-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11271934&dopt=Abstract
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Paradoxical recurrent meningitis following therapy of cryptococcal meningitis: an immune reconstitution syndrome after initiation of highly active antiretroviral therapy. Author(s): King MD, Perlino CA, Cinnamon J, Jernigan JA. Source: International Journal of Std & Aids. 2002 October; 13(10): 724-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396546&dopt=Abstract
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Parental perception of educational, behavioural and general health problems in school-age survivors of bacterial meningitis. Author(s): Koomen I, Grobbee DE, Jennekens-Schinkel A, Roord JJ, van Furth AM. Source: Acta Paediatrica (Oslo, Norway : 1992). 2003; 92(2): 177-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12710643&dopt=Abstract
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Passive exposure to tobacco smoke and bacterial meningitis in children. Author(s): Iles K, Poplawski NK, Couper RT. Source: Journal of Paediatrics and Child Health. 2001 August; 37(4): 388-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11532060&dopt=Abstract
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Pasteurella gallinarum neonatal meningitis. Author(s): Ahmed K, Sein PP, Shahnawaz M, Hoosen AA. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2002 January; 8(1): 55-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11906503&dopt=Abstract
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Pasteurella multocida meningitis in an adult: case report. Author(s): Armstrong GR, Sen RA, Wilkinson J. Source: Journal of Clinical Pathology. 2000 March; 53(3): 234-5. Erratum In: J Clin Pathol 2000 May; 53(5): 405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10823146&dopt=Abstract
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Pasteurella multocida meningitis: case report and review of the last 11 y. Author(s): Green BT, Ramsey KM, Nolan PE. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(3): 213-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12030400&dopt=Abstract
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Pathogenesis and pathophysiology of pneumococcal meningitis. Author(s): Koedel U, Scheld WM, Pfister HW. Source: The Lancet Infectious Diseases. 2002 December; 2(12): 721-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467688&dopt=Abstract
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Pathogenic isolates in meningitis patients in Dar Es Salaam, Tanzania. Author(s): Matee MI, Matre R. Source: East Afr Med J. 2001 September; 78(9): 458-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11921576&dopt=Abstract
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Pathophysiology of bacterial meningitis: mechanism(s) of neuronal injury. Author(s): Scheld WM, Koedel U, Nathan B, Pfister HW. Source: The Journal of Infectious Diseases. 2002 December 1; 186 Suppl 2: S225-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12424702&dopt=Abstract
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Pathophysiology of meningococcal meningitis and septicaemia. Author(s): Pathan N, Faust SN, Levin M. Source: Archives of Disease in Childhood. 2003 July; 88(7): 601-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12818907&dopt=Abstract
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Pattern of meningitis in Al-Ain medical district, United Arab Emirates--a decadal experience (1990-99). Author(s): Mahmoud R, Mahmoud M, Badrinath P, Sheek-Hussein M, Alwash R, Nicol AG. Source: The Journal of Infection. 2002 January; 44(1): 22-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11972414&dopt=Abstract
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PCR-RFLP based molecular typing of enteroviruses isolated from patients with aseptic meningitis in Korea. Author(s): Lee YS, Kim KS, Chung YS, Cheon DS, Jung SK, Park KS, Na BK, Jee YM, Kim DS, Yoon JD, Song CY, Lee KH. Source: Archives of Virology. 2002 September; 147(9): 1711-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12209311&dopt=Abstract
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Penicillin-resistant pneumococci-implications for management of communityacquired pneumonia and meningitis. Author(s): Ziglam HM, Finch RG. Source: International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases. 2002 March; 6 Suppl 1: S14-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12044285&dopt=Abstract
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Penicillin-resistant Streptococcus pneumoniae septic shock and meningitis complicating chronic graft versus host disease: a case report and review of the literature. Author(s): Haddad PA, Repka TL, Weisdorf DJ. Source: The American Journal of Medicine. 2002 August 1; 113(2): 152-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133754&dopt=Abstract
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Pentoxifylline-induced aseptic meningitis in a patient with mixed connective tissue disease. Author(s): Mathian A, Amoura Z, Piette JC. Source: Neurology. 2002 November 12; 59(9): 1468-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427911&dopt=Abstract
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Perceived stress and psychological well-being are associated with antibody status after meningitis C conjugate vaccination. Author(s): Burns VE, Drayson M, Ring C, Carroll D. Source: Psychosomatic Medicine. 2002 November-December; 64(6): 963-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461201&dopt=Abstract
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Performance after cochlear implantation: a comparison of children deafened by meningitis and congenitally deaf children. Author(s): Mitchell TE, Psarros C, Pegg P, Rennie M, Gibson WP. Source: The Journal of Laryngology and Otology. 2000 January; 114(1): 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10789408&dopt=Abstract
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Pharmacodynamics of gatifloxacin in experimental models of pneumococcal meningitis. Author(s): McCracken GH Jr. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 August; 31 Suppl 2: S45-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10984328&dopt=Abstract
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Pharmacokinetic model for tobramycin in acinetobacter meningitis. Author(s): Chicano-Pia PV, Cercos-Lleti AC, Roma-Sanchez E. Source: The Annals of Pharmacotherapy. 2002 January; 36(1): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11816266&dopt=Abstract
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Phase I clinical trial of intrathecal topotecan in patients with neoplastic meningitis. Author(s): Blaney SM, Heideman R, Berg S, Adamson P, Gillespie A, Geyer JR, Packer R, Matthay K, Jaeckle K, Cole D, Kuttesch N, Poplack DG, Balis FM. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 January 1; 21(1): 143-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12506183&dopt=Abstract
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Phylogenetic distribution of virulence-associated genes among Escherichia coli isolates associated with neonatal bacterial meningitis in the Netherlands. Author(s): Johnson JR, Oswald E, O'Bryan TT, Kuskowski MA, Spanjaard L. Source: The Journal of Infectious Diseases. 2002 March 15; 185(6): 774-84. Epub 2002 February 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11920295&dopt=Abstract
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Platelet functions in patients with meningococcal meningitis at the Kenyatta National Hospital, Nairobi. Author(s): Amayo EO, Kayima JK, Joshi MD. Source: East Afr Med J. 2002 August; 79(8): 405-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638840&dopt=Abstract
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Pneumococcal antibiotic resistance and rates of meningitis in children. Author(s): Ryan MW, Antonelli PJ. Source: The Laryngoscope. 2000 June; 110(6): 961-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10852513&dopt=Abstract
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Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. Author(s): Kastenbauer S, Pfister HW. Source: Brain; a Journal of Neurology. 2003 May; 126(Pt 5): 1015-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690042&dopt=Abstract
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Pneumococcal meningitis in an immunocompetent adult with a cochlear implant. Author(s): Graveriau C, Roman S, Garrigues B, Triglia JM, Stein A. Source: The Journal of Infection. 2003 May; 46(4): 248-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799152&dopt=Abstract
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Pneumococcal meningitis in children: relationship of antibiotic resistance to clinical characteristics and outcomes. Author(s): Buckingham SC, McCullers JA, Lujan-Zilbermann J, Knapp KM, Orman KL, English BK. Source: The Pediatric Infectious Disease Journal. 2001 September; 20(9): 837-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11734760&dopt=Abstract
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Pneumococcal meningitis in the intensive care unit: prognostic factors of clinical outcome in a series of 80 cases. Author(s): Auburtin M, Porcher R, Bruneel F, Scanvic A, Trouillet JL, Bedos JP, Regnier B, Wolff M. Source: American Journal of Respiratory and Critical Care Medicine. 2002 March 1; 165(5): 713-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874820&dopt=Abstract
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Pneumococcal meningitis masquerading as subarachnoid haemorrhage. Author(s): Chatterjee T, Gowardman JR, Goh TD. Source: The Medical Journal of Australia. 2003 May 19; 178(10): 505-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741939&dopt=Abstract
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Pneumococcal meningitis: antibiotics essential but insufficient. Author(s): Davis LE, Greenlee JE. Source: Brain; a Journal of Neurology. 2003 May; 126(Pt 5): 1013-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690041&dopt=Abstract
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Pneumococcal pneumolysin and H(2)O(2) mediate brain cell apoptosis during meningitis. Author(s): Braun JS, Sublett JE, Freyer D, Mitchell TJ, Cleveland JL, Tuomanen EI, Weber JR. Source: The Journal of Clinical Investigation. 2002 January; 109(1): 19-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11781347&dopt=Abstract
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Polymerase chain reaction for the laboratory diagnosis of aseptic meningitis and encephalitis. Author(s): Chesky M, Scalco R, Failace L, Read S, Jobim LF. Source: Arquivos De Neuro-Psiquiatria. 2000 September; 58(3B): 836-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11018820&dopt=Abstract
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Polymicrobial meningitis revealing an anterior sacral meningocele in a 23-year-old woman. Author(s): Guerin JM, Leibinger F, Raskine L, Ekherian JM. Source: The Journal of Infection. 2000 March; 40(2): 195-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10841102&dopt=Abstract
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Polyradiculomyelitis associated with clinically diagnosed tuberculous meningitis. Author(s): Kim BJ, Park MH, Koh SB, Park MK, Park KW, Lee DH. Source: European Neurology. 2001; 46(3): 156-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11598335&dopt=Abstract
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Polysaccharide vaccines for preventing serogroup A meningococcal meningitis. Author(s): Patel M, Lee CK. Source: Cochrane Database Syst Rev. 2001; (3): Cd001093. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686976&dopt=Abstract
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Polysaccharide vaccines for preventing serogroup A meningococcal meningitis. Author(s): Patel M. Source: Cochrane Database Syst Rev. 2000; (2): Cd001093. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10796590&dopt=Abstract
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Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination. Author(s): Gomez E, Peguero M, Sanchez J, Castellanos PL, Feris J, Pena C, BrudzinskiLaClaire L, Levine OS. Source: Epidemiology and Infection. 2000 December; 125(3): 549-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11218205&dopt=Abstract
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Population-based survey of antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae from meningitis patients in Salvador, Brazil. Author(s): Reis JN, Cordeiro SM, Coppola SJ, Salgado K, Carvalho MG, Teixeira LM, Thompson TA, Facklam RR, Reis MG, Ko AI. Source: Journal of Clinical Microbiology. 2002 January; 40(1): 275-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773131&dopt=Abstract
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Post spinal meningitis and asepsis. Author(s): Videira RL, Ruiz-Neto PP, Brandao Neto M. Source: Acta Anaesthesiologica Scandinavica. 2002 July; 46(6): 639-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12059885&dopt=Abstract
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Postneurosurgical meningitis due to Proteus penneri with selection of a ceftriaxoneresistant isolate: analysis of chromosomal class A beta-lactamase HugA and its LysRtype regulatory protein HugR. Author(s): Liassine N, Madec S, Ninet B, Metral C, Fouchereau-Peron M, Labia R, Auckenthaler R. Source: Antimicrobial Agents and Chemotherapy. 2002 January; 46(1): 216-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751137&dopt=Abstract
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Postsurgical meningitis caused by Bordetella bronchiseptica. Author(s): Belen O, Campos JM, Cogen PH, Jantausch BA. Source: The Pediatric Infectious Disease Journal. 2003 April; 22(4): 380-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712975&dopt=Abstract
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Posttransplantation Epstein-Barr viral meningitis in a patient with chronic myelogenous leukemia. Author(s): Kanamori H, Fujisawa S, Yamaji S, Tanaka M, Tomita N, Fujimaki K, Ishigatsubo Y. Source: International Journal of Hematology. 2001 December; 74(4): 473-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11794708&dopt=Abstract
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Post-traumatic meningitis: histomorphological findings, postmortem microbiology and forensic implications. Author(s): Matschke J, Tsokos M. Source: Forensic Science International. 2001 January 15; 115(3): 199-205. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11074175&dopt=Abstract
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Potential for expansion of the donor pool using liver allografts from donors with bacterial meningitis. Author(s): Issa NC, Patel R. Source: Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2002 October; 8(10): 977-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360446&dopt=Abstract
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Predicting outcome in childhood bacterial meningitis: are pneumococci stronger than glutamate? Author(s): Whalen MJ. Source: Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2003 April; 4(2): 260-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749667&dopt=Abstract
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Predicting the outcome of neonatal bacterial meningitis. Author(s): Klinger G, Chin CN, Beyene J, Perlman M. Source: Pediatrics. 2000 September; 106(3): 477-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10969090&dopt=Abstract
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Prediction of bacterial meningitis in children with meningeal signs: reduction of lumbar punctures. Author(s): Oostenbrink R, Moons KG, Donders AR, Grobbee DE, Moll HA. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 June; 90(6): 611-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11440091&dopt=Abstract
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Predictive value of serum and cerebrospinal fluid procalcitonin levels for the diagnosis of bacterial meningitis. Author(s): Jereb M, Muzlovic I, Hojker S, Strle F. Source: Infection. 2001 August; 29(4): 209-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11545482&dopt=Abstract
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Predictors of bacterial meningitis in the era after Haemophilus influenzae. Author(s): Freedman SB, Marrocco A, Pirie J, Dick PT. Source: Archives of Pediatrics & Adolescent Medicine. 2001 December; 155(12): 1301-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732947&dopt=Abstract
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Predictors of inpatient mortality in 190 adult patients with tuberculous meningitis. Author(s): Qureshi HU, Merwat SN, Nawaz SA, Rana AA, Malik A, Mahmud MK, Latif A, Khan A, Sarwari AR. Source: J Pak Med Assoc. 2002 April; 52(4): 159-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174481&dopt=Abstract
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Predictors of outcome in patients with tuberculous meningitis. Author(s): Hosoglu S, Geyik MF, Balik I, Aygen B, Erol S, Aygencel TG, Mert A, Saltoglu N, Dokmetas I, Felek S, Sunbul M, Irmak H, Aydin K, Kokoglu OF, Ucmak H, Altindis M, Loeb M. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2002 January; 6(1): 64-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11931403&dopt=Abstract
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Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center. Author(s): Miner JR, Heegaard W, Mapes A, Biros M. Source: The Journal of Emergency Medicine. 2001 November; 21(4): 387-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11728765&dopt=Abstract
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Prevalence of fungal meningitis among HIV positive & negative subjects in Indore (MP state). Author(s): Jaiswal SP, Hemwani N, Sharma N, Athale S, Chitnis DS. Source: Indian Journal of Medical Sciences. 2002 July; 56(7): 325-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12645168&dopt=Abstract
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Preventing and treating meningococcal meningitis. Author(s): Michael PA. Source: Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses. 2002 February; 11(1): 9-12; Quiz 13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11901615&dopt=Abstract
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Prevention of Haemophilus influenzae type b (Hib) meningitis and emergence of serotype replacement with type a strains after introduction of Hib immunization in Brazil. Author(s): Ribeiro GS, Reis JN, Cordeiro SM, Lima JB, Gouveia EL, Petersen M, Salgado K, Silva HR, Zanella RC, Almeida SC, Brandileone MC, Reis MG, Ko AI. Source: The Journal of Infectious Diseases. 2003 January 1; 187(1): 109-16. Epub 2002 December 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508153&dopt=Abstract
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Prevention of meningitis: cochlear implants and inner ear abnormalities. Author(s): Bluestone CD. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 March; 129(3): 279-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622535&dopt=Abstract
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Prevention, treatment and outcomes of bacterial meningitis in childhood. Author(s): Bedford H. Source: Prof Nurse. 2001 October; 17(2): 100-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12030056&dopt=Abstract
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Prevotella intermedia meningitis associated with cerebrospinal fluid leakage in an adolescent. Author(s): Brook I. Source: The Pediatric Infectious Disease Journal. 2003 August; 22(8): 751-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12938679&dopt=Abstract
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Primary diffuse leptomeningeal gliomatosis simulating tuberculous meningitis. Author(s): Rees JH, Balakas N, Agathonikou A, Hain SF, Giovanonni G, Panayiotopoulos CP, Luxsuwong M, Revesz T. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2001 January; 70(1): 120-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11118261&dopt=Abstract
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Primary HIV infection in an adolescent presenting as aseptic meningitis. Author(s): Das BB, Posada R, Mendez H. Source: Indian J Pediatr. 2002 August; 69(8): 731. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356231&dopt=Abstract
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Primary Staphylococcus aureus meningitis in an infant. Author(s): Gnanalingham MG, Clarke MA. Source: Journal of the Royal Society of Medicine. 2001 February; 94(2): 86-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11234209&dopt=Abstract
184 Meningitis
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Problem of timely diagnosis in anthrax meningitis. Author(s): Kanungo R, Kumar A, Bhattacharya S, Dutta TK, Das AK, Badrinath S. Source: J Assoc Physicians India. 2002 July; 50: 913-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12126347&dopt=Abstract
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Prochlorperazine-induced extrapyramidal effects mimicking meningitis in a child. Author(s): Muniz AE. Source: Southern Medical Journal. 2000 June; 93(6): 629-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10881788&dopt=Abstract
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Profile of childhood meningitis in a hospital in South West Saudi Arabia. Author(s): Al-Binali AM, Al-Fifi SH. Source: Saudi Med J. 2002 July; 23(7): 793-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174227&dopt=Abstract
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Prognosis of tuberculous meningitis in adults in the era of modern antituberculous chemotherapy. Author(s): Wang JT, Hung CC, Sheng WH, Wang JY, Chang SC, Luh KT. Source: J Microbiol Immunol Infect. 2002 December; 35(4): 215-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12542246&dopt=Abstract
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Prognostic factors in childhood tuberculous meningitis. Author(s): Mahadevan B, Mahadevan S, Serane VT. Source: Journal of Tropical Pediatrics. 2002 December; 48(6): 362-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521280&dopt=Abstract
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Prognostic factors in children with purulent meningitis in Turkey. Author(s): Kirimi E, Tuncer O, Arslan S, Atas B, Caksen H, Uner A, Oner AF, Odabas D. Source: Acta Medica Okayama. 2003 February; 57(1): 39-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765223&dopt=Abstract
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Prognostic value of EEG in neonatal bacterial meningitis. Author(s): Klinger G, Chin CN, Otsubo H, Beyene J, Perlman M. Source: Pediatric Neurology. 2001 January; 24(1): 28-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11182277&dopt=Abstract
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Prospective analysis of 61 cases of enteroviral meningitis: interest of systematic genome detection in cerebrospinal fluid irrespective of cytologic examination results. Author(s): Henquell C, Chambon M, Bailly JL, Alcaraz S, De Champs C, Archimbaud C, Labbe A, Charbonne F, Peigue-Lafeuille H. Source: Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology. 2001 April; 21(1): 29-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255095&dopt=Abstract
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Prospective validation of a diagnosis model as an aid to therapeutic decision-making in acute meningitis. Author(s): Baty V, Viel JF, Schuhmacher H, Jaeger F, Canton P, Hoen B. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2000 June; 19(6): 422-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10947216&dopt=Abstract
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Prospects for prevention of meningococcal meningitis. Author(s): Perkins BA. Source: Lancet. 2001 July 28; 358(9278): 255-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11498206&dopt=Abstract
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Protection against meningitis-associated central nervous system complications by uric acid. Author(s): Kastenbauer S, Pfister HW. Source: Medical Hypotheses. 2002 May; 58(5): 431. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12199194&dopt=Abstract
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Psychometric testing in bacterial meningitis: results of a long-term prospective study of infants and children treated between 1973 and 1977. Author(s): Dodge PR, Scaer M, Holmes SJ, Pomeroy SL, Feigin RD. Source: Journal of Child Neurology. 2001 November; 16(11): 854-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732773&dopt=Abstract
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Purulent meningitis with unusual diffusion-weighted MRI findings. Author(s): Abe M, Takayama Y, Yamashita H, Noguchi M, Sagoh T. Source: European Journal of Radiology. 2002 October; 44(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12350401&dopt=Abstract
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Quality-of-life-adjusted survival comparison of sustained-release cytosine arabinoside versus intrathecal methotrexate for treatment of solid tumor neoplastic meningitis. Author(s): Cole BF, Glantz MJ, Jaeckle KA, Chamberlain MC, Mackowiak JI. Source: Cancer. 2003 June 15; 97(12): 3053-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784341&dopt=Abstract
186 Meningitis
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Quinolone treatment for pediatric bacterial meningitis: a comparative study of trovafloxacin and ceftriaxone with or without vancomycin. Author(s): Saez-Llorens X, McCoig C, Feris JM, Vargas SL, Klugman KP, Hussey GD, Frenck RW, Falleiros-Carvalho LH, Arguedas AG, Bradley J, Arrieta AC, Wald ER, Pancorbo S, McCracken GH Jr, Marques SR; Trovan menigitis Study Group. Source: The Pediatric Infectious Disease Journal. 2002 January; 21(1): 14-22. Erratum In: Pediatr Infect Dis J 2002 March; 21(3): 270. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11791092&dopt=Abstract
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Radiological case of the month. Intracranial hypertension and reduced cerebral blood flow in meningococcal meningitis. Author(s): Ibsen LM. Source: Archives of Pediatrics & Adolescent Medicine. 2002 March; 156(3): 293-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11876677&dopt=Abstract
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Randomized trial of four vs. seven days of ceftriaxone treatment for bacterial meningitis in children with rapid initial recovery. Author(s): Roine I, Ledermann W, Foncea LM, Banfi A, Cohen J, Peltola H. Source: The Pediatric Infectious Disease Journal. 2000 March; 19(3): 219-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10749463&dopt=Abstract
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Rapid detection of Haemophilus influenzae type b in Bangladeshi children with pneumonia and meningitis by PCR and analysis of antimicrobial resistance. Author(s): Shoma S, Rahman M, Yasmin M. Source: J Health Popul Nutr. 2001 December; 19(4): 268-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11855348&dopt=Abstract
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Rapid diagnosis of acute pyogenic meningitis by a combined PCR dot-blot assay. Author(s): Balganesh M, Lalitha MK, Nathaniel R. Source: Molecular and Cellular Probes. 2000 April; 14(2): 61-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10799266&dopt=Abstract
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Rapid diagnosis of tuberculous meningitis by a dot-immunobinding assay. Author(s): Sumi MG, Annamma M, Sarada C, Radhakrishnan VV. Source: Acta Neurologica Scandinavica. 2000 January; 101(1): 61-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10660155&dopt=Abstract
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Rapid diagnosis of tuberculous meningitis by ligase chain reaction amplification. Author(s): Rajo MC, Perez Del Molina ML, Lado Lado FL, Lopez MJ, Prieto E, Pardo F. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(1): 14-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11878290&dopt=Abstract
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Rapid molecular diagnosis of tuberculous meningitis using the Gen-probe Amplified Mycobacterium Tuberculosis direct test in a large Canadian public health laboratory. Author(s): Chedore P, Jamieson FB. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2002 October; 6(10): 913-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365579&dopt=Abstract
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Rapid real-time PCR for determination of penicillin susceptibility in pneumococcal meningitis, including culture-negative cases. Author(s): Kearns AM, Graham C, Burdess D, Heatherington J, Freeman R. Source: Journal of Clinical Microbiology. 2002 February; 40(2): 682-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11825996&dopt=Abstract
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Rational antibiotics therapy in bacterial meningitis. Author(s): Dutta AK, Bhatnagar SK. Source: Indian J Pediatr. 2001 July; 68 Suppl 3: S32-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980457&dopt=Abstract
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Recent increase in meningitis Caused by Neisseria meningitidis serogroups A and W135, Yaounde, Cameroon. Author(s): Fonkoua MC, Taha MK, Nicolas P, Cunin P, Alonso JM, Bercion R, Musi J, Martin PM. Source: Emerging Infectious Diseases. 2002 March; 8(3): 327-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927034&dopt=Abstract
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Recurrence of bacterial meningitis in a patient with Crouzon syndrome and pseudomeningocele. Author(s): Ohmori M, Kamio H, Inokuchi K, Tsutsumi H, Fujimura A. Source: Southern Medical Journal. 2002 July; 95(7): 780-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12144091&dopt=Abstract
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Recurrence of pneumococcal meningitis due to primary spontaneous cerebrospinal fluid fistulas. Author(s): Wen HY, Chou ML, Lin KL, Kao PF, Chen JF. Source: Chang Gung Med J. 2001 November; 24(11): 724-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11820653&dopt=Abstract
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Recurrent aseptic meningitis due to different non-steroidal anti-inflammatory drugs including rofecoxib. Author(s): Ashwath ML, Katner HP. Source: Postgraduate Medical Journal. 2003 May; 79(931): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782779&dopt=Abstract
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Recurrent aseptic meningitis in a five-year-old Latino boy. Author(s): Ng L, Janner D. Source: The Pediatric Infectious Disease Journal. 2003 April; 22(4): 386-7, 389-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712979&dopt=Abstract
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Recurrent bacterial meningitis: the search for a cause. Author(s): Harsha WJ, Varon D, Pritchard PB 3rd. Source: J S C Med Assoc. 2002 August; 98(4): 193-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12216381&dopt=Abstract
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Recurrent dermatomal vesicular skin lesions: a clue to diagnosis of herpes simplex virus 2 meningitis. Author(s): Gonzales N, Tyler KL, Gilden DH. Source: Archives of Neurology. 2003 June; 60(6): 868-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12810492&dopt=Abstract
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Recurrent herpes simplex virus type 2 meningitis: a case report of Mollaret's meningitis. Author(s): Kojima Y, Hashiguchi H, Hashimoto T, Tsuji S, Shoji H, Kazuyama Y. Source: Japanese Journal of Infectious Diseases. 2002 June; 55(3): 85-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195049&dopt=Abstract
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Recurrent meningitis due to unrecognised skull fracture. Author(s): Emby D. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2003 March; 93(3): 160-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768931&dopt=Abstract
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Recurrent meningitis due to unrecognised skull fracture. Author(s): Ouma JR. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2002 October; 92(10): 778-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432796&dopt=Abstract
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Recurrent meningitis in a seven-year-old girl. Author(s): Nakhla IA, Mansour A, Sultan Y, Frenck W Jr. Source: The Pediatric Infectious Disease Journal. 2002 November; 21(11): 1081, 1093-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12458573&dopt=Abstract
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Recurrent Pneumococcal bacteraemia and meningitis in an asplenic adult with possible unusual focus. Author(s): Kragsbjerg P, Rydman H. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(9): 706-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11669231&dopt=Abstract
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Recurrent pneumococcal meningitis in homozygous C3 deficiency. Author(s): Totan M. Source: Indian J Pediatr. 2002 July; 69(7): 625-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173704&dopt=Abstract
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Recurrent pyogenic meningitis in a case of transethmoid encephalocele. Author(s): Dhar MC, Chaudhuri S, Basu K, Pain S, Sau TJ, Mitra K. Source: J Assoc Physicians India. 2001 July; 49: 767-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11573570&dopt=Abstract
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Recurrent pyogenic meningitis: an unusual presentation in a case of neurofibromatosis-1. Author(s): Goel D, Jha S, Gupta RK, Hussain M. Source: Pediatric Neurosurgery. 2001 May; 34(5): 242-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11423774&dopt=Abstract
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Recurrent Streptococcus pneumoniae meningitis. Author(s): Davachi F, Bregu H, Lito G. Source: Journal of Tropical Pediatrics. 2002 August; 48(4): 249-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12200990&dopt=Abstract
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Recurring aseptic meningitis after travel to the tropics: a case of Mollaret's meningitis? Case report with review of the literature. Author(s): Wynants H, Taelman H, Martin JJ, Van den Ende J. Source: Clinical Neurology and Neurosurgery. 2000 June; 102(2): 113-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10817900&dopt=Abstract
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Relationship between penicillin and cephalosporin resistance of Streptococcus pneumoniae strains and its inflammatory activity in the experimental model of meningitis. Author(s): Fernandez A, Cabellos C, Tubau F, Linares J, Viladrich PF, Gudiol F. Source: Medical Microbiology and Immunology. 2001 December; 190(3): 135-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11827202&dopt=Abstract
190 Meningitis
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Repeated relapses in a meropenem-treated Pseudomonas aeruginosa meningitis. Author(s): Esen S, Leblebicioglu H, Sunbul M, Eroglu C, Leblebcioglu H. Source: Journal of Chemotherapy (Florence, Italy). 2002 October; 14(5): 535-6. Erratum In: J Chemother. 2002 December; 14(6): 642. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462436&dopt=Abstract
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Reprogramming the host response in bacterial meningitis: how best to improve outcome? Author(s): van der Flier M, Geelen SP, Kimpen JL, Hoepelman IM, Tuomanen EI. Source: Clinical Microbiology Reviews. 2003 July; 16(3): 415-29. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12857775&dopt=Abstract
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Reversible acute hydrocephalus complicating Listeria monocytogenes meningitis. Author(s): Frat JP, Veinstein A, Wager M, Burucoa C, Robert R. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 July; 20(7): 512-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11561813&dopt=Abstract
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Rhodococcus equi nosocomial meningitis cured by levofloxacin and shunt removal. Author(s): Scotton PG, Tonon E, Giobbia M, Gallucci M, Rigoli R, Vaglia A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 January; 30(1): 223-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619769&dopt=Abstract
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Rhodotorula glutinis-related meningitis. Author(s): Lanzafame M, De Checchi G, Parinello A, Trevenzoli M, Cattelan AM. Source: Journal of Clinical Microbiology. 2001 January; 39(1): 410. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191228&dopt=Abstract
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Rich nations, poor nations, and bacterial meningitis. Author(s): McCracken GH Jr. Source: Lancet. 2002 July 20; 360(9328): 183. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133648&dopt=Abstract
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Rickettsia typhi infection presenting as subacute meningitis. Author(s): Galanakis E, Gikas A, Bitsori M, Sbyrakis S. Source: Journal of Child Neurology. 2002 February; 17(2): 156-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952082&dopt=Abstract
Studies 191
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Risk analysis of aseptic meningitis after measles-mumps-rubella vaccination in Korean children by using a case-crossover design. Author(s): Ki M, Park T, Yi SG, Oh JK, Choi B. Source: American Journal of Epidemiology. 2003 January 15; 157(2): 158-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522023&dopt=Abstract
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Risk and case fatality rate of meningitis in patients with liver cirrhosis. Author(s): Molle I, Thulstrup AM, Svendsen N, Schonheyder HC, Sorensen HT. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(4): 407-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10959650&dopt=Abstract
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Risk factors and prognostic indicators of bacterial meningitis in a cohort of 3580 postneurosurgical patients. Author(s): Federico G, Tumbarello M, Spanu T, Rosell R, Iacoangeli M, Scerrati M, Tacconelli E. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(7): 533-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11515765&dopt=Abstract
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Risk factors for meningococcal meningitis in northern Ghana. Author(s): Hodgson A, Smith T, Gagneux S, Adjuik M, Pluschke G, Mensah NK, Binka F, Genton B. Source: Trans R Soc Trop Med Hyg. 2001 September-October; 95(5): 477-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11706652&dopt=Abstract
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Risk of bacterial meningitis in children with cochlear implants. Author(s): Reefhuis J, Honein MA, Whitney CG, Chamany S, Mann EA, Biernath KR, Broder K, Manning S, Avashia S, Victor M, Costa P, Devine O, Graham A, Boyle C. Source: The New England Journal of Medicine. 2003 July 31; 349(5): 435-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12890842&dopt=Abstract
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Risk of tuberculosis infection and tuberculous meningitis after discontinuation of Bacillus Calmette-Guerin in Beijing. Author(s): Zhang LX, Tu DH, He GX, Ma ZQ, Nagelkerke NJ, Borgdorff MW, Enarson DA, Broekmans JF. Source: American Journal of Respiratory and Critical Care Medicine. 2000 October; 162(4 Pt 1): 1314-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11029337&dopt=Abstract
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Role of cerebrospinal fluid shunting for human immunodeficiency virus-positive patients with tuberculous meningitis and hydrocephalus. Author(s): Nadvi SS, Nathoo N, Annamalai K, van Dellen JR, Bhigjee AI. Source: Neurosurgery. 2000 September; 47(3): 644-9; Discussion 649-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10981752&dopt=Abstract
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Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: a multivariable analysis. Author(s): Misra UK, Kalita J, Roy AK, Mandal SK, Srivastava M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 March; 68(3): 300-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10675210&dopt=Abstract
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Role of dexamethasone in acute bacterial meningitis in adults. Author(s): Ahsan T, Shahid M, Mahmood T, Jabeen R, Jehangir U, Saleem M, Ahmed N, Shaheer A. Source: J Pak Med Assoc. 2002 June; 52(6): 233-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481630&dopt=Abstract
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Role of IS6110-targeted PCR, culture, biochemical, clinical, and immunological criteria for diagnosis of tuberculous meningitis. Author(s): Caws M, Wilson SM, Clough C, Drobniewski F. Source: Journal of Clinical Microbiology. 2000 September; 38(9): 3150-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10970348&dopt=Abstract
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Role of the urokinase plasminogen activator system in patients with bacterial meningitis. Author(s): Winkler F, Kastenbauer S, Koedel U, Pfister HW. Source: Neurology. 2002 November 12; 59(9): 1350-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427882&dopt=Abstract
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Safety and efficacy of liposomal amphotericin B in patients with cryptococcal meningitis. Author(s): Kotwani RN, Gokhale PC, Bodhe PV, Kirodian BG, Kshirsagar NA. Source: J Assoc Physicians India. 2001 November; 49: 1086-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868862&dopt=Abstract
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Safety and efficacy of recombinant granulocyte colony-stimulating factor as an adjunctive therapy for Streptococcus pneumoniae meningitis in non-neutropenic adult patients: a pilot study. Author(s): de Lalla F, Nicolin R, Lazzarini L. Source: The Journal of Antimicrobial Chemotherapy. 2000 November; 46(5): 843-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11062212&dopt=Abstract
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Salmonella enteritidis meningitis in an infant. Author(s): Gupta N, Gupta P. Source: Indian Pediatrics. 2001 February; 38(2): 205-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11224593&dopt=Abstract
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Salmonella Group B meningitis 6 weeks after hospitalization in a neonatal care unit. Author(s): Price EH, Workman MR, de Louvois J. Source: The Journal of Hospital Infection. 2001 May; 48(1): 80-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11358475&dopt=Abstract
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Salmonella group B meningitis six weeks after hospitalization in a neonatal care unit. Author(s): Meessen NE, Jansen NJ, Tjhie HT. Source: The Journal of Hospital Infection. 2000 October; 46(2): 160-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11049713&dopt=Abstract
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Salmonella meningitis in adults infected with HIV: case report and review of the literature. Author(s): Leonard MK, Murrow JR, Jurado R, Gaynes R. Source: The American Journal of the Medical Sciences. 2002 May; 323(5): 266-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018670&dopt=Abstract
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Salmonella meningitis: report of three cases in adults and literature review. Author(s): Karim M, Islam N. Source: Infection. 2002 April; 30(2): 104-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018467&dopt=Abstract
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Salmonella typhimurium DT104 septicaemia with meningitis in neonatal piglets. Author(s): van der Wolf PJ, Vercammen TJ, Geene JJ, van Exsel AC, Peperkamp NH, Voets MTh, Zeeuwen AA. Source: Vet Q. 2001 November; 23(4): 199-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765240&dopt=Abstract
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Salmonella virchow meningitis in an adult. Author(s): Gille-Johnson P, Kovamees J, Lindgren V, Aufwerber E, Struve J. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(4): 431-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10959659&dopt=Abstract
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Seasonal paradox in acute meningitis at Nawabshah. Author(s): Shaikh S, Shaikh RB, Faiz MS. Source: J Coll Physicians Surg Pak. 2003 April; 13(4): 207-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718775&dopt=Abstract
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Sensorineural hearing loss following acute bacterial meningitis in non-neonates. Author(s): Cherian B, Singh T, Chacko B, Abraham A. Source: Indian J Pediatr. 2002 November; 69(11): 951-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503658&dopt=Abstract
194 Meningitis
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Sepsis and meningitis due to penicillin-resistant viridans streptococci in neutropenic children. Author(s): Tokuda K, Nishi J, Yoshinaga M, Ijichi O, Ikarimoto N, Shii A, Etoh S, Fukushige T, Mogi A, Kawakami K, Miyata K. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2000 April; 42(2): 174-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10804736&dopt=Abstract
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Septic shock, meningitis and adrenal hemorrhages in a twelve-year-old. Toxic shocklike syndrome accompanied by meningitis and bilateral adrenal hemorrhage. Author(s): Hoare S, Bajwa RS, Abinun M. Source: The Pediatric Infectious Disease Journal. 2001 January; 20(1): 89-90, 92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11176580&dopt=Abstract
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Septicaemia and meningitis in an infant. Author(s): Arslan S, Bozkurt H, Guducuoglu H, Berktas M, Caksen H, Kurtoglu MG, Akcay G. Source: Journal of Paediatrics and Child Health. 2001 August; 37(4): 414-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547776&dopt=Abstract
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Septicaemia and meningitis in neonates and during early infancy in the Goteborg area of Sweden. Author(s): Persson E, Trollfors B, Brandberg LL, Tessin I. Source: Acta Paediatrica (Oslo, Norway : 1992). 2002; 91(10): 1087-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434895&dopt=Abstract
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Sequelae after bacterial meningitis in childhood. Author(s): Oostenbrink R, Maas M, Moons KG, Moll HA. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(5): 379-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069024&dopt=Abstract
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Sequential MRI in chronic meningitis during adrenocorticotropic hormone treatment for West syndrome. Author(s): Go T. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2001 August; 17(8): 497-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11508542&dopt=Abstract
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Serial study of clinical and CT changes in tuberculous meningitis. Author(s): Ranjan P, Kalita J, Misra UK. Source: Neuroradiology. 2003 May; 45(5): 277-82. Epub 2003 April 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12687301&dopt=Abstract
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Serum C-reactive protein in the differential diagnosis of childhood meningitis. Author(s): Tatara R, Imai H. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2000 October; 42(5): 541-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11059546&dopt=Abstract
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Seven days vs. 10 days ceftriaxone therapy in bacterial meningitis. Author(s): Singhi P, Kaushal M, Singhi S, Ray P. Source: Journal of Tropical Pediatrics. 2002 October; 48(5): 273-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405169&dopt=Abstract
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Shortfalls in the use of adenosine deaminase in tuberculous meningitis. Author(s): John MA, Coovadia YM. Source: Trop Doct. 2001 July; 31(3): 138-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11444331&dopt=Abstract
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Short-term antibiotic prophylaxis for the prevention of wound infection and secondary meningitis in acoustic neuroma surgery: a ten-year experience in a regional hospital. Author(s): Minola E, Farina C, Zappone C, Arosio M, Lorenzi N, Mazzoni A. Source: Journal of Chemotherapy (Florence, Italy). 2000 December; 12(6): 521-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11154037&dopt=Abstract
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Should an India ink test be used to detect cryptococcal meningitis in a low-risk population--primarily in a general acute care setting--or are better stat tests available? Author(s): Koneman EW. Source: Cap Today. 2000 December; 14(12): 62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11188352&dopt=Abstract
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Should repeat lumbar punctures be routinely done in neonates with bacterial meningitis?. Results of a survey into clinical practice. Author(s): Agarwal R, Emmerson AJ. Source: Archives of Disease in Childhood. 2001 May; 84(5): 451-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360821&dopt=Abstract
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Shunt surgery for hydrocephalus complicating cryptococcal meningitis in human immunodeficiency virus-negative patients. Author(s): Liliang PC, Liang CL, Chang WN, Chen HJ, Su TM, Lu K, Lu CH. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 September 1; 37(5): 673-8. Epub 2003 August 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942399&dopt=Abstract
196 Meningitis
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Significance of cerebrospinal fluid adenosine deaminase isoenzymes in tuberculous (TB) meningitis. Author(s): Schutte CM, Ungerer JP, du Plessis H, van der Meyden CH. Source: Journal of Clinical Laboratory Analysis. 2001; 15(5): 236-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11574950&dopt=Abstract
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Signs of meningeal irritation at the emergency department: how often bacterial meningitis? Author(s): Oostenbrink R, Moons KG, Theunissen CC, Derksen-Lubsen G, Grobbee DE, Moll HA. Source: Pediatric Emergency Care. 2001 June; 17(3): 161-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11437138&dopt=Abstract
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Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR. Author(s): Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB. Source: Journal of Clinical Microbiology. 2001 April; 39(4): 1553-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11283086&dopt=Abstract
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Single photon emission computed tomography in tuberculous meningitis. Author(s): Misra UK, Kalita J, Das BK. Source: Postgraduate Medical Journal. 2000 October; 76(900): 642-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11009579&dopt=Abstract
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Sinusitis complicated by meningitis: current management. Author(s): Younis RT, Anand VK, Childress C. Source: The Laryngoscope. 2001 August; 111(8): 1338-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11568566&dopt=Abstract
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Specific humoral immunity in mumps meningitis in children. Author(s): Kacprzak-Bergman I, Zaleska I, Jasonek J. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 September-October; 7(5): 977-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11535945&dopt=Abstract
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SPECT changes and their correlation with EEG changes in tuberculous meningitis. Author(s): Kalita J, Misra UK, Das BK. Source: Electromyogr Clin Neurophysiol. 2002 January-February; 42(1): 39-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11851008&dopt=Abstract
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Spectrum of clinical and histopathologic responses to intracranial electrodes: from multifocal aseptic meningitis to multifocal hypersensitivity-type meningovasculitis. Author(s): Stephan CL, Kepes JJ, SantaCruz K, Wilkinson SB, Fegley B, Osorio I. Source: Epilepsia. 2001 July; 42(7): 895-901. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11488890&dopt=Abstract
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Spinal epidermoid tumors: novel approach to aseptic meningitis. Author(s): Kapoor JR, Kapoor R, Buzea C, Gropper MR. Source: Journal of Spinal Disorders & Techniques. 2003 April; 16(2): 193-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679675&dopt=Abstract
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Spinal epidural haematoma misdiagnosed as meningitis. Author(s): Hui AC, Wong HT, Lam JM. Source: Hosp Med. 2001 September; 62(9): 571. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584621&dopt=Abstract
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Spinal seeding of anaplastic ependymoma mimicking fungal meningitis. A case report and review of the literature. Author(s): Murakami M, Kuratsu J, Takeshima H, Soyama N, Shinojima N, Ushio Y. Source: Journal of Neurosurgical Sciences. 2000 March; 44(1): 46-51; Discussion 51-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10961497&dopt=Abstract
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Spontaneous Escherichia coli meningitis in an adult. Author(s): Mofredj A, Guerin JM, Leibinger F, Mamoudi R. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(6): 699-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11200386&dopt=Abstract
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Spontaneous esophageal perforation presenting as meningitis. Author(s): Jurani CC, Early GL, Roberts SR. Source: The Annals of Thoracic Surgery. 2002 April; 73(4): 1294-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11996275&dopt=Abstract
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Staphylococcus aureus meningitis in a post splenectomy patient. Author(s): Sharief S, Memon M, Sarwari AR. Source: J Pak Med Assoc. 2000 September; 50(9): 320-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043025&dopt=Abstract
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Staphylococcus aureus meningitis in adults: a clinical comparison of infections caused by methicillin-resistant and methicillin-sensitive strains. Author(s): Chang WN, Lu CH, Wu JJ, Chang HW, Tsai YC, Chen FT, Chien CC. Source: Infection. 2001 October; 29(5): 245-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11688900&dopt=Abstract
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Staphylococcus aureus meningitis in children: a review of 30 community-acquired cases. Author(s): Rodrigues MM, Patrocinio SJ, Rodrigues MG. Source: Arquivos De Neuro-Psiquiatria. 2000 September; 58(3B): 843-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11018821&dopt=Abstract
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Staphylococcus aureus meningitis: experience with cefuroxime treatment during a 16 year period in a Danish region. Author(s): Norgaard M, Gudmundsdottir G, Larsen CS, Schonheyder HC. Source: Scandinavian Journal of Infectious Diseases. 2003; 35(5): 311-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875516&dopt=Abstract
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Stenotrophomonas maltophilia meningitis - a rare cause of headache in the ED. Author(s): Spencer MT, Baron BJ. Source: The American Journal of Emergency Medicine. 2001 October; 19(6): 532-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11593485&dopt=Abstract
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Stenotrophomonas maltophilia meningitis, bacteremia and respiratory infection. Author(s): Platsouka E, Routsi C, Chalkis A, Dimitriadou E, Paniara O, Roussos C. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(5): 391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069028&dopt=Abstract
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Still's disease can cause neutrophilic meningitis. Author(s): Blockmans DE, Knockaert DC, Bobbaers HJ. Source: Neurology. 2000 March 14; 54(5): 1203-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10720305&dopt=Abstract
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Streptococcal meningitis after spinal anesthesia: report of a case. Author(s): Kocamanoglu IS, Sener EB, Tur A, Ustun E, Sahinoglu H. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 March; 50(3): 314-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12620962&dopt=Abstract
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Streptococcal meningitis in adults: therapeutic outcomes and prognostic factors. Author(s): Lu CH, Chang WN, Chang HW. Source: Clinical Neurology and Neurosurgery. 2001 October; 103(3): 137-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11532551&dopt=Abstract
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Streptococcal meningitis resulting from contact with an infected horse. Author(s): Downar J, Willey BM, Sutherland JW, Mathew K, Low DE. Source: Journal of Clinical Microbiology. 2001 June; 39(6): 2358-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11376093&dopt=Abstract
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Streptococcus agalactiae meningitis in adults: report of two cases. Author(s): Chotmongkol V, Poonsriaram A. Source: J Med Assoc Thai. 2002 March; 85(3): 385-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12117031&dopt=Abstract
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Streptococcus bovis meningitis in a healthy adult patient. Author(s): Vilarrasa N, Prats A, Pujol M, Gason A, Viladrich PF. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(1): 61-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874167&dopt=Abstract
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Streptococcus bovis meningitis in a neonate with Ivemark syndrome. Author(s): Koh TH, Ho S. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(1): 63-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874168&dopt=Abstract
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Streptococcus bovis meningitis in an infant. Author(s): Grant RJ, Whitehead TR, Orr JE. Source: Journal of Clinical Microbiology. 2000 January; 38(1): 462-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10618145&dopt=Abstract
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Streptococcus bovis meningitis in an otherwise healthy infant. Author(s): Okumura A, Takahashi H, Ogawa A, Kuno K, Watanabe K. Source: Clinical Pediatrics. 2002 September; 41(7): 523-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365316&dopt=Abstract
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Streptococcus intermedius: A cause of lobar pneumonia with meningitis and brain abscesses. Author(s): Khatib R, Ramanathan J, Baran J Jr. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 February; 30(2): 396-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10671350&dopt=Abstract
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Streptococcus mitis-induced meningitis after spinal anesthesia. Author(s): Villevieille T, Vincenti-Rouquette I, Petitjeans F, Koulmann P, Legulluche Y, Rousseau JM, Diraison Y, Brinquin L. Source: Anesthesia and Analgesia. 2000 February; 90(2): 500-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10648351&dopt=Abstract
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Streptococcus pneumoniae sepsis and meningitis during the penicillin prophylaxis era in children with sickle cell disease. Author(s): Hord J, Byrd R, Stowe L, Windsor B, Smith-Whitley K. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2002 August-September; 24(6): 470-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218595&dopt=Abstract
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Streptococcus sanguis meningitis: report of a case. Author(s): Chotmongkol V, Panthavasit J, Vorachit M. Source: J Med Assoc Thai. 2002 July; 85(7): 839-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296418&dopt=Abstract
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Streptococcus suis meningitis and septicemia contracted from a wild boar in Germany. Author(s): Rosenkranz M, Elsner HA, Sturenburg HJ, Weiller C, Rother J, Sobottka I. Source: Journal of Neurology. 2003 July; 250(7): 869-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883932&dopt=Abstract
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Streptococcus suis meningitis, a poacher's risk. Author(s): Halaby T, Hoitsma E, Hupperts R, Spanjaard L, Luirink M, Jacobs J. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2000 December; 19(12): 943-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11205632&dopt=Abstract
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Streptococcus zooepidemicus meningitis and bacteraemia. Author(s): Ural O, Tuncer I, Dikici N, Aridogan B. Source: Scandinavian Journal of Infectious Diseases. 2003; 35(3): 206-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751721&dopt=Abstract
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Subcortical low intensity on MR images of meningitis, viral encephalitis, and leptomeningeal metastasis. Author(s): Lee JH, Na DG, Choi KH, Kim KJ, Ryoo JW, Lee SY, Suh YL. Source: Ajnr. American Journal of Neuroradiology. 2002 April; 23(4): 535-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11950641&dopt=Abstract
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Subdural empyemas--a rare complication of meningococcal cerebrospinal meningitis in children. Author(s): Bako W, Raczkowska-Kozak J, Liberek A, Gora-Gebka M. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2000 September-October; 6(5): 1008-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11208447&dopt=Abstract
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Subhyaloid or subinternal limiting membrane haemorrhage in meningococcal meningitis. Author(s): Sung VC, Murray DC, Price NJ. Source: The British Journal of Ophthalmology. 2000 October; 84(10): 1206-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11202918&dopt=Abstract
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Successful treatment of Acanthamoeba meningitis with combination oral antimicrobials. Author(s): Singhal T, Bajpai A, Kalra V, Kabra SK, Samantaray JC, Satpathy G, Gupta AK. Source: The Pediatric Infectious Disease Journal. 2001 June; 20(6): 623-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11419508&dopt=Abstract
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Successful treatment of coccidioidal meningitis with voriconazole. Author(s): Cortez KJ, Walsh TJ, Bennett JE. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 June 15; 36(12): 1619-22. Epub 2003 Jun 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802765&dopt=Abstract
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Successful treatment of cryptococcal meningitis with liposomal amphotericin B (LAMP-LRC-1) intolerant to conventional amphotericin B. Author(s): Kirodian BG, Virani AR, Kshirsagar NA. Source: J Assoc Physicians India. 2002 April; 50: 601-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12164423&dopt=Abstract
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Successful treatment of meningitis caused by highly-penicillin-resistant Streptococcus mitis in a leukemic child. Author(s): Jaing TH, Chiu CH, Hung IJ. Source: Chang Gung Med J. 2002 March; 25(3): 190-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12022740&dopt=Abstract
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Successful treatment of multidrug-resistant Acinetobacter baumannii meningitis with intravenous colistin sulfomethate sodium. Author(s): Jimenez-Mejias ME, Becerril B, Marquez-Rivas FJ, Pichardo C, Cuberos L, Pachon J. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2000 December; 19(12): 970-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11205640&dopt=Abstract
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Successful treatment of multi-resistant Stenotrophomonas maltophilia meningitis with ciprofloxacin in a pre-term infant. Author(s): Lo WT, Wang CC, Lee CM, Chu ML. Source: European Journal of Pediatrics. 2002 December; 161(12): 680-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12536991&dopt=Abstract
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Successful treatment of vancomycin-resistant Enterococcus faecium meningitis with linezolid: case report and literature review. Author(s): Shaikh ZH, Peloquin CA, Ericsson CD. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(5): 375-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11440224&dopt=Abstract
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Successful treatment of vancomycin-resistant Enterococcus meningitis with linezolid. Author(s): Hachem R, Afif C, Gokaslan Z, Raad I. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 June; 20(6): 432-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476449&dopt=Abstract
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Successful treatment of vancomycin-resistant enterococcus meningitis with linezolid: case report and review of the literature. Author(s): Steinmetz MP, Vogelbaum MA, De Georgia MA, Andrefsky JC, Isada C. Source: Critical Care Medicine. 2001 December; 29(12): 2383-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11801846&dopt=Abstract
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Successful treatment of ventriculostomy-related meningitis caused by vancomycinresistant Enterococcus with intravenous and intraventricular quinupristin/dalfopristin. Author(s): Williamson JC, Glazier SS, Peacock JE Jr. Source: Clinical Neurology and Neurosurgery. 2002 January; 104(1): 54-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792478&dopt=Abstract
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Sudden death in a 35-year-old man with occult malformation of the brain and aseptic meningitis. Author(s): Matschke J, Makrigeorgi-Butera M, Stavrou D. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 2003 March; 24(1): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12605005&dopt=Abstract
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Surveillance of measles-mumps-rubella vaccine-associated aseptic meningitis in Germany. Author(s): Schlipkoter U, Muhlberger N, von Kries R, Weil J. Source: Infection. 2002 December; 30(6): 351-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478324&dopt=Abstract
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Survival and sequelae of meningococcal meningitis in Ghana. Author(s): Hodgson A, Smith T, Gagneux S, Akumah I, Adjuik M, Pluschke G, Binka F, Genton B. Source: International Journal of Epidemiology. 2001 December; 30(6): 1440-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821360&dopt=Abstract
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Suspected allopurinol-induced aseptic meningitis. Author(s): Greenberg LE, Nguyen T, Miller SM. Source: Pharmacotherapy. 2001 August; 21(8): 1007-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11718488&dopt=Abstract
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Syphilitic meningitis in HIV-patients with meningeal syndrome: report of two cases and review. Author(s): Carmo RA, Moura AS, Christo PP, Morandi AC, Oliveira MS. Source: The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases. 2001 October; 5(5): 280-7. Epub 2003 February 21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779455&dopt=Abstract
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Syringomyelia as a complication of tuberculous meningitis. Author(s): Tiamkao S, Tanapaisal C, Kanpittaya J, Jitpimolmard S. Source: J Med Assoc Thai. 2001 January; 84(1): 125-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11281491&dopt=Abstract
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Syringomyelia complicating syphilitic spinal meningitis: a case report. Author(s): Bulundwe KK, Myburgh CJ, Gledhill RF. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2000 March; 7(2): 231-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10809948&dopt=Abstract
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Targeting effective treatment of bacterial meningitis. 2. Author(s): Raser K, Deziel PJ. Source: Jaapa. 2001 May; 14(5): 26-8, 31-2, 35. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11523337&dopt=Abstract
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TB PCR in the early diagnosis of tuberculous meningitis: evaluation of the Roche semi-automated COBAS Amplicor MTB test with reference to the manual Amplicor MTB PCR test. Author(s): Bonington A, Strang JI, Klapper PE, Hood SV, Parish A, Swift PJ, Damba J, Stevens H, Sawyer L, Potgieter G, Bailey A, Wilkins EG. Source: Tubercle and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2000; 80(4-5): 191-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052908&dopt=Abstract
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Temozolomide in early stages of newly diagnosed malignant glioma and neoplastic meningitis. Author(s): Friedman HS. Source: Seminars in Oncology. 2000 June; 27(3 Suppl 6): 35-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10866348&dopt=Abstract
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Temporal bone fracture and latent meningitis: temporal bone histopathology study of the month. Author(s): Sudhoff H, Linthicum FH Jr. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 May; 24(3): 521-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806310&dopt=Abstract
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The antibiotic and anti-inflammatory treatment of bacterial meningitis in adults: do we have to change our strategies in an era of increasing antibiotic resistance? Author(s): Vandecasteele SJ, Knockaert D, Verhaegen J, Van Eldere J, Peetermans WE. Source: Acta Clin Belg. 2001 July-August; 56(4): 225-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11603252&dopt=Abstract
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The application of the Mancini technique as a diagnostic test in the CSF of tuberculous meningitis patients. Author(s): Kashyap RS, Agarwal NP, Chandak NH, Taori GM, Biswas SK, Purohit HJ, Daginawala HF. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 June; 8(6): Mt95-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12070446&dopt=Abstract
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The changing epidemiology of bacterial meningitis and invasive non-meningitic bacterial disease in scotland during the period 1983-99. Author(s): Kyaw MH, Christie P, Jones IG, Campbell H. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(4): 289-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064693&dopt=Abstract
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The clinical, radiological and pathological profile of tuberculous meningitis in patients with and without human immunodeficiency virus infection. Author(s): Katrak SM, Shembalkar PK, Bijwe SR, Bhandarkar LD. Source: Journal of the Neurological Sciences. 2000 December 1; 181(1-2): 118-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11099721&dopt=Abstract
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The danger of bacterial meningitis in the adult. 1. Author(s): Raser K, Deziel PJ. Source: Jaapa. 2001 May; 14(5): 16-8, 21-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11523336&dopt=Abstract
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The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis. Author(s): Thomas KE, Hasbun R, Jekel J, Quagliarello VJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 July 1; 35(1): 46-52. Epub 2002 June 05. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060874&dopt=Abstract
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The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis. Author(s): Schoeman JF, Elshof JW, Laubscher JA, Janse van Rensburg A, Donald PR. Source: Annals of Tropical Paediatrics. 2001 December; 21(4): 299-305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732147&dopt=Abstract
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The efficacy of fluconazole 600 mg/day versus itraconazole 600 mg/day as consolidation therapy of cryptococcal meningitis in AIDS patients. Author(s): Mootsikapun P, Chetchotisakd P, Anunnatsiri S, Choksawadphinyo K. Source: J Med Assoc Thai. 2003 April; 86(4): 293-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12757072&dopt=Abstract
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The emergence of resistant pneumococcal meningitis--implications for empiric therapy. Author(s): McMaster P, McIntyre P, Gilmour R, Gilbert L, Kakakios A, Mellis C. Source: Archives of Disease in Childhood. 2002 September; 87(3): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12193427&dopt=Abstract
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The epidemiology of acute meningitis in children in England and Wales. Author(s): Davison KL, Ramsay ME. Source: Archives of Disease in Childhood. 2003 August; 88(8): 662-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12876156&dopt=Abstract
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The EQ-5D and the Health Utilities Index for permanent sequelae after meningitis: a head-to-head comparison. Author(s): Oostenbrink R, A Moll HA, Essink-Bot ML. Source: Journal of Clinical Epidemiology. 2002 August; 55(8): 791-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12384194&dopt=Abstract
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The future of meningitis vaccines. Author(s): Segal S, Pollard AJ. Source: Hosp Med. 2003 March; 64(3): 161-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669483&dopt=Abstract
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The impact of an enteroviral RT-PCR assay on the diagnosis of aseptic meningitis and patient management. Author(s): Stellrecht KA, Harding I, Woron AM, Lepow ML, Venezia RA. Source: Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology. 2002 July; 25 Suppl 1: S19-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091078&dopt=Abstract
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The impact of HIV on meningitis as seen at a South African Academic Hospital (1994 to 1998). Author(s): Schutte CM, Van der Meyden CH, Magazi DS. Source: Infection. 2000 January-February; 28(1): 3-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10697783&dopt=Abstract
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The impact of new diagnostic methodologies in the management of meningitis in adults at a teaching hospital. Author(s): Chadwick DR, Lever AM. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 October; 95(10): 663-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12324638&dopt=Abstract
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The importance of quickly initiating antibiotic therapy in a 20-year-old man with bacterial meningitis. Author(s): Bridy MA. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2001 October; 27(5): 437-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11577282&dopt=Abstract
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The management of bacterial meningitis in children. Author(s): Duke T, Curtis N, Fuller DG. Source: Expert Opinion on Pharmacotherapy. 2003 August; 4(8): 1227-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877633&dopt=Abstract
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The meningitis mind-bender. Author(s): Parini SM. Source: Nursing Management. 2002 August; 33(8): 21-5; Quiz 26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12163750&dopt=Abstract
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The possible role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in adults. Author(s): Choi SH, Kim YS, Bae IG, Chung JW, Lee MS, Kang JM, Ryu J, Woo JH. Source: Clinical Neurology and Neurosurgery. 2002 January; 104(1): 10-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792470&dopt=Abstract
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The potential roles of C-reactive protein and procalcitonin concentrations in the serum and cerebrospinal fluid in the diagnosis of bacterial meningitis. Author(s): Nathan BR, Scheld WM. Source: Curr Clin Top Infect Dis. 2002; 22: 155-65. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520652&dopt=Abstract
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The prognostic factors of adult tuberculous meningitis. Author(s): Lu CH, Chang WN, Chang HW. Source: Infection. 2001 December; 29(6): 299-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11787828&dopt=Abstract
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The risk of aseptic meningitis associated with the Leningrad-Zagreb mumps vaccine strain following mass vaccination with measles-mumps-rubella vaccine, Rio Grande do Sul, Brazil, 1997. Author(s): da Silveira CM, Kmetzsch CI, Mohrdieck R, Sperb AF, Prevots DR. Source: International Journal of Epidemiology. 2002 October; 31(5): 978-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435771&dopt=Abstract
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The role of lumbar puncture in the management of elevated intracranial pressure in patients with AIDS-associated cryptococcal meningitis. Author(s): Antinori S, Ridolfo AL, Gianelli E, Piazza M, Gervasoni C, Monforte AA. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 November; 31(5): 1309-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11073737&dopt=Abstract
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The stereochemistry of the amino acid side chain influences the inflammatory potential of muramyl dipeptide in experimental meningitis. Author(s): Cottagnoud P, Gerber CM, Majcherczyk PA, Acosta F, Cottagnoud M, Neftel K, Moreillon P, Tauber MG. Source: Infection and Immunity. 2003 June; 71(6): 3663-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761158&dopt=Abstract
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The syndrome of inappropriate secretion of antidiuretic hormone and fluid restriction in meningitis--how strong is the evidence? Author(s): Moller K, Larsen FS, Bie P, Skinhoj P. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(1): 13-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11234973&dopt=Abstract
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The trigeminovascular system in bacterial meningitis. Author(s): Hoffmann O, Dirnagl U, Weber JR. Source: Microscopy Research and Technique. 2001 May 1; 53(3): 188-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11301494&dopt=Abstract
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The use of clinical scales in depicting cerebrovascular complications in bacterial meningitis. Author(s): Merkelbach S, Konig J, Rohn S, Muller M. Source: Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging. 2001 January; 11(1): 25-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198523&dopt=Abstract
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The use of ethambutol has lowered the 2-year mortality rate in patients with tuberculous meningitis. Author(s): Lau KK. Source: Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine. 2000 September; 6(3): 329-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11025857&dopt=Abstract
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The use of liver grafts from donors with bacterial meningitis. Author(s): Satoi S, Bramhall SR, Solomon M, Hastings M, Mayer AD, de Goyet JV, Buckels JA, McMaster P, Mirza DF. Source: Transplantation. 2001 September 27; 72(6): 1108-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11579309&dopt=Abstract
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The use of the Internet to inform young international travellers of contact with a case of meningococcal meningitis. Author(s): Buxton JA, Smythe MS, Salzman JR. Source: Can Commun Dis Rep. 2002 March 1; 28(5): 37-40. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889906&dopt=Abstract
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Thoracic myelopathy complicating acute meningococcal meningitis: MRI findings. Author(s): Bhojo AK, Akhter N, Bakshi R, Wasay M. Source: The American Journal of the Medical Sciences. 2002 May; 323(5): 263-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018669&dopt=Abstract
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Three cases of bacterial meningitis after spinal and epidural anesthesia. Author(s): Trautmann M, Lepper PM, Schmitz FJ. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 January; 21(1): 43-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11913500&dopt=Abstract
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Three ECHOvirus serotypes responsible for outbreak of aseptic meningitis in RhoneAlpes region, France. Author(s): Chomel JJ, Antona D, Thouvenot D, Lina B. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2003 March; 22(3): 191-3. Epub 2003 March 04. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649719&dopt=Abstract
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Timely detection of meningococcal meningitis epidemics in Africa. Author(s): Lewis R, Nathan N, Diarra L, Belanger F, Paquet C. Source: Lancet. 2001 July 28; 358(9278): 287-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11498215&dopt=Abstract
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Timing of shunt surgery in childhood tuberculous meningitis with hydrocephalus. Author(s): Kemaloglu S, Ozkan U, Bukte Y, Ceviz A, Ozates M. Source: Pediatric Neurosurgery. 2002 October; 37(4): 194-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372912&dopt=Abstract
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Tissue adhesive and postoperative allergic meningitis. Author(s): Kitoh A, Arima Y, Nishigori C, Kikuta K, Miyachi Y. Source: Lancet. 2002 May 11; 359(9318): 1668-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12020530&dopt=Abstract
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Toll-like receptor 2 participates in mediation of immune response in experimental pneumococcal meningitis. Author(s): Koedel U, Angele B, Rupprecht T, Wagner H, Roggenkamp A, Pfister HW, Kirschning CJ. Source: Journal of Immunology (Baltimore, Md. : 1950). 2003 January 1; 170(1): 438-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496429&dopt=Abstract
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Transient elevation of interleukin-16 levels at the initial stage of meningitis in children. Author(s): Suzuki T, Ishiguro A, Shimbo T. Source: Clinical and Experimental Immunology. 2003 March; 131(3): 484-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12605702&dopt=Abstract
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Trastuzumab for breast cancer-related carcinomatous meningitis. Author(s): Robins HI, Liu G, Hayes L, Mehta M. Source: Clinical Breast Cancer. 2002 January; 2(4): 316. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11899365&dopt=Abstract
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Travel warning: Eosinophilic meningitis caused by rat lungworm. Author(s): Weir E. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 April 30; 166(9): 1184. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12000253&dopt=Abstract
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Treatment of gram-negative bacterial meningitis in term neonates with third generation cephalosporins plus amikacin. Author(s): Dellagrammaticas HD, Christodoulou C, Megaloyanni E, Papadimitriou M, Kapetanakis J, Kourakis G. Source: Biology of the Neonate. 2000 March; 77(3): 139-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10729716&dopt=Abstract
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Treatment of intracranial hypertension and aspects on lumbar dural puncture in severe bacterial meningitis. Author(s): Grande PO, Myhre EB, Nordstrom CH, Schliamser S. Source: Acta Anaesthesiologica Scandinavica. 2002 March; 46(3): 264-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939916&dopt=Abstract
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Treatment of intracranial hypertension and aspects on lumbar dural puncture in severe bacterial meningitis. Author(s): Cold GE, Moller K. Source: Acta Anaesthesiologica Scandinavica. 2002 November; 46(10): 1281-5; Author Reply. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12421206&dopt=Abstract
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Treatment of Salmonella meningitis: two case reports and a review of the literature. Author(s): Owusu-Ofori A, Scheld WM. Source: International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases. 2003 March; 7(1): 53-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718811&dopt=Abstract
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Trimethoprim-induced aseptic meningitis in an adolescent male. Author(s): Redman RC 4th, Miller JB, Hood M, DeMaio J. Source: Pediatrics. 2002 August; 110(2 Pt 1): E26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165625&dopt=Abstract
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Trimethoprim-sulfamethoxazole induced aseptic meningitis in a renal transplant patient. Author(s): Muller MP, Richardson DC, Walmsley SL. Source: Clinical Nephrology. 2001 January; 55(1): 80-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11200873&dopt=Abstract
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Trimethoprim-sulfamethoxazole induced recurrent aseptic meningitis. Author(s): Meng MV, St Lezin M. Source: The Journal of Urology. 2000 November; 164(5): 1664-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11025739&dopt=Abstract
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Trimethoprim-sulfamethoxazole-induced aseptic meningitis: case report and literature review. Author(s): Capra C, Monza GM, Meazza G, Ramella G. Source: Intensive Care Medicine. 2000 February; 26(2): 212-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10784311&dopt=Abstract
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Triptans reduce the inflammatory response in bacterial meningitis. Author(s): Hoffmann O, Keilwerth N, Bille MB, Reuter U, Angstwurm K, Schumann RR, Dirnagl U, Weber JR. Source: Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism. 2002 August; 22(8): 98896. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172384&dopt=Abstract
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Tuberculosis meningitis and attention deficit hyperactivity disorder in children. Author(s): Wait JW, Stanton L, Schoeman JF. Source: Journal of Tropical Pediatrics. 2002 October; 48(5): 294-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405172&dopt=Abstract
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Tuberculous granulomas in childhood tuberculous meningitis: radiological features and course. Author(s): Ravenscroft A, Schoeman JF, Donald PR. Source: Journal of Tropical Pediatrics. 2001 February; 47(1): 5-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11245351&dopt=Abstract
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Tuberculous meningitis and dystonia. Author(s): Serrano-Duenas M. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2001 May; 16(3): 582-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11391767&dopt=Abstract
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Tuberculous meningitis associated with urinary tract tuberculosis. Author(s): Chotmongkol V, Kiertiburanakul S. Source: Southeast Asian J Trop Med Public Health. 2001 June; 32(2): 394-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11556594&dopt=Abstract
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Tuberculous meningitis following correction of kyphosis by spinal osteotomy. A case report. Author(s): Alvarez L, Calvo E. Source: The Journal of Bone and Joint Surgery. American Volume. 2002 June; 84-A(6): 1022-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12063339&dopt=Abstract
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Tuberculous meningitis in a country with a low incidence of tuberculosis: still a serious disease and a diagnostic challenge. Author(s): Bidstrup C, Andersen PH, Skinhoj P, Andersen AB. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(11): 811-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578148&dopt=Abstract
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Tuberculous meningitis in a renal transplant recipient. Author(s): Blaschke S, Steffgen J, Grunewald RW, Muller GA. Source: Journal of Nephrology. 2002 January-February; 15(1): 93-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936435&dopt=Abstract
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Tuberculous meningitis in children: clinical features and outcome in 40 cases. Author(s): Paganini H, Gonzalez F, Santander C, Casimir L, Berberian G, Rosanova MT. Source: Scandinavian Journal of Infectious Diseases. 2000; 32(1): 41-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10716076&dopt=Abstract
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Tuberculous meningitis in children: problem to be addressed effectively with thorough contact tracing. Author(s): Walia R, Hoskyns W. Source: European Journal of Pediatrics. 2000 July; 159(7): 535-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10923231&dopt=Abstract
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Tuberculous meningitis in infancy. Author(s): Tung YR, Lai MC, Lui CC, Tsai KL, Huang LT, Chang YC, Huang SC, Yang SN, Hung PL. Source: Pediatric Neurology. 2002 October; 27(4): 262-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435563&dopt=Abstract
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Tuberculous meningitis presenting as sensorineural hearing loss. Author(s): Kotnis R, Simo R. Source: The Journal of Laryngology and Otology. 2001 June; 115(6): 491-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11429076&dopt=Abstract
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Tuberculous meningitis with spinal tuberculous arachnoiditis. Author(s): Poon TL, Ho WS, Pang KY, Wong CK. Source: Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine. 2003 February; 9(1): 59-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12547960&dopt=Abstract
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Tuberculous meningitis with tuberculomata presenting as postpartum pyrexia of unknown origin. Author(s): Chan KH, Ho PL, Cheung RT, Tsang KL, Fong GC, Cheng PW, Ho SL. Source: Hosp Med. 2003 May; 64(5): 306-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789743&dopt=Abstract
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Tuberculous meningitis. Author(s): Thwaites G, Chau TT, Mai NT, Drobniewski F, McAdam K, Farrar J. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 March; 68(3): 289-99. Review. Erratum In: J Neurol Neurosurg Psychiatry 2000 June; 68(6): 802. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10675209&dopt=Abstract
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Tuberculous meningitis: a disease of fatal outcome in children. Author(s): Khan IM, Khan S, Laaser U. Source: European Journal of Pediatrics. 2003 April; 162(4): 281-2. Epub 2003 February 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12647206&dopt=Abstract
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Tuberculous meningitis: is a 6-month treatment regimen sufficient? Author(s): van Loenhout-Rooyackers JH, Keyser A, Laheij RJ, Verbeek AL, van der Meer JW. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 2001 November; 5(11): 1028-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11716339&dopt=Abstract
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Tuberculous meningitis: pitfalls in diagnosis. Author(s): Joosten AA, van der Valk PD, Geelen JA, Severin WP, Jansen Steur EN. Source: Acta Neurologica Scandinavica. 2000 December; 102(6): 388-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11125755&dopt=Abstract
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Tuberculous radiculomyelitis complicating tuberculous meningitis: case report and review. Author(s): Hernandez-Albujar S, Arribas JR, Royo A, Gonzalez-Garcia JJ, Pena JM, Vazquez JJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 June; 30(6): 915-21. Epub 2000 June 14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10854362&dopt=Abstract
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Twelve year outcomes following bacterial meningitis: further evidence for persisting effects. Author(s): Grimwood K, Anderson P, Anderson V, Tan L, Nolan T. Source: Archives of Disease in Childhood. 2000 August; 83(2): 111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10906014&dopt=Abstract
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Uncomplicated postoperative lipoid meningitis secondary to autologous fat graft necrosis. Author(s): Ricaurte JC, Murali R, Mandell W. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 March; 30(3): 613-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10722462&dopt=Abstract
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Unilateral facial paralysis occurring in an infant with enteroviral otitis media and aseptic meningitis. Author(s): Hostetler MA, Suara RO, Denison MR. Source: The Journal of Emergency Medicine. 2002 April; 22(3): 267-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932090&dopt=Abstract
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Unusual presentation of carcinomatous meningitis: case report and review of typical CSF findings. Author(s): Zeller JA, Zunker P, Witt K, Schlueter E, Deuschl G. Source: Neurological Research. 2002 October; 24(7): 652-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392200&dopt=Abstract
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Use of intrathecal trastuzumab in a patient with carcinomatous meningitis. Author(s): Laufman LR, Forsthoefel KF. Source: Clinical Breast Cancer. 2001 October; 2(3): 235. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11899418&dopt=Abstract
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Use of the NOW Streptococcus pneumoniae urinary antigen test in cerebrospinal fluid for rapid diagnosis of pneumococcal meningitis. Author(s): Samra Z, Shmuely H, Nahum E, Paghis D, Ben-Ari J. Source: Diagnostic Microbiology and Infectious Disease. 2003 April; 45(4): 237-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729992&dopt=Abstract
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Use of universal PCR on cerebrospinal fluid to diagnose bacterial meningitis in culture-negative patients. Author(s): Margall Coscojuela N, Majo Moreno M, Latorre Otin C, Fontanals Amyerich D, Dominguez Garcia A, Prats Pastor G. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 January; 21(1): 67-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11913508&dopt=Abstract
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Use of ventriculoperitoneal shunts to treat uncontrollable intracranial hypertension in patients who have cryptococcal meningitis without hydrocephalus. Author(s): Liliang PC, Liang CL, Chang WN, Lu K, Lu CH. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 June 15; 34(12): E64-8. Epub 2002 May 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032912&dopt=Abstract
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Utility of prognostic stratification in adults with community-acquired bacterial meningitis. Author(s): Aronin SI, Quagliarello VJ. Source: Compr Ther. 2001 Spring; 27(1): 72-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280860&dopt=Abstract
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Utility of transcranial Doppler ultrasonography in the diagnosis and follow-up of tuberculous meningitis-related vasculopathy. Author(s): Kilic T, Elmaci I, Ozek MM, Pamir MN. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2002 April; 18(3-4): 142-6. Epub 2002 March 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981621&dopt=Abstract
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Uveitis associated with Mycoplasma pneumoniae meningitis. Author(s): Yashar SS, Yashar B, Epstein E, Viani RM. Source: Acta Ophthalmologica Scandinavica. 2001 February; 79(1): 100-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11167302&dopt=Abstract
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Validation of a diagnosis model for differentiating bacterial from viral meningitis in infants and children under 3.5 years of age. Author(s): Jaeger F, Leroy J, Duchene F, Baty V, Baillet S, Estavoyer JM, Hoen B. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2000 June; 19(6): 418-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10947215&dopt=Abstract
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Value of cerebrospinal fluid leukocyte aggregation in distinguishing the causes of meningitis in children. Author(s): Michelow IC, Nicol M, Tiemessen C, Chezzi C, Pettifor JM. Source: The Pediatric Infectious Disease Journal. 2000 January; 19(1): 66-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10643853&dopt=Abstract
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Vancomycin-resistant Enterococcus faecium meningitis successfully managed with linezolid: case report and review of the literature. Author(s): Zeana C, Kubin CJ, Della-Latta P, Hammer SM. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 August 15; 33(4): 477-82. Epub 2001 July 11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11462183&dopt=Abstract
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Varicella zoster meningitis preceeded by thrombophlebitis in a patient with Hodgkin's disease. Author(s): Saif MW, Hamilton JM, Allegra CJ. Source: Leukemia & Lymphoma. 2000 October; 39(3-4): 421-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11342324&dopt=Abstract
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Varicella-zoster virus meningitis and cerebrospinal fluid HIV RNA. Author(s): Moling O, Rossi P, Rimenti G, Vedovelli C, Mian P. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(5): 398-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11440237&dopt=Abstract
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Varicella-zoster virus: an overlooked cause of aseptic meningitis. Author(s): Jhaveri R, Sankar R, Yazdani S, Cherry JD. Source: The Pediatric Infectious Disease Journal. 2003 January; 22(1): 96-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553305&dopt=Abstract
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Vascular endothelial growth factor in bacterial meningitis: detection in cerebrospinal fluid and localization in postmortem brain. Author(s): van der Flier M, Stockhammer G, Vonk GJ, Nikkels PG, van DiemenSteenvoorde RA, van der Vlist GJ, Rupert SW, Schmutzhard E, Gunsilius E, Gastl G, Hoepelman AI, Kimpen JL, Geelen SP. Source: The Journal of Infectious Diseases. 2001 January 1; 183(1): 149-53. Epub 2000 November 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11106541&dopt=Abstract
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Vascular endothelial growth factor in CSF: a biological marker for carcinomatous meningitis. Author(s): Stockhammer G, Poewe W, Burgstaller S, Deisenhammer F, Muigg A, Kiechl S, Schmutzhard E, Maier H, Felber S, Schumacher P, Gunsilius E, Gastl G. Source: Neurology. 2000 April 25; 54(8): 1670-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10762512&dopt=Abstract
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Vasculitic complications associated with coccidioidal meningitis. Author(s): Williams PL. Source: Seminars in Respiratory Infections. 2001 December; 16(4): 270-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740829&dopt=Abstract
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Veillonella parvula meningitis: case report and review of Veillonella infections. Author(s): Bhatti MA, Frank MO. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 September; 31(3): 839-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11017846&dopt=Abstract
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Venous sinus thrombosis after Proteus vulgaris meningitis and concomitant Clostridium abscess formation. Author(s): Bodur H, Colpan A, Gozukucuk R, Akinci E, Cevik MA, Balaban N. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(9): 694-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12374367&dopt=Abstract
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Ventriculoperitoneal shunting in childhood tuberculous meningitis. Author(s): Lamprecht D, Schoeman J, Donald P, Hartzenberg H. Source: British Journal of Neurosurgery. 2001 April; 15(2): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360374&dopt=Abstract
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Viral meningitis and encephalitis: traditional and emerging viral agents. Author(s): Romero JR, Newland JG. Source: Seminars in Pediatric Infectious Diseases. 2003 April; 14(2): 72-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881794&dopt=Abstract
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CHAPTER 2. NUTRITION AND MENINGITIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and meningitis.
Finding Nutrition Studies on Meningitis 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 “meningitis” (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.
220 Meningitis
The following information is typical of that found when using the “Full IBIDS Database” to search for “meningitis” (or a synonym): •
A retrospective study on the efficacy and safety of amphotericin B in a lipid emulsion for the treatment of cryptococcal meningitis in AIDS patients. Author(s): Division of Infectious Diseases, Ospedali Riuniti, Bergamo, Italy. Source: Torre, D Banfi, G Tambini, R Speranza, F Zeroli, C Martegani, R Airoldi, M Fiori, G J-Infect. 1998 July; 37(1): 36-8 0163-4453
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Amphotericin B in a lipid emulsion for the treatment of cryptococcal meningitis in AIDS patients. Author(s): Hopital Bichat-Claude Bernard, Paris, France. Source: Joly, V Geoffray, C Reynes, J Goujard, C Mechali, D Maslo, C Raffi, F Yeni, P JAntimicrob-Chemother. 1996 July; 38(1): 117-26 0305-7453
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An immunotoxin for the treatment of T-acute lymphoblastic leukemic meningitis: studies in rhesus monkeys. Author(s): Division of Hematology and Oncology, Duke University Medical Center, Durham, NC 27710. Source: Hertler, A A Schlossman, D M Borowitz, M J Poplack, D G Frankel, A E CancerImmunol-Immunother. 1989; 28(1): 59-66 0340-7004
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An outbreak of eosinophilic meningitis caused by Angiostrongylus cantonensis in travelers returning from the Caribbean. Author(s): Department of Infectious Diseases, Northwestern University Medical School, Chicago, USA. Source: Slom, Trevor J Cortese, Margaret M Gerber, Susan I Jones, Roderick C Holtz, Timothy H Lopez, Adriana S Zambrano, Carlos H Sufit, Robert L Sakolvaree, Yuwaporn Chaicumpa, Wanpen Herwaldt, Barbara L Johnson, Stuart N-Engl-J-Med. 2002 February 28; 346(9): 668-75 1533-4406
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Aseptic meningitis and optic neuritis preceding varicella-zoster progressive outer retinal necrosis in a patient with AIDS. Author(s): Division of Infectious Diseases, Department of Medicine, Veterans Affairs Medical Center, Emory University School of Medicine, 69 Butler Street, Atlanta, GA 30303, USA. Source: Franco Paredes, Carlos Bellehemeur, Thomas Merchant, Ali Sanghi, Pramod DiazGranados, Carlos Rimland, David AIDS. 2002 May 3; 16(7): 1045-9 0269-9370
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Bacterial meningitis in children and adults. Changes in community-acquired disease may affect patient care. Author(s): Sunnybrook Health Science Centre, Ontario, Canada.
[email protected] Source: Phillips, E J Simor, A E Postgrad-Med. 1998 March; 103(3): 102-117 0032-5481
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Bacterial meningitis in children: current concepts of neurologic management. Author(s): Department of Pediatrics, Loma Linda University School of Medicine, California. Source: Ashwal, S Perkin, R M Thompson, J R Schneider, S Tomasi, L G Curr-ProblPediatr. 1994 September; 24(8): 267-84 0045-9380
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Bacterial meningitis observed in a phase I trial of vinorelbine, cisplatin and thoracic radiotherapy for non-small cell lung cancer: report of a case and discussion on doselimiting toxicity. Author(s): Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
[email protected]
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Source: Sekine, I Matsuda, T Saisho, T Watanabe, H Yamamoto, N Kunitoh, H Ohe, Y Tamura, T Kodama, T Saijo, N Jpn-J-Clin-Oncol. 2000 September; 30(9): 401-5 0368-2811 •
Catastrophic visual loss due to Cryptococcus neoformans meningitis. Author(s): Center for Infectious Diseases, University of Texas Health Sciences Center, Houston 77030. Source: Rex, J H Larsen, R A Dismukes, W E Cloud, G A Bennett, J E Medicine(Baltimore). 1993 July; 72(4): 207-24 0025-7974
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Cerebral vasculature is the major target of oxidative protein alterations in bacterial meningitis. Author(s): Institute for Infectious Diseases, University of Berne, Switzerland. Source: Schaper, Manuela Gergely, Suzanne Lykkesfeldt, Jens Zbaren, Jakob Leib, Stephen L Tauber, Martin G Christen, Stephan J-Neuropathol-Exp-Neurol. 2002 July; 61(7): 605-13 0022-3069
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Cerebrovascular permeability changes during experimental meningitis in the rat. Author(s): Department of Pharmaceutics, School of Pharmacy, University of Buffalo, New York, USA. Source: Boje, K M J-Pharmacol-Exp-Ther. 1995 September; 274(3): 1199-203 0022-3565
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Could antioxidant therapy reduce the incidence of deafness following bacterial meningitis? Author(s): Department of Pathology, Houston Medical Center, Warner Robins, GA 31093, USA. Source: Maurizi, C P Med-Hypotheses. 1999 January; 52(1): 85-7 0306-9877
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Craniospinal pachymeningitis. Author(s): Department of Neurosurgery, Hotel-Dieu, Beirut, Lebanon. Source: Nohra, G Maarrawi, J Samaha, E Rizk, T Okais, N Acta-Neurochir-(Wien). 2000; 142(6): 713-4 0001-6268
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Diabetes insipidus as a hallmark neuroendocrine complication of neonatal meningitis. Author(s): Yale University School of Medicine, New Haven, CT 06520, USA. Source: Cohen, C Rice, E N Thomas, D E Carpenter, T O Curr-Opin-Pediatr. 1998 August; 10(4): 449-52 1040-8703
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Diagnostic criteria for Tuberculous Meningitis. Author(s): Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
[email protected] Source: Seth, Rachna Sharma, Usha Indian-J-Pediatr. 2002 April; 69(4): 299-303 0019-5456
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Epidural complications and a case of malignant meningitis. Author(s): Pembridge Palliative Care Centre, St Charles Hospital, London. Source: Jennings, A L Rothwell, M P Naysmith, A Palliat-Med. 1997 November; 11(6): 483-6 0269-2163
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Familial outbreak of disseminated multidrug-resistant tuberculosis and meningitis. Author(s): Department of Respiratory Disease, University of Naples Federico II, Italy. Source: Sofia, M Maniscalco, M Honore, N Molino, A Mormile, M Heym, B Cole, S T IntJ-Tuberc-Lung-Dis. 2001 June; 5(6): 551-8 1027-3719
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Gastric linitis adenocarcinoma and carcinomatous meningitis: an infrequent but aggressive association--report of four cases. Author(s): Service d'Oncologie digestive Medicale, Institut Gustave Roussy, Villejuif, France.
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Source: Delaunoit, T Boige, V Belloc, J Elias, D Lasser, P Duvillard, P Ducreux, M AnnOncol. 2001 June; 12(6): 869-71 0923-7534 •
Idiopathic hypertrophic cranial pachymeningitis. Author(s): Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
[email protected] Source: Sylaja, P N Cherian, P J Das, C K Radhakrishnan, V V Radhakrishnan, K NeurolIndia. 2002 March; 50(1): 53-9 0028-3886
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Inhibition of matrix metalloproteinases and tumour necrosis factor alpha converting enzyme as adjuvant therapy in pneumococcal meningitis. Author(s): Institute for Infectious Diseases, University of Bern, Berne, Switzerland.
[email protected] Source: Leib, S L Clements, J M Lindberg, R L Heimgartner, C Loeffler, J M Pfister, L A Tauber, M G Leppert, D Brain. 2001 September; 124(Pt 9): 1734-42 0006-8950
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Intrathecal administration of amikacin for treatment of meningitis secondary to cephalosporin-resistant Escherichia coli. Author(s): Albany College of Pharmacy, NY 12208. Source: Preston, S L Briceland, L L Ann-Pharmacother. 1993 Jul-August; 27(7-8): 870-3 1060-0280
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Intrathecal administration of etoposide in the treatment of malignant meningitis: feasibility and pharmacokinetic data. Author(s): Department of Medical Oncology, University Hospital Rotterdam-Dijkzigt, The Netherlands. Source: van der Gaast, A Sonneveld, P Mans, D R Splinter, T A Cancer-ChemotherPharmacol. 1992; 29(4): 335-7 0344-5704
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Intrathecal chemotherapy in carcinomatous meningitis from breast cancer. Author(s): Division of Medical Oncology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
[email protected] Source: Orlando, L Curigliano, G Colleoni, M Fazio, N Nole, F Martinelli, G Cinieri, S Graffeo, R Peruzzotti, G Goldhirsch, A Anticancer-Res. 2002 Sep-October; 22(5): 3057-9 0250-7005
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Is nitric oxide involved as a mediator of cerebrovascular changes in the early phase of experimental pneumococcal meningitis? Author(s): Department of Neurology, University of Munich, Germany. Source: Haberl, R L Anneser, F Kodel, U Pfister, H W Neurol-Res. 1994 April; 16(2): 10812 0161-6412
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Isolated leptomeningeal carcinomatosis (carcinomatous meningitis) after taxaneinduced major remission in patients with advanced breast cancer. Author(s): Department of Medicine, Medical Oncology Unit, Helena-Venizelou Hospital, Athens, Greece.
[email protected] Source: Kosmas, C Malamos, N A Tsavaris, N B Stamataki, M Gregoriou, A Rokana, S Vartholomeou, M Antonopoulos, M J Oncology. 2002; 63(1): 6-15 0030-2414
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Long-term follow up of childhood tuberculous meningitis. Author(s): Department of Paediatrics and Child Health, Tygerberg Children's Hospital, South Africa.
[email protected] Source: Schoeman, J Wait, J Burger, M van Zyl, F Fertig, G van Rensburg, A J Springer, P Donald, P Dev-Med-Child-Neurol. 2002 August; 44(8): 522-6 0012-1622
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Low levels of LTB4 in cerebrospinal fluid of AIDS patients with cryptococcal meningitis. Author(s): Department of Medicine, University of Milan, Italy. Source: Froldi, M Parma, M Marenzi, R Piona, A Lorini, M Nobile Orazio, E Castagna, A Lazzarin, A J-Clin-Lab-Immunol. 1995; 47(1): 41-7 0141-2760
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Management of bacterial meningitis. Author(s): Department of Medical Microbiology, University of Liverpool, UK. Source: Hart, C A Cuevas, L E Marzouk, O Thomson, A P Sills, J J-AntimicrobChemother. 1993 July; 32 Suppl A49-59 0305-7453
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Meningitis in a girl with recurrent otitis media caused by Streptococcus pyogenes-otitis media has to be treated appropriately. Author(s): Children's Hospital, University of Leipzig, Germany.
[email protected] Source: Steppberger, K Adams, I Deutscher, J Muller, H Kiess, W Infection. 2001 October; 29(5): 286-8 0300-8126
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Migraine-like headache in bacterial meningitis. Author(s): Department of Neurology, Psychiatry and Pain Clinic, General Hospital Linz, Austria.
[email protected] Source: Lampl, C Yazdi, K Buzath, A Klingler, D Cephalalgia. 2000 October; 20(8): 738-9 0333-1024
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Neurologic evaluation of the patient with acute bacterial meningitis. Author(s): Department of Pediatrics, Loma Linda University School of Medicine, California, USA. Source: Ashwal, S Neurol-Clin. 1995 August; 13(3): 549-77 0733-8619
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Oxidant and antioxidant activities in childhood meningitis. Author(s): Department of Pediatrics, Faculty of Medicine, Fukui Medical University, Japan.
[email protected] Source: Tsukahara, H Haruta, T Todoroki, Y Hiraoka, M Noiri, E Maeda, M Mayumi, M Life-Sci. 2002 October 25; 71(23): 2797-806 0024-3205
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Oxidative stress in bacterial meningitis in humans. Author(s): Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany. Source: Kastenbauer, S Koedel, U Becker, B F Pfister, H W Neurology. 2002 January 22; 58(2): 186-91 0028-3878
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Pathologic quiz case: progressive diffuse weakness after chemotherapy for large cell lymphoma in a middle-aged woman. Lymphomatous meningitis with neurolymphomatosis. Author(s): Departments of Pathology, University of Utah Hospital, Salt Lake City, Utah, USA. Source: Carey, M J Smith, A G Townsend, J J Arch-Pathol-Lab-Med. 2000 April; 124(4): 645-6 0003-9985
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Pediatric bacterial meningitis in the emergency department. Author(s): Foote Hospital, Jackson, Michigan, USA. Source: Strawser, D J-Emerg-Nurs. 1997 August; 23(4): 310-5 0099-1767
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Penicillin therapy of spontaneous streptococcal meningitis in pigs. Author(s): Department of Veterinary Pharmacology, University of Glasgow Veterinary School, Bearsden.
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Source: McKellar, Q A Baxter, P Taylor, D Bogan, J A Vet-Rec. 1987 October 10; 121(15): 347-50 0042-4900 •
Pentoxifylline-induced aseptic meningitis in a patient with mixed connective tissue disease. Author(s): Internal Medicine Unit, Hopital Pitie-Salpetriere, Paris, France. Source: Mathian, A Amoura, Z Piette, J C Neurology. 2002 November 12; 59(9): 1468-9 0028-3878
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Phenoxymethyl penicillin potassium as an in-feed medication for pigs with streptococcal meningitis. Source: Johnston, P.I. Henry, N. Boer, R. de Braidwood, J.C. Vet-Rec-J-Br-Vet-Assoc. London : The Association. February 15, 1992. volume 130 (7) page 138-139. 0042-4900
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Pituitary abscess: an unusual presentation of “aseptic meningitis”. Author(s): Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri 64108, USA. Source: Schwartz, I D Zalles, M C Foster, J L Burry, V F J-Pediatr-Endocrinol-Metab. 1995 Apr-June; 8(2): 141-6
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Pneumococcal meningitis in children: relationship of antibiotic resistance to clinical characteristics and outcomes. Author(s): Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, TN, USA.
[email protected] Source: Buckingham, S C McCullers, J A LuJanuary Zilbermann, J Knapp, K M Orman, K L English, B K Pediatr-Infect-Dis-J. 2001 September; 20(9): 837-43 0891-3668
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Rapid diagnosis of acute pyogenic meningitis by a combined PCR dot-blot assay. Author(s): Astra Research Centre India, 18th Cross, Malleswaram, Bangalore-560003, India.
[email protected] Source: Balganesh, M Lalitha, M K Nathaniel, R Mol-Cell-Probes. 2000 April; 14(2): 61-9 0890-8508
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Rational antibiotics therapy in bacterial meningitis. Author(s): Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi. Source: Dutta, A K Bhatnagar, S K Indian-J-Pediatr. 2001 July; 68 Suppl 3: S32-9 00195456
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Recurrent central diabetes insipidus secondary to cryptococcal meningitis. Author(s): Department of Medicine, Brooklyn Veterans Administration Medical Center, New York, USA. Source: Woredekal, Y J-Assoc-Acad-Minor-Phys. 1998; 9(1): 22-4 1048-9886
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Recurrent herpes simplex virus type 2 meningitis: a case report of Mollaret's meningitis. Author(s): Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu 870-8555, Japan. Source: Kojima, Y Hashiguchi, H Hashimoto, T Tsuji, S Shoji, H Kazuyama, Y Jpn-JInfect-Dis. 2002 June; 55(3): 85-8 1344-6304
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Recurring aseptic meningitis after travel to the tropics: a case of Mollaret's meningitis? Case report with review of the literature. Author(s): Instituut voor Tropische Geneeskunde, Nationalestraat 155, 2000, Antwerpen, Belgium. Source: Wynants, H Taelman, H Martin, J J Van den Ende, J Clin-Neurol-Neurosurg. 2000 June; 102(2): 113-5 0303-8467
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Risk/benefit in the treatment of children with imipenem-cilastatin for meningitis caused by penicillin-resistant pneumococcus. Author(s): Section of Pediatric Infectious Diseases, University Hospital La Fe, Valencia, Spain. Source: Asensi, F Otero, M C Perez Tamarit, D Rodriguez Escribano, I Cabedo, J L Gresa, S Canton, E J-Chemother. 1993 April; 5(2): 133-4 1120-009X
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Sequential MRI in chronic meningitis during adrenocorticotropic hormone treatment for West syndrome. Author(s): Department of Pediatrics, Otsu Red Cross Hospital, Japan.
[email protected] Source: Go, T Childs-Nerv-Syst. 2001 August; 17(8): 497-9 0256-7040
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Spin trapping agent, phenyl N-tert-butylnitrone, reduces nitric oxide production in the rat brain during experimental meningitis. Author(s): Institute for Life Support Technology, Yamagata Public Corporation for the Development of Industry, 2-2-1 Matsuei, Yamagata 990-2473, Japan. Source: Endoh, H Kato, N Fujii, S Suzuki, Y Sato, S Kayama, T Kotake, Y Yoshimura, T Free-Radic-Res. 2001 November; 35(5): 583-91 1071-5762
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Steroids for treating tuberculous meningitis. Author(s): Neurology, All India Institute of Medical Sciences, Ansarinagar, New Delhi, Delhi, India, 110029.
[email protected] Source: Prasad, K Volmink, J Menon, G R Cochrane-Database-Syst-Revolume 2000; (3): CD002244 1469-493X
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Successful treatment of resistant cryptococcal meningitis with amphotericin B lipid emulsion after nephrotoxicity with conventional intravenous amphotericin B. Author(s): Department of Medicine, Brighton Health Care, U.K. Source: Leake, H A Appleyard, M N Hartley, J P J-Infect. 1994 May; 28(3): 319-22 01634453
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The management of cryptococcal meningitis in Papua New Guinea. Author(s): Department of Clinical Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea. Source: Seaton, R A P-N-G-Med-J. 1996 March; 39(1): 67-73 0031-1480
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The neurochemical markers in cerebrospinal fluid to differentiate between aseptic and tuberculous meningitis. Author(s): Department of Clinical Neuroscience and Family Medicine, Huddinge University Hospital, Sweden. Source: Qureshi, G A Baig, S M Bednar, I Halawa, A Parvez, S H Neurochem-Int. 1998 February; 32(2): 197-203 0197-0186
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The use of corticosteroids in the management of bacterial meningitis in adults. Author(s): Department of Internal Medicine, University of Virginia, Charlottesville 22908, USA. Source: Townsend, G C Scheld, W M J-Antimicrob-Chemother. 1996 June; 37(6): 1051-61 0305-7453
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Transient diabetes insipidus following Escherichia coli meningitis complicated by ventriculoperitoneal shunt. Author(s): Department of Pediatrics, Firat University Medical School, Elazig, Turkey. Source: Kabakus, N Yilmaz, B Aydinoglu, H Serhathoglu, S J-Endocrinol-Invest. 1999 November; 22(10): 800-2 0391-4097
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Transitional cell carcinomatous meningitis after M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) chemotherapy. Author(s): Urology Service, Walter Reed Army Medical Center, Washington, D.C. Source: Bishop, J R Moul, J W Maldonado, L McLeod, D G Urology. 1990 October; 36(4): 373-7 0090-4295
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Tuberculous meningitis. 23 cases from a 12-year period (1976-1987). Author(s): Department of Infectious Diseases, Rigshospitalet, Copenhagen. Source: Jensen, T H Magnussen, P Eriksen, N H Skinhoj, P Dan-Med-Bull. 1990 October; 37(5): 459-62 0907-8916
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Vasculitic complications associated with coccidioidal meningitis. Author(s): Visalia Medical Clinic, Inc., Visalia, CA. Source: Williams, P L Semin-Respir-Infect. 2001 December; 16(4): 270-9 0882-0546
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND MENINGITIS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to meningitis. 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 meningitis 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 “meningitis” (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 meningitis: •
A placebo-controlled trial of maintenance therapy with fluconazole after treatment of cryptococcal meningitis in the acquired immunodeficiency syndrome. California Collaborative Treatment Group. Author(s): Bozzette SA, Larsen RA, Chiu J, Leal MA, Jacobsen J, Rothman P, Robinson P, Gilbert G, McCutchan JA, Tilles J, et al. Source: The New England Journal of Medicine. 1991 February 28; 324(9): 580-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1992319&dopt=Abstract
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Acute confusion, Chinese herbal medicines and tuberculous meningitis. Author(s): Chan JC, Tomlinson B, Kay R, Chan TY, Critchley JA. Source: Aust N Z J Med. 1994 October; 24(5): 590-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7848176&dopt=Abstract
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An outbreak of pneumonia and meningitis caused by a previously undescribed gramnegative bacterium in a hot spring spa.
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Author(s): Hubert B, de Mahenge A, Grimont F, Richard C, Peloux Y, de Mahenge C, Fleurette J, Grimont PA. Source: Epidemiology and Infection. 1991 October; 107(2): 373-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1936159&dopt=Abstract •
Antiviral activity of higher plants and propionin on lymphocytic choriomeningitis infection. Author(s): Furusawa E, Ramanathan S, Furusawa S, Woo YK, Cutting W. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1967 May; 125(1): 234-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4961253&dopt=Abstract
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Antiviral activity of higher plants on lymphocytic choriomeningitis infection in vitro and in vivo. Author(s): Furusawa E, Cutting W. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1966 May; 122(1): 280-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4957672&dopt=Abstract
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Aseptic meningitis associated with Ehrlichia canis infection. Author(s): Golden SE. Source: The Pediatric Infectious Disease Journal. 1989 May; 8(5): 335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2726324&dopt=Abstract
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Bacillus species pseudomeningitis. Author(s): Lettau LA, Benjamin D, Cantrell HF, Potts DW, Boggs JM. Source: Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America. 1988 September; 9(9): 394-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3171138&dopt=Abstract
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Bacterial meningitis and lumbar epidural hematoma due to lumbar acupunctures: a case report. Author(s): Chen CY, Liu GC, Sheu RS, Huang CL. Source: Kaohsiung J Med Sci. 1997 May; 13(5): 328-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9226976&dopt=Abstract
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Bacterial meningitis observed in a phase I trial of vinorelbine, cisplatin and thoracic radiotherapy for non-small cell lung cancer: report of a case and discussion on doselimiting toxicity. Author(s): Sekine I, Matsuda T, Saisho T, Watanabe H, Yamamoto N, Kunitoh H, Ohe Y, Tamura T, Kodama T, Saijo N.
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Source: Japanese Journal of Clinical Oncology. 2000 September; 30(9): 401-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11095138&dopt=Abstract •
Balneatrix alpica gen. nov., sp. nov., a bacterium associated with pneumonia and meningitis in a spa therapy center. Author(s): Dauga C, Gillis M, Vandamme P, Ageron E, Grimont F, Kersters K, de Mahenge C, Peloux Y, Grimont PA. Source: Research in Microbiology. 1993 January; 144(1): 35-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8327781&dopt=Abstract
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Binding of mannan-binding protein to various bacterial pathogens of meningitis. Author(s): van Emmerik LC, Kuijper EJ, Fijen CA, Dankert J, Thiel S. Source: Clinical and Experimental Immunology. 1994 September; 97(3): 411-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8082295&dopt=Abstract
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Capnocytophaga canimorsus meningitis in a newborn: an avoidable infection. Author(s): Rosenman JR, Reynolds JK, Kleiman MB. Source: The Pediatric Infectious Disease Journal. 2003 February; 22(2): 204-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12613462&dopt=Abstract
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Comparison of counterimmunoelectrophoresis, latex agglutination and bacterial culture for the diagnosis of bacterial meningitis using urine, serum and cerebrospinal fluid samples. Author(s): Requejo HI, Nascimento CM, Fahrat CK. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 1992; 25(4): 357-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1342212&dopt=Abstract
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Congenital lymphocytic choriomeningitis virus infection: decade of rediscovery. Author(s): Barton LL, Mets MB. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 August 1; 33(3): 370-4. Epub 2001 July 05. Review. Erratum In: Clin Infect Dis 2001 October 15; 33(8): 1445. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11438904&dopt=Abstract
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Cryptococcal meningitis in a patient with Hodgkin's lymphoma. Author(s): Rajkumar K, Rajkumar T, Sagar TG, Maitreyan V, Shanta V. Source: J Assoc Physicians India. 1991 October; 39(10): 785. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1816214&dopt=Abstract
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Cryptococcal meningitis in Papua New Guinea: ecology and the role of eucalypts. Author(s): Laurenson I, Naraqi S, Howcroft N, Burrows I, Saulei S.
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Source: The Medical Journal of Australia. 1993 February 1; 158(3): 213. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8450794&dopt=Abstract •
Cryptococcal meningitis. Author(s): Tjia TL, Yeow YK, Tan CB. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1985 September; 48(9): 853-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4045478&dopt=Abstract
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Development of a protocol for early treatment of endemic meningitis in children in Vanuatu. Author(s): Harris M, Carrol K, Carrol C. Source: J Trop Med Hyg. 1991 February; 94(1): 8-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1995940&dopt=Abstract
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Effect of catalase on regional cerebral blood flow and brain edema during the early phase of experimental pneumococcal meningitis. Author(s): Pfister HW, Kodel U, Dirnagl U, Haberl RL, Ruckdeschel G, Einhaupl KM. Source: The Journal of Infectious Diseases. 1992 December; 166(6): 1442-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1431262&dopt=Abstract
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Eosinophilic meningitis beyond the Pacific Basin: the global dispersal of a peridomestic zoonosis caused by Angiostrongylus cantonensis, the nematode lungworm of rats. Author(s): Kliks MM, Palumbo NE. Source: Social Science & Medicine (1982). 1992 January; 34(2): 199-212. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1738873&dopt=Abstract
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Eosinophilic meningitis due to Angiostrongylus cantonensis. Author(s): Fuller AJ, Munckhof W, Kiers L, Ebeling P, Richards MJ. Source: The Western Journal of Medicine. 1993 July; 159(1): 78-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8123100&dopt=Abstract
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Further studies of antiviral activity of natural products on lymphocytic choriomeningitis infection. Author(s): Furusawa E, Furusawa S, Ramanathan S, Cutting W. Source: Chemotherapy. 1968; 13(3): 172-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5660664&dopt=Abstract
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Haemophilus influenzae meningitis: an evolving therapeutic regimen. Author(s): Barkin RM, Greer CC, Schumacher CJ, McIntosh K.
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Source: Am J Dis Child. 1976 December; 130(12): 1318-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1087110&dopt=Abstract •
Haemopoietic defects in mice infected with lymphocytic choriomeningitis virus. 1. The enhanced x-ray sensitivity of virus infected mice. Author(s): Bro-Jorgensen K, Volkert M. Source: Acta Pathol Microbiol Scand [b] Microbiol Immunol. 1972; 80(6): 845-52. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4509394&dopt=Abstract
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Hearing loss and pneumococcal meningitis: an animal model. Author(s): Bhatt S, Halpin C, Hsu W, Thedinger BA, Levine RA, Tuomanen E, Nadol JB Jr. Source: The Laryngoscope. 1991 December; 101(12 Pt 1): 1285-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1766298&dopt=Abstract
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Hypertrophic chronic pachymeningitis as a localized immune process in the craniocervical region. Author(s): Voller B, Vass K, Wanschitz J, Machold K, Asenbaum S, Hoberstorfer M, Auff E. Source: Neurology. 2001 January 9; 56(1): 107-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11148246&dopt=Abstract
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Hyperventilation as the initial manifestation of lymphomatous meningitis. Author(s): Karp G, Nahum K. Source: Journal of Neuro-Oncology. 1992 June; 13(2): 173-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1279132&dopt=Abstract
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Idiopathic hypertrophic cranial pachymeningitis with accumulation of thallium-201 on single-photon emission CT. Author(s): Nishioka H, Ito H, Haraoka J, Yamada Y, Nojima H. Source: Ajnr. American Journal of Neuroradiology. 1998 March; 19(3): 450-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9541297&dopt=Abstract
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Imipenem resistance in a case of AIDS with relapsing Pseudomonas meningitis. Author(s): Eng RH, Lynch AM, Smith SM, Ambros RA, Fan-Havard P, Mangia A, Tecson-Tumang F, Cherubin C. Source: Southern Medical Journal. 1990 August; 83(8): 979-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2116669&dopt=Abstract
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Immunodiagnosis of pneumococcal meningitis using immunosorbent assay. Author(s): Requejo HI, das Gracas M, Alkmin A, Landgraf IM.
Dot-enzyme-linked
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Source: Journal of Tropical Pediatrics. 2001 October; 47(5): 288-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11695728&dopt=Abstract •
Incompatibilities of professional and religious ideology: problems of medical management and outcome in a case of pediatric meningitis. Author(s): Redlener IE, Scott CS. Source: Soc Sci Med [med Anthropol]. 1979 April; 13B(2): 89-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=505059&dopt=Abstract
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Intrathecal administration of etoposide in the treatment of malignant meningitis: feasibility and pharmacokinetic data. Author(s): van der Gaast A, Sonneveld P, Mans DR, Splinter TA. Source: Cancer Chemotherapy and Pharmacology. 1992; 29(4): 335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1311219&dopt=Abstract
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Isolated leptomeningeal carcinomatosis (carcinomatous meningitis) after taxaneinduced major remission in patients with advanced breast cancer. Author(s): Kosmas C, Malamos NA, Tsavaris NB, Stamataki M, Gregoriou A, Rokana S, Vartholomeou M, Antonopoulos MJ. Source: Oncology. 2002; 63(1): 6-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187065&dopt=Abstract
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Isolation of parainfluenza virus type 3 from cerebrospinal fluid associated with aseptic meningitis. Author(s): Craver RD, Gohd RS, Sundin DR, Hierholzer JC. Source: American Journal of Clinical Pathology. 1993 June; 99(6): 705-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8391749&dopt=Abstract
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Long-term impairments of brain and auditory functions of children recovered from purulent meningitis. Author(s): Jiang ZD, Liu XY, Wu YY, Zheng MS, Liu HC. Source: Developmental Medicine and Child Neurology. 1990 June; 32(6): 473-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2365140&dopt=Abstract
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Meningitis from canine Pasteurella multocida following mastoidectomy. Author(s): Dammeijer PF, McCombe AW. Source: The Journal of Laryngology and Otology. 1991 July; 105(7): 571-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1875142&dopt=Abstract
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Meningitis with Burkitt like B-cell lymphoma in HIV infection. Author(s): Bomfim da Paz R, Kolmel HW.
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Source: Journal of Neuro-Oncology. 1992 May; 13(1): 73-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1613539&dopt=Abstract •
Neuroretinitis, aseptic meningitis, and lymphadenitis associated with Bartonella (Rochalimaea) henselae infection in immunocompetent patients and patients infected with human immunodeficiency virus type 1. Author(s): Wong MT, Dolan MJ, Lattuada CP Jr, Regnery RL, Garcia ML, Mokulis EC, LaBarre RA, Ascher DP, Delmar JA, Kelly JW, et al. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1995 August; 21(2): 352-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8562744&dopt=Abstract
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Observations with a variant of lymphocytic choriomeningitis virus in mouse tumors. Author(s): Eiselein J, Biggs MW. Source: Cancer Research. 1970 July; 30(7): 1953-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4989547&dopt=Abstract
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Pasteurella multocida meningitis following orbital exenteration. Author(s): Dolman PJ, Ezzat S, Rootman J, Bowie WR. Source: American Journal of Ophthalmology. 1988 June 15; 105(6): 698-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3377053&dopt=Abstract
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Pasteurella multocida meningitis in infancy - (a lick may be as bad as a bite). Author(s): Wade T, Booy R, Teare EL, Kroll S. Source: European Journal of Pediatrics. 1999 November; 158(11): 875-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10541939&dopt=Abstract
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Pasteurella multocida meningitis in infancy. An avoidable infection. Author(s): Clapp DW, Kleiman MB, Reynolds JK, Allen SD. Source: Am J Dis Child. 1986 May; 140(5): 444-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3962937&dopt=Abstract
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Pathologic quiz case: progressive diffuse weakness after chemotherapy for large cell lymphoma in a middle-aged woman. Lymphomatous meningitis with neurolymphomatosis. Author(s): Carey MJ, Smith AG, Townsend JJ. Source: Archives of Pathology & Laboratory Medicine. 2000 April; 124(4): 645-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10747335&dopt=Abstract
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Prevention of hearing loss in experimental pneumococcal meningitis administration of dexamethasone and ketorolac. Author(s): Rappaport JM, Bhatt SM, Burkard RF, Merchant SN, Nadol JB Jr.
by
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Source: The Journal of Infectious Diseases. 1999 January; 179(1): 264-8. Erratum In: J Infect Dis 1999 March; 179(3): 753. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9841852&dopt=Abstract •
Primary pseudomonas meningitis in an adult, splenectomized, multitransfused thalassaemia major patient. Author(s): Ghosh K, Daar S, Hiwase D, Nursat N. Source: Haematologia. 2000; 30(1): 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10841329&dopt=Abstract
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Regional cerebral blood flow during hyperventilation in patients with acute bacterial meningitis. Author(s): Moller K, Hogh P, Larsen FS, Strauss GI, Skinhoj P, Sperling BK, Knudsen GM. Source: Clinical Physiology (Oxford, England). 2000 September; 20(5): 399-410. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971552&dopt=Abstract
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Transitional cell carcinomatous meningitis after M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) chemotherapy. Author(s): Bishop JR Jr, Moul JW, Maldonado L, McLeod DG. Source: Urology. 1990 October; 36(4): 373-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2219624&dopt=Abstract
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Treatment of carcinomatous meningitis from transitional cell carcinoma of the bladder. Author(s): Raghavan D, Chye RW. Source: British Journal of Urology. 1991 April; 67(4): 438-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2032089&dopt=Abstract
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Treatment of malignant meningitis in retinoblastoma. Author(s): Stannard CE, Sealy R, Sevel D, Brinton FA. Source: The British Journal of Ophthalmology. 1975 July; 59(7): 362-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1242674&dopt=Abstract
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Update on bacterial meningitis. Author(s): Kaplan SL, Fishman MA. Source: Journal of Child Neurology. 1988 April; 3(2): 82-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3286749&dopt=Abstract
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to meningitis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Integrative Medicine Communications; www.drkoop.com Histoplasmosis Source: Integrative Medicine Communications; www.drkoop.com Lyme Disease Source: Integrative Medicine Communications; www.drkoop.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com Seizure Disorders Source: Integrative Medicine Communications; www.drkoop.com
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Tuberculosis Source: Integrative Medicine Communications; www.drkoop.com •
Alternative Therapy Osteopathy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,724,00.html
•
Chinese Medicine Angong Niuhuang San Alternative names: (An Gong Niu Huang San) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Angong%20Niuhuang%20San &mh=10&sb=---&view_records=View+Records Nambaniangan Alternative names: Baphicacanthus Root; Rhizoma et Radix Baphicacanthis Cusae Source: Chinese Materia Medica
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Herbs and Supplements Aloe Alternative names: Aloe vera, Aloe barbadensis, Aloe ferox , Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Fluconazole 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.
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CHAPTER 4. DISSERTATIONS ON MENINGITIS Overview In this chapter, we will give you a bibliography on recent dissertations relating to meningitis. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “meningitis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on meningitis, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Meningitis ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to meningitis. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Comparative Study of Children Who Have Recovered from Aseptic Meningitis and Their Unaffected Siblings. by Rosen, Linda Merle, Phd from University of Pittsburgh, 1978, 158 pages http://wwwlib.umi.com/dissertations/fullcit/7817276
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Meningitis in South African Adults: an Evaluation of Prognostic Indicators, Impact of Hiv-infection, and Diagnostic Dilemmas by Schutte, Clara-maria; Md from University of Pretoria (south Africa), 2002 http://wwwlib.umi.com/dissertations/fullcit/f304497
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Sequelae of H. Influenzae Meningitis in Children by Topp, Sylvia, Phd from Boston College, 1980, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8017619
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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND MENINGITIS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning meningitis.
Recent Trials on Meningitis The following is a list of recent trials dedicated to meningitis.8 Further information on a trial is available at the Web site indicated. •
DepoCyt Therapy in Patients with Neoplastic Meningitis from Lymphoma or a Solid Tumor Condition(s): Meningeal Neoplasms Study Status: This study is currently recruiting patients. Sponsor(s): SkyePharma Purpose - Excerpt: The purpose of this study is to find out how well an experimental drug called DepoCyt works for neoplastic meningitis (cancer that has spread to the tissues around the brain and spinal cord). DepoCyt is a new slow-release form of the cancer drug called ara-C (cytarabine). Cytarabine has been used for many years to treat cancer. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00029523
•
Gemcitabine in Treating Neoplastic Meningitis in Patients With Leukemia, Lymphoma, or Solid Tumors Condition(s): leptomeningeal metastases Study Status: This study is currently recruiting patients.
8
These are listed at www.ClinicalTrials.gov.
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Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase I trial to study the effectiveness of gemcitabine in treating neoplastic meningitis in patients who have leukemia, lymphoma, or solid tumors. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00052806 •
Intrathecal Gemcitabine in Treating Patients With Cancer and Neoplastic Meningitis Condition(s): leptomeningeal metastases Study Status: This study is currently recruiting patients. Sponsor(s): Baylor College of Medicine Purpose - Excerpt: RATIONALE: Giving gemcitabine intrathecally may be an effective treatment for neoplastic meningitis. PURPOSE: Phase I trial to study the effectiveness of intrathecal gemcitabine in treating patients who have cancer and neoplastic meningitis. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00039143
•
Safety and Antifungal Activity of Recombinant Interferon-gamma 1b (rIFN-gamma 1b) Given with Standard Therapy in Patients with Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): InterMune Pharmaceuticals Purpose - Excerpt: The purpose of this study is to examine the antifungal activity of recombinant interferon-gamma 1b (rIFN-gamma 1b) given with standard antifungal therapy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00012467
•
A Comparison of Fluconazole and Amphotericin B in the Treatment of Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer
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Purpose - Excerpt: To compare the safety and effectiveness of fluconazole and amphotericin B, alone or in combination with flucytosine, as treatment for acute cryptococcal meningitis. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002305 •
A Multicenter Comparison of Fluconazole (UK-49,858) and Amphotericin B as Treatment for Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the safety and effectiveness of fluconazole and amphotericin B, alone or in combination with flucytosine, as treatment for acute cryptococcal meningitis. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002068
•
A Pilot Study of Fluconazole Plus Flucytosine for the Treatment of AIDS Patients With Acute Cryptococcal Meningitis. Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To evaluate and estimate the safety and efficacy of the combination of fluconazole and flucytosine as treatment for acute cryptococcal meningitis in patients with AIDS. Fluconazole and flucytosine have different mechanisms of action. Since fluconazole has not been associated with hematologic suppression and does not produce renal impairment that can result in higher serum flucytosine levels, this combination may be better tolerated than is amphotericin B plus flucytosine. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002113
•
A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and
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safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000639 •
A Study of Fluconazole in the Treatment of Cryptococcal Meningitis in Patients Who Have Not Had Success with Amphotericin B Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To evaluate the safety and effectiveness of fluconazole as treatment for acute cryptococcal meningitis in patients who have had an unsatisfactory response to or have experienced unacceptable toxicity with amphotericin B. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002306
•
A Study of Fluconazole in the Treatment of Cryptococcal Meningitis in Patients with AIDS Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the safety and effectiveness of fluconazole with that of placebo as maintenance treatment for preventing the relapse of cryptococcal meningitis in patients with AIDS. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002294
•
An Open, Non-Comparative Study of Intravenous and Oral Fluconazole in the Treatment of Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To evaluate the safety and effectiveness of fluconazole as an intravenous dose as initial treatment for acute cryptococcal meningitis followed by oral therapy in AIDS and non-AIDS patients. Lack of satisfactory response will allow increase of dose. Both newly diagnosed and relapsed patients are eligible. Study Type: Interventional Contact(s): see Web site below
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Web Site: http://clinicaltrials.gov/ct/show/NCT00002077 •
Comparison of Fluconazole and Amphotericin B in the Treatment of Brain Infections in Patients with AIDS Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer; National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To compare the safety and effectiveness of a new drug, fluconazole, with that of the usual therapy, amphotericin B, in the prevention of a relapse of cryptococcal meningitis (CM) in patients with AIDS who have been successfully treated for acute CM in the last 6 months. Cryptococcal meningitis is a life-threatening infectious complication of AIDS. Because relapse after treatment occurs in over 50 percent of cases, chronic maintenance therapy with intravenous (IV) amphotericin B is usually given. However, amphotericin B is not always effective, has toxic effects, and must be given by the intravenous route. Fluconazole is an antifungal agent that can be given orally and has been shown to be effective against cryptococcal infections in animals and against acute CM in a few AIDS patients. Also, the side effects experienced by over 2000 patients or volunteers given fluconazole have seldom been severe enough to require withdrawal of the drug. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001017
•
Dexamethasone in Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To evaluate the effect of corticosteroids on reducing elevated intracranial pressure in cryptococcal meningitis. To evaluate the safety of corticosteroids in patients with cryptococcal meningitis and intracranial hypertension. In AIDS patients with cryptococcal meningitis, a correlation has been found between early death and elevated intracranial pressure. Since dexamethasone has been found to reduce intracranial pressure resulting from other forms of meningitis, it may be of benefit in AIDS patients with cryptococcal meningitis. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000776
•
Multicenter Comparison of Fluconazole (UK-49,858) and Amphotericin B as Maintenance Treatment for the Prevention of Relapse of Cryptococcal Meningitis in Patients With Acquired Immunodeficiency Syndrome Condition(s): Meningitis, Cryptococcal; HIV Infections
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Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the safety and effectiveness of fluconazole and amphotericin B as maintenance treatment for preventing the relapse of cryptococcal meningitis in patients with AIDS. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002074 •
Multi-center Comparison of Fluconazole (UK-49,858) and Amphotericin B as Treatment for Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To compare the safety and effectiveness of fluconazole (FCZ) and amphotericin B (AMB), alone or in combination with flucytosine (FLC), as treatment for acute cryptococcal meningitis in patients who have not been treated previously or who have relapsed after a previous successful treatment. Cryptococcal meningitis is an important cause of disease and death among patients with AIDS. Usually AMB is given either alone or with FLC to patients with this infection, but these treatments are not always effective and both have toxic effects. Animal studies and preliminary studies in humans show that FCZ is active in cryptococcal meningitis and suggest that it may be less toxic than either AMB or FLC. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000708
•
Multicenter Comparison of Fluconazole (UK-49,858) and Amphotericin B as Treatment for Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the safety and effectiveness of fluconazole and amphotericin B, alone or in combination with flucytosine, as treatment for acute cryptococcal meningitis. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002075
•
Open, Non-comparative Study of Fluconazole in Patients With Coccidioidal Meningitis Condition(s): Meningitis; HIV Infections Study Status: This study is completed.
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Sponsor(s): Pfizer Purpose - Excerpt: The study is intended to examine the efficacy of fluconazole for the treatment of coccidioidal meningitis in patients with new onset of infection, relapse of previous infection, or failed previous therapy. Drug efficacy, safety and tolerance will be examined. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002010 •
Open, Non-Comparative Study of Intravenous and Oral Fluconazole in the Treatment of Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To evaluate the safety and effectiveness of fluconazole as an intravenous dose as initial treatment for acute cryptococcal meningitis followed by oral therapy in AIDS and non-AIDS patients. Both newly diagnosed and relapsed patients are eligible. The effectiveness of maintenance fluconazole therapy in sustaining a clinical cure in AIDS patients will also be evaluated. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002040
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Pilot Study of Oral Fluconazole in the Treatment of Acute Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To evaluate the safety and effectiveness of fluconazole as treatment for acute cryptococcal meningitis in AIDS patients. Both newly diagnosed and relapsed patients are eligible. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002076
•
Safety and Efficacy of Amphotericin B Lipid Complex in the Treatment of Cryptococcal Meningitis in Patients With the Acquired Immunodeficiency Syndrome Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Liposome Purpose - Excerpt: To evaluate the safety, tolerance and efficacy of three different dosage regimens of Amphotericin B Lipid Complex (ABLC) compared to Fungizone (Amphotericin B) in patients with AIDS and cryptococcal meningitis. Study Type: Interventional
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002019 •
SCH 39304 as Therapy for Acute Cryptococcal Meningitis in HIV-Infected Patients Followed by Maintenance Therapy Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID); ScheringPlough Purpose - Excerpt: To assess the safety and effectiveness of SCH 39304 as primary treatment of acute cryptococcal meningitis in HIV-infected patients. Safety and effectiveness of maintenance therapy following successful treatment of acute disease are also evaluated. Cryptococcal meningitis is a significant cause of illness and death in HIV-infected patients. Intravenous amphotericin B is effective for acute disease but relapse occurs in the majority of patients. Maintenance therapy is recommended but must be balanced against the multiple toxicities of the drugs used and the problems associated with the weekly administration of intravenous therapy. Treatments that are equally or more effective and less toxic than traditional methods are needed, especially oral therapy. SCH 39304 is an orally active antifungal drug that in animal studies is active against a wide range of systemic fungal infections including infections due to Cryptococcus. Features of SCH 39304 suggest that it might be of value in the treatment of cryptococcal meningitis. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000677
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The Safety and Effectiveness of RMP-7 Plus Amphotericin B in Patients with HIV and Cryptococcal Meningitis Condition(s): Meningitis, Cryptococcal; HIV Infections Study Status: This study is completed. Sponsor(s): Alkermes Purpose - Excerpt: To evaluate the safety of escalating doses of RMP-7 administered in persons with HIV infection and cryptococcal meningitis and to determine the MTD of the drug. To evaluate the pharmacokinetics, including cerebrospinal fluid (CSF) penetration, of amphotericin B when administered with RMP-7. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002316
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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “meningitis” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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•
For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON MENINGITIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “meningitis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on meningitis, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Meningitis By performing a patent search focusing on meningitis, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on meningitis: •
Antibodies which bind meningitis related homologous antigenic sequences Inventor(s): Van Alstyne; Diane (Vancouver, CA), Sharma; Lawrence R. (Vancouver, CA) Assignee(s): Insight Biotech Inc. (St. Michael, BB) Patent Number: 5,510,264 Date filed: September 28, 1993 Abstract: Monoclonal antibodies capable of binding to a Meningitis Related Homologous Antigenic Sequence (MRHAS) are provided. The MRHAS is found in meningitis-causing organisms and chemokines involved in cell chemotaxis. The monoclonal antibodies are useful for detection and diagnosis of meningitis. Excerpt(s): This invention relates to the application of immunological techniques that provide novel materials useful in the diagnosis, treatment and vaccination against meningitis caused by either bacterial or viral agents. These techniques include the production and application of novel monoclonal antibodies, peptides, and mixtures and combinations thereof that are useful for detecting meningitis infections. The techniques also include eliciting antibodies specific to meningitis causing agents. These immunological techniques may also be applied to the treatment of such disease. The term meningitis is a general one, referring to the inflammatory response to infection of the meninges and the cerebrospinal fluid (CSF). See Roos, "Chapter 16", in Scheld, et al. eds., 1991, Infections of the Central Nervous System:335-403 which is incorporated herein in its entirety by reference. The fact that the inflammatory response occurs in the proximity of the brain and in the space limited by a rigid cranium, makes these infections serious and life threatening. Most patients exhibit nonspecific clinical signs and symptoms such as fever, irritability, altered mental status usually accompanied by vomiting and loss of appetite. In children one year of age and older, photophobia and headache are common complaints. Specific clinical signs indicative of meningitis are neck rigidity and pain on neck flexion. Brudzinski's sign (neck flexion producing knee and hip flexion) and Kernig's sign (difficulty and pain in raising extended leg) are other useful clinical signs. Web site: http://www.delphion.com/details?pn=US05510264__
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Combined meningitis vaccine Inventor(s): Costantino; Paolo (Colle Val D'Elsa, IT), D'Ascenzi; Sandro (Colle Val D'Elsa, IT), Norelli; Francesco (Siena, IT), Giannozzi; Aldo (Siena, IT), Ceccarini; Costante (Castelnuovo Berardenga, IT) Assignee(s): Chiron S.p.A. (Siena, IT) Patent Number: 6,251,401 Date filed: May 1, 1997 Abstract: A combined vaccine for bacterial meningitis comprises Hib and MenC oligosaccharide conjugates.
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Excerpt(s): The present invention relates to a combined vaccine for the treatment of bacterial meningitis. In particular, the combined vaccine effectively protects against infection by Haemophilus influenzae type B (Hib) and Neisseria meningitidis (meningococcus) serotypes B and C (MenB, MenC). Bacterial meningitis caused by infection with Hib, MenB and/or MenC represents a worldwide problem. Infection by these organisms can result in permanent disability and death among young children. Recently, however, a conjugate Hib vaccine has become generally available and has resulted in the effective control of Hib infections. Similar vaccines are shortly to become available for MenC infection and also for MenB infection (see Costantino et al., 1992 Vaccine, 10,691-698). The Hib and meningococcal vaccines are based on conjugates between oligosaccharides derived from the bacterial surface, which define epitopes specific for the bacterium in question, conjugated to carrier proteins, such as non-toxic mutants of diphtheria toxin, for example CRM197. Web site: http://www.delphion.com/details?pn=US06251401__ •
Method for differential diagnosis of meningitis with a limulus lysate test Inventor(s): Khan; Waheed N. (Potomac, MD) Assignee(s): Research Foundation of Children's Hospital (Washington, DC) Patent Number: 4,067,776 Date filed: November 25, 1975 Abstract: A method for rapid bedside diagnostic differentiation between aseptic meningitis and Gram-negative bacterial meningitis is carried out in a positive control vessel, a negative control vessel and a test vessel, wherein each vessel contains an equal amount of lyophilized limulus lysate and the positive control vessel also contains an amount of lyophilized Gram-negative bacterial endotoxin. Excerpt(s): As is known in the art, meningitis may be broadly characterized as aseptic meningitis or bacterial meningitis. Aseptic meningitis may refer to two different but related forms of meningitis. Firstly, it may be referring to an acute febrile illness with meningeal irritation and cerebro-spinal fluid (CSF) pleocytosis, but with normal glucose contents and on culture of the CSF no bacterial isolation is obtained. The second form of aseptic meningitis can be characterized by CSF pleocytosis, normal glucose and the absence of organism involvement. This can include not only viral but other infections as well as non-infectious causes. When viral infections of the central nervous system are invovled, these infections may take three different forms. In the first form, there may be no symptoms and only fever and malaise, but the CSF may be abnormal with a lymphocytic pleocytosis. In a second form, the symptoms may be confined to meningeal manifestations, such as fever, headache, vomiting, stiff neck and back and the like. In the third form, referred to as encephalitis, the meningeal symptoms, noted above, may be accompanied by cerebral disorders including alterations of consciousness, personality changes and the like. Bacterial meningitis may be caused by one or more of several known bacteria. Among the generally accepted bacteria are the Gram-negative bacteria Neisseria meningitidis, Haemophilus influenzae, Escherichia coli, Salmonella enteridis (or group B), Proteus species (indole positive and negative) and Pseudomonas arugeniosa, and the Gram-positive bacteria, Diplococcus pneumoniae, Strepococcus pyogenes, and Straphylococcus aureus. In bacterial meningitis, clinical indications show brain and meninges involvement. Some of the clinical signs can include fever, headache, stiff neck and vomiting. Thus, from a clinical observation, it is difficult to tell whether aseptic meningitis or bacterial meningitis is involved, since the clinical symptoms of the
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different forms of meningitis can be, at least, overlapping in their manifestations. However, the proper treatment for the forms of meningitis vary significantly, and a rapid and positive diagnosis of the form of meningitis is extremely important in the treatment of meningitis. If the meningitis is diagnosed as bacterial meningitis, the more usual therapy involves administration of antibiotics, of specific types, and such administration should be given as promptly as possible once the diagnosis has been established. The prompt commencement of the thereapy is fundamental to the more successful treatment of bacterial meningitis. Web site: http://www.delphion.com/details?pn=US04067776__ •
Method of discriminating bacterial from aseptic meningitis Inventor(s): Stahel; Phillip (Birmingham, AL), Barnum; Scott R. (Sterrett, AL) Assignee(s): UAB Research Foundation (Birmingham, AL) Patent Number: 5,778,895 Date filed: January 29, 1997 Abstract: The present invention provides a method for the differential diagnosis of bacterial meningitis in an individual in need of such diagnosis, comprising the steps of: measuring the levels of complement C3 and complement factor B in the cerebrospinal fluid of the individual; and determining whether that individual has bacterial menigitis based on the levels of complement C3 and complement factor B in the cerebrospinal fluid of that individual. Also provided is a method for the differential diagnosis of bacterial menigitis in an individual in need of such diagnosis, comprising the steps of: measuring the levels of complement factor B in a sample from the individual; and determining whether that individual has bacterial menigitis based on the levels of complement factor B in the sample from that individual. Excerpt(s): The present invention relates generally to the fields of medicine, neuroimmunology and protein chemistry. More specifically, the present invention relates to a method of discriminating bacterial from aseptic meningitis. Bacterial meningitis occurs in about 25,000 cases per year in the United States with an overall mortality rate of from 10-35%. About 30% of individuals with acute bacterial meningitis experience seizures and about 10-30% of those who survive a case of bacterial meningitis exhibit long-term neurological sequelae. Bacterial meningitis remains a major cause of morbidity and mortality, with a high incidence of residual neurological impairment (reviewed in Quagliarello & Scheld 1992). Early diagnosis and immediate onset of adequate antimicrobial treatment are essential for the survival of patients with bacterial meningitis (Lieu et al. 1992). However, establishing the diagnosis of bacterial meningitis represents a difficult task in most cases, since clinical signs of acute meningitis are non-specific, and laboratory examinations of cerebrospinal fluid (CSF) often do not accurately differentiate between bacterial and aseptic meningitis (Lindquist et al. 1988, Rodewald et al. 1991). Accurate differentiation between bacterial and aseptic (viral) meningitis is difficult as both are inflammatory diseases that elicit similar host defense responses and clinical symptoms. Differential diagnosis can be made on positive identification of the bacteria from the cerebrospinal fluid of the affected individual. Unfortunately, it may take several days to grow and identify the bacteria and twentyfive percent of the time culture results are negative or equivocal even though the patients have bacterial meningitis. Similar or greater error rates affect nearly every laboratory parameter used for diagnostic purposes.
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Web site: http://www.delphion.com/details?pn=US05778895__ •
Method of treating bacterial meningitis with anti-tumor necrosis factor antibody Inventor(s): Hector; Richard F. (Dublin, CA), Collins; Michael S. (Madison, CT) Assignee(s): Bayer Corporation (Berkeley, CA) Patent Number: 5,616,321 Date filed: March 23, 1995 Abstract: Bacterial meningitis infection in a mammal is treated by intravenous infusion of a therapeutically effective amount of a monoclonal antibody which binds to tumor necrosis factor alpha and an antibiotic. Treatment can be initiated up to five hours after bacterial challenge and the antibiotic is preferably selected from cephalosporins and aminoglycosides. Excerpt(s): This application is concerned generally with a treatment of infection and specifically with the use of monoclonal antibodies that bind to TNF to treat bacterial meningitis. Bacterial meningitis remains one of the more difficult management problems in clinical medicine. Evidence suggests that bacterial meningitis represents infection in a site with a reduced potential for host resistance. With essentially no antibodies or complement present in the spinal fluid, polymorphonucleocytes are essentially unable to contribute to the clearing of the intruding bacteria in the early steps of disease. Morbidity and mortality from bacterial meningitis remains high; a death rate of 30% for pneumococcal meningitis has not changed over the past 40 years despite new antibiotics and improved understanding of therapy practices. Bacterial meningitis is described in detail in Cecil, Textbook of Medicine, 19th addition at pages 1655-161, the details of which are incorporated into this application. The role of tumor necrosis factor (TNF) in bacterial meningitis is described in an article by Arditi et al. in the Journal of Infectious Diseases, 162:p. 139-145(1990). See also related articles by Arditi et al., in the Journal of Infectious Diseases, vol. 160, no. 6, pp. 1005-1011, December 1989 and an article by Mustafa et al., the Journal of Infectious Diseases, vol. 160, no. 5, pp. 818-825, November 1989. Web site: http://www.delphion.com/details?pn=US05616321__
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PCR assay for bacterial and viral meningitis Inventor(s): Glustein; Joseph Z. (Pittsburgh, PA), Ehrlich; Garth D. (Pittsburgh, PA), Zhang; Yingze (Pittsburgh, PA) Assignee(s): University of Pittsburgh (Pittsburgh, PA) Patent Number: 6,258,570 Date filed: April 17, 1998 Abstract: A multiplex assay is provided for the simultaneous detection and discrimination of pathogens that cause bacterial and viral meningitis. Excerpt(s): The present invention relates generally to methods for clinically distinguishing between bacterial and viral meningitis. In particular, the present invention relates to a PCR-based multiplex assay for the rapid detection and discrimination of pathogens causing bacterial and viral meningitis. Bacterial meningitis is a neurologically devastating and often life threatening illness. Rapid and accurate
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diagnosis is therefore of utmost importance in providing timely and optimal care. In contrast, viral meningitis, which often presents with the same clinical signs and symptoms as bacterial meningitis, is a self-limiting illness that does not require antimicrobial treatment and hospitalization. See, Cherry, J. D., Textbook of Pediatric Infectious Diseases, 3rd ed. Feigin, R. D., et al. (Eds.) W.B. Saunders Co., Philadelphia, pp. 439-445 (1992), the disclosure of which is incorporated herein by reference. Currently, physicians in the emergency room setting are repeatedly faced with the diagnostic dilemma of how to clinically distinguish between bacterial and viral meningitis. This feat is virtually impossible with any degree of certainty. Therefore, a patient is often hospitalized and treated with intravenous antibiotics until the results of bacterial cultures from the cerebrospinal fluid ("CSF") are determined. This process generally takes between 48 to 72 hours to complete. The waiting period can therefore result in a tremendous increase in health care costs and the provision of suboptimal care, particularly since greater than 90% of meningitis cases are of a viral etiology. Web site: http://www.delphion.com/details?pn=US06258570__ •
Peptides representing epitopic sites for bacterial and viral meningitis causing agents and their CNS carrier and uses thereof Inventor(s): Sharma; Lawrence R. (Vancouver, CA), Alstyne; Diane V. (Vancouver, CA) Assignee(s): Insight Biotek, Inc. (St. Michaels, BB) Patent Number: 5,556,757 Date filed: June 7, 1995 Abstract: Peptides comprising a Meningitis Related Homologous Antigenic Sequence (MRHAS) are provided. The MRHAS is found in meningitis-causing organisms and chemokines involved in cell chemotaxis. The peptides are useful as antigens and vaccines for detection, diagnosis and treatment of meningitis. Excerpt(s): This invention relates to the application of immunological techniques that provide novel materials useful in the diagnosis, treatment and vaccination against meningitis caused by either bacterial or viral agents. These techniques include the production and application of novel monoclonal antibodies, peptides, and mixtures and combinations thereof that are useful for detecting meningitis infections. The techniques also include eliciting antibodies specific to meningitis causing agents. These immunological techniques may also be applied to the treatment of such disease. The term meningitis is a general one, referring to the inflammatory response to infection of the meninges and the cerebrospinal fluid (CSF). See Roos, "Chapter 16", in Scheld, et al. eds., 1991, Infections of the Central Nervous System:335-403 which is incorporated herein in its entirety by reference. The fact that the inflammatory response occurs in the proximity of the brain and in the space limited by a rigid cranium, makes these infections serious and life threatening. Most patients exhibit nonspecific clinical signs and symptoms such as fever, irritability, altered mental status usually accompanied by vomiting and loss of appetite. In children one year of age and older, photophobia and headache are common complaints. Specific clinical signs indicative of meningitis are neck rigidity and pain on neck flexicn. Brudzinski's sign (neck flexion producing knee and hip flexicn) and Kernig's sign (difficulty and pain in raising extended leg) are other useful clinical signs. Web site: http://www.delphion.com/details?pn=US05556757__
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Patent Applications on Meningitis As of December 2000, U.S. patent applications are open to public viewing.10 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 meningitis: •
Novel meningitis conjugate vaccine Inventor(s): D'Ambra, Anello J. (Mount Pocono, PA), Arnold, Frank J. (Newfoundland, PA), Maleckar, James R. (Nazareth, PA), McMaster, Ronald P. (Stroudsburg, PA) Correspondence: Aventis Pasteur, Inc. Route 611, Discovery Drive; Swiftwater; PA; 18370; US Patent Application Number: 20030035806 Date filed: May 9, 2002 Abstract: The present invention relates to immunogenic protein-polysaccharide conjugates comprising pneumococcal surface protein (PspA) obtained from Streptococcus pneumoniae conjugated to a capsular polysaccharide from N. meningitidis, and compositions comprising the same. Also provided are methods of manufacture of such immunogenic combinations as well as methods of use of such immunogenic combinations in the prevention and treatment of bacterial meningitis, particularly pneumococcal and meningococcal meningitis. Excerpt(s): The present invention relates to the fields of immunology, vaccines and the prevention of bacterial infections by immunization, more specifically to polysaccharideprotein conjugates useful as vaccines, vaccine compositions comprising two or more polysaccharide-protein conjugates and methods of vaccination using the same. Neisseria meningitidis (N. meningitidis) is a leading cause of bacterial meningitis and sepsis throughout the world. Pathogenic meningococci are enveloped by a polysaccharide capsule that is attached to the outer membrane surface of the organism. N. meningitidis is classified by the immunological specificity of the capsular polysaccharide. Thirteen different serogroups of meningococci have been identified, of which five (A, B, C, W135, and Y) cause the majority of meningococcal disease. Serogroup A is responsible for most epidemic disease, which is rare in the industrialized world but occurs periodically in developing countries. Serogroups B, C, and Y cause the majority of endemic disease and localized outbreaks. Although more rare, serogroup W135 outbreaks have increased worldwide in recent years. [Samuelsson S., Eurosurveillance Weekly, 2000:17:1-5.] There are approximately 2,600 cases of bacterial meningitis per year in the United States and on average 330,000 cases in developing countries, with case fatality rates ranging between 10 and 20%. Current meningococcal vaccines elicit an immune response against the capsular polysaccharide. The antibodies thus generated are capable of complementmediated bacteriolysis of the serogroup specific meningococci. Meningococcal polysaccharide vaccines have been shown to be efficacious in older children and adults (Artenstein, M. S., et al. New Engl. J. Med. 282: 417-420, 1970 and Peltola, H., et al. New Engl. J. Med. 297: 686-691, 1977, but the efficacy is limited in infants and young children Reingold, A. L., et al. Lancet 2: 114-118, 1985). Subsequent doses of polysaccharide in younger populations elicited weak or no booster responses (Goldschneider, I., et al. J. Inf. Dis. 128: 769-776, 1973 and Gold, R., et al. J. Inf. Dis. 136: S31-S35, 1977). Also, the protection elicited by the meningococcal polysaccharide vaccines is not long-lasting
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This has been a common practice outside the United States prior to December 2000.
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having been estimated to be between 3 to 5 years (Brandt, B., et al. J. Inf. Dis. 131: S69S72, 1975, and Kyhty, H., et al. J. Inf. Dis. 142: 861-868, 1980, and Ceesay, S. J., et al. J. Inf. Dis. 167: 1212-1216, 1993). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with meningitis, 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 “meningitis” (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 meningitis. You can also use this procedure to view pending patent applications concerning meningitis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON MENINGITIS Overview This chapter provides bibliographic book references relating to meningitis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on meningitis 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 “meningitis” (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 meningitis: •
AIDS Clinical Review Contact: Marcel Dekker, Incorporated, 270 Madison Ave, New York, NY, 10016, (800) 228-1160. Summary: This monograph presents 14 papers, all written within 12 months of publication, focusing on specific areas in which significant new advances have occurred in the epidemiology, diagnosis, therapy, and prevention of HIV infection and HIVassociated complications. Chapter One discusses the clinical significance of the biological phenotype of HIV. Counseling and medical evaluation of HTLV-I and HTLVII infected persons is explored in Chapter Two. Chapter Three through Eight emphasize developments in epidemiology, diagnosis, treatment and prevention of opportunistic infections resulting from HIV disease, such as: bacillary angiomatosis, syphilis, tuberculosis, pneumocystis carinii pneumonia, cryptococcal meningitis, and hepatitis B and C. Chapter Nine summarizes the diagnosis and management of AIDS-related lymphoma; Chapter Ten surveys treatment of HIV disease presently available; Chapter
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Eleven describes the clinical uses of hematopoietic growth hormones in HIV-related illness; and the final three chapters report on vaccines, risk of HIV infection in health care workers, patient rights and physician responsibility. •
Directory of Chicago HIV/AIDS Clinical Trials. Translated title Contact: AIDS Foundation of Chicago, 411 S Wells Ste 300, Chicago, IL, 60607-3924, (312) 922-2322, http://www.aidschicago.org. Test Positive Aware Network, 5537 N Broadway, Chicago, IL, 60640, (773) 989-9400, http://www.tpan.com. African American AIDS Network, 1307 S Wabash Ave 2nd Fl, Chicago, IL, 60605, (773) 371-0032. Summary: This directory provides access to clinical trials related to Acquired immunodeficiency syndrome (AIDS) in the Chicago area. It explains what clinical trials are and the Food and Drug Administration (FDA) approval process, and answers questions about drug studies. The entries include information on anemia, anorexia, cytomegalovirus (CMV) retinitis, meningitis, herpes simplex, histoplasmosis, Human immunodeficiency virus (HIV) infection, Kaposi's sarcoma, lymphoma, mycobacterial prophylaxis, Pneumocystis carinii pneumonia (PCP), and toxoplasma, and studies on women and children.
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The Edge of Discovery Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, 31 Center Dr MSC 2520, Bethesda, MD, 20892-2520, (301) 496-5717, http://www.niaid.nih.gov. Summary: This monograph presents information about intramural and extramural programs conducted by the National Institute of Allergy and Infectious Diseases (NIAID). It presents highlights of research projects in immunology; allergy and asthma; Acquired immunodeficiency syndrome (AIDS); Human immunodeficiency virus (HIV), including treatment programs and epidemiology; and other Sexually transmitted diseases (STD's). Development of new vaccines for pertussis, meningitis, and hepatitis B is described, as is antiviral drug research and international collaborations in malaria and other parasite research.
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First Responder Refresher Training Program: National Standard Curriculum Contact: National Association of State Emergency Medical, Services Directors, 111 Park Pl, Falls Church, VA, 22046-4513, (703) 538-1799, http://www.nasemsd.org. Summary: Designed to assure the continuing competency of the individual first responder, this teaching guide establishes the minimum set of objectives which must be met to maintain acceptable knowledge and skill levels. The course is divided into four separate modules addressing trauma management and triage; patient management and operations; cardiovascular and respiratory assessment; and medical emergencies, including the appropriate prehospital management of communicable diseases, such as Acquired immunodeficiency syndrome (AIDS), Hepatitis B, and meningitis. Safety precautions to prevent the transmission of Human immunodeficiency virus (HIV) are consistent with the universal blood and body fluid precautions observed among health care providers. Course scope, performance objectives, and instructional strategies are each delineated, with recommendations for training materials, student appraisal, and instructor recruitment.
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HIV Infection in Developing Countries: Emerging Clinical Pictures in Africa Source: The Global Impact of AIDS. Proceedings of the First International Conference on the Global Impact of AIDS; London, United Kingdom, March 8-10, 1988. Contact: Alan R. Liss, Incorporated, 41 E 11th St, New York, NY, 10003, (212) 353-2957. Summary: This book chapter describes a presentation from the First International Conference on the Global Impact of AIDS held in London on March 8-10, 1988. It discusses the clinical manifestations associated with Human immunodeficiency virus (HIV) infection in Africa. It examines the interrelation between prevalent endemic infectious diseases and Acquired immunodeficiency syndrome (AIDS), particularly Sexually transmitted diseases (STD's), tuberculosis, and tuberculosis meningitis. It also describes symptoms such as generalized weakness syndrome, cough, dementia, and dermatological manifestations.
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When I Die, Will I Get Better? Source: New York, NY: Peter Bedrick Books. 1993. 33 p. Contact: Available from Peter Bedrick Books, 2112 Broadway, New York, NY 10023. (212) 496-0751. $11.95. ISBN 0-87226-375-4. Summary: This storybook was created by a boy whose younger brother died of meningitis at the age of 2 1/2 years. The book describes Joeri Breebaart's own experiences with his brother's death (i.e., how his brother got ill, how he died, and the funeral) using a family of rabbits to play the roles of his brother, his parents, and himself. When young Fred Rabbit becomes sick and dies, the death has an effect on all the animals in the forest. The storybook is intended to help children come to an understanding of death and express their feelings about it.
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All by myself Source: Boulder, CO: Light On Books and Videotapes. 1991. ca. 60 pp. Contact: Available from Light On Books and Videotapes, Suite 358, P.O. Box 8005, Boulder, CO 80306. Telephone: (303) 444-3340. $12.00; price includes postage and handling. Summary: This book contains two versions of the story of Micah, the author's son, who developed meningitis at the age of three weeks. The infection left him with cerebral palsy. The first version is appropriate for young children through third grade, and the second, more in-depth version is for adults. Both address the joys and trials one experiences living with children who have special needs.
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 “meningitis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “meningitis” (or a synonym) in their titles. The
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following is indicative of the results you might find when searching for “meningitis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Dr Spot Casebook: George Has Meningitis by Leigh Jenny; ISBN: 1902463919; http://www.amazon.com/exec/obidos/ASIN/1902463919/icongroupinterna
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Bacterial Meningitis by J. D. Williams (Editor), J. Burnie (Editor); ISBN: 0127551557; http://www.amazon.com/exec/obidos/ASIN/0127551557/icongroupinterna
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Bacterial Meningitis by Allan R. Tunkel; ISBN: 0781711029; http://www.amazon.com/exec/obidos/ASIN/0781711029/icongroupinterna
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Bacterial Meningitis (Antibiotics and Chemotherapy, Vol 45) by H. Schonfeld, et al (1992); ISBN: 3805554842; http://www.amazon.com/exec/obidos/ASIN/3805554842/icongroupinterna
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Bacterial Meningitis (Contemporary Issues in Infectious Disease Vol 3) by Merle A. Sande, et al; ISBN: 0443083266; http://www.amazon.com/exec/obidos/ASIN/0443083266/icongroupinterna
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Brain abscess and meningitis; Subarachnoid hemorrhage : timing problems; ISBN: 0387105395; http://www.amazon.com/exec/obidos/ASIN/0387105395/icongroupinterna
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Cerebrospinal Meningitis Control: Report (1976); ISBN: 9241205881; http://www.amazon.com/exec/obidos/ASIN/9241205881/icongroupinterna
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Cerebrospinal Meningitis Epidemics : A Scientific American article [DOWNLOAD: PDF] by Patrick S. Moore (Author), Claire V. Broome (Author); ISBN: B00006BNNC; http://www.amazon.com/exec/obidos/ASIN/B00006BNNC/icongroupinterna
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Cerebrospinal Meningitis in West Africa and Sudan in the Twentieth Century by K. David Patterson, Gerald W. Hartwig; ISBN: 091845655X; http://www.amazon.com/exec/obidos/ASIN/091845655X/icongroupinterna
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Die menschliche Herpes-simplex-Encephalitis und -Meningitis : e. klin.neuropatholog. Unters by Friedrich-Wilhelm Spaar; ISBN: 3437104306; http://www.amazon.com/exec/obidos/ASIN/3437104306/icongroupinterna
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Emerging Strategies in the Fight Against Meningitis by Carlos Ferreiros (Editor), et al; ISBN: 1898486344; http://www.amazon.com/exec/obidos/ASIN/1898486344/icongroupinterna
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Meningitis by Yuriy Tarnawsky; ISBN: 0914590480; http://www.amazon.com/exec/obidos/ASIN/0914590480/icongroupinterna
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Meningitis (Diseases and People) by Edward Willett (1999); ISBN: 0766011879; http://www.amazon.com/exec/obidos/ASIN/0766011879/icongroupinterna
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Meningitis : a work of fiction by IUrii Tarnavs§kyi; ISBN: 0914590499; http://www.amazon.com/exec/obidos/ASIN/0914590499/icongroupinterna
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MENINGITIS C AUDIO TAPE by HPE; ISBN: 0752119613; http://www.amazon.com/exec/obidos/ASIN/0752119613/icongroupinterna
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MENINGITIS C LEAFLET BRAILLE by HPE; ISBN: 0752119605; http://www.amazon.com/exec/obidos/ASIN/0752119605/icongroupinterna
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Meningitis Im Kindesalter by H. Isenberg (1993); ISBN: 3798509409; http://www.amazon.com/exec/obidos/ASIN/3798509409/icongroupinterna
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Meningitis: 100 Maxims (100 Maxims in Neurology, 4) by Karen L. Roos (1996); ISBN: 034060879X; http://www.amazon.com/exec/obidos/ASIN/034060879X/icongroupinterna
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Meningitis: a Guide for Families by J.S. Kroll; ISBN: 190133600X; http://www.amazon.com/exec/obidos/ASIN/190133600X/icongroupinterna
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Neonatal Meningitis by Pamela A. Davies (Author), P. T. Rudd (Author) (1995); ISBN: 0901260967; http://www.amazon.com/exec/obidos/ASIN/0901260967/icongroupinterna
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Neonatal Sepsis and Meningitis by Alistair Philip; ISBN: 0816122539; http://www.amazon.com/exec/obidos/ASIN/0816122539/icongroupinterna
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Stephen--Learning about Meningitis by Jenny Wilson (2000); ISBN: 1857925726; http://www.amazon.com/exec/obidos/ASIN/1857925726/icongroupinterna
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The Official Patient's Sourcebook on Meningitis: A Revised and Updated Directory for the Internet Age by Icon Health Publications (2002); ISBN: 0597833303; http://www.amazon.com/exec/obidos/ASIN/0597833303/icongroupinterna
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Tuberculous Meningitis by Malcolm L. Parsons; ISBN: 0192611666; http://www.amazon.com/exec/obidos/ASIN/0192611666/icongroupinterna
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Tuberculous Meningitis: Tuberculomas and Spinal Tuberculosis: A Handbook for Clinicians (Oxford Medical Publications) by Malcolm Parsons; ISBN: 0192617214; http://www.amazon.com/exec/obidos/ASIN/0192617214/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 “meningitis” (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:11 •
An Annotated bibliography of the sequelae of acute bacterial meningitis, 1945-1968 [by] Sarah H. Sell [et al.]. Author: Sell, Sarah Hamilton Wood,; Year: 1970; Nashville, Dept. of Psychiatry, Vanderbilt Univ., 1969
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Animal experimentation in relation to epidemic cerebrospinal meningitis Author: Dunn, Charles Hunter,; Year: 1954; Chicago: American Medical Association., 1911
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CRDA special report on the 1989 meningitis epidemic. Author: Christian Relief; Development Association (Ethiopia); Year: 1971; Addis Ababa: Christian Relief; Development Association, Ethiopia, [1989?]
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In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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Factors contributing to incidences of meningitis in Chavuma District in the past one year Author: Likando, C. M.; Year: 1969; Kabwe, Zambia: Pan African Institute for Development, East and Southern Africa, [1997]
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Gastroenteritis, encephalitis, meningitis, & kala-azar: an epidemiological review Author: Bista, Mahendra Bahadur.; Year: 1971; Kathmandu, Napal: Epidemiology Division, Ministry of Health, [1993]
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Infective meningitis Author: Furth, Ralph van.; Year: 1942; The Netherlands: Boerhaave Committee for Postgraduate Medical Education, Leiden University, [1989?]; ISBN: 9067671835
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Management of bacterial meningitis and septicaemia in children: role of antibiotics, immunoglobulins and corticosteroids Author: Iwarson, Sten.; Year: 1952; Stockholm, Sweden: Distributed by Almqvist; Wiksell International, [1990]
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Meningitis [by] George Gee Jackson [and] Lowell W. Lapham. Author: Jackson, George Gee,; Year: 1958; Chicago, Year Book Publishers, 1958
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Present-day antibiotic treatment of bacterial meningitis Author: Modaï, J. (Jacques); Year: 1942; Basel, Switzerland: Editiones Roche, c1990; ISBN: 3907946235
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Report of a committee of the Massachusetts Medical Society on spotted fever or cerebro-spinal meningitis in the state of Massachusetts, May, 1866. Author: Daniels, Worth B., donor.; Year: 1950; Boston: David Clapp; Son., 1867
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Social and medical prognosis of child with acute nontuberculous purulent meningitis Author: Sillanpää, Matti.; Year: 1964; Stockholm: Almqvist; Wiksell, 1977
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The treatment of meningococcic meningitis with sulfanilamide: preliminary report Author: Schwentker, Francis F.; Year: 1955; Chicago, Ill.: American Medical Association, c1937
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Workshop on Problems of Bacterial Meningitis: February 4, 1984, Wiesbaden Author: Klein, Jerome O.,; Year: 1957; München: MMV Medizin Verlag, c1984
Chapters on Meningitis In order to find chapters that specifically relate to meningitis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and meningitis 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 “meningitis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on meningitis: •
Dementia Source: in Cassel, C.K., et al., eds. Geriatric Medicine. 2nd ed. New York, NY: SpringerVerlag. 1990. p. 428-448. ISBN: 0387178864. Contact: This publication may be available from your local medical library. Call for information. Summary: This chapter defines and summarizes the causes, evaluation, and treatment of dementia. Behavioral syndromes of elderly individuals that must be distinguished from dementia are briefly described prior to the discussion of the dementing disorders.
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Specific information is provided about delirium; amnestic syndromes; organic delusional, mood, anxiety, and personality syndromes; organic hallucinosis; aphasic syndromes; ageassociated memory impairment; and the various dementias and their characteristics. In the discussion of dementias, attention is given to primary dementias, including Alzheimer's disease, dementia with extrapyramidal disorders, Pick's disease, Parkinson's disease, Huntington's diseases, and other extrapyramidal disorders; secondary dementias, including vascular dementia syndromes, drug-induced dementia, and dementias induced by alcohol and nondrug toxins; infectious causes of dementia, including AIDS, Jakob-Creutzfeldt disease, Gerstmann-Straussler syndrome, general paresis, chronic meningitis, and non-infectious systemic illnesses, including neoplasms; traumatic dementias; hydrocephalus; and depression. Finally, attention is focused on the history and varied applications of neuropsychiatric assessments and to the various treatments. 76 references. •
Chapter 21-D: Vasculitides: Vasculitis of the Central nervous System Source: in Klippel, J.H., et al., eds. Primer on the Rheumatic Diseases. 12th ed. Atlanta, GA: Arthritis Foundation. 2001. p. 405-409. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. Website: www.arthritis.org. PRICE: $69.95 plus shipping and handling. ISBN: 0912423293. Summary: This chapter provides health professionals with information on vasculitis of the central nervous system (CNS). CNS vasculitis can be divided into primary and secondary forms. The primary form is known as primary angiitis of the CNS (PACNS). Using the criteria for PACNS established by Calabrese and Malek, a diverse group of disorders can be defined, including granulomatous angiitis of the CNS (GACNS) and benign angiopathy of the CNS (BACNS). GACNS is a slowly progressive disorder characterized by a prodrome of 6 or more months. The most common clinical features are chronic headache, neurologic defects, alternations in higher cortical function, cerebrospinal fluid (CSF) abnormalities consistent with chronic meningitis, and inflammatory spinal cord lesions. When GACNS is suspected, biopsy of CNS tissues is the diagnostic mode of choice. Normal lumbar puncture and normal magnetic imaging results virtually rule out the possibility of GACNS. BACNS tends to occur in young women. Clinical features include acute onset of a severe headache or focal neurologic deficit, relatively normal CSF analyses, and highly abnormal angiograms. The diagnosis of BACNS is usually based on both clinical and radiographic findings and requires further analysis to differentiate it from more progressive forms of PACNS. No controlled trials of any therapy for PACNS or BACNS have been conducted, but reports suggest that if patients are diagnosed and treated promptly, most can achieve remission. GACNS is treated with high dose prednisone and cyclophosphamide. For people who are diagnosed with BACNS, a short course of high dose corticosteroids for a period of 2 to 3 months with taper is prescribed. For patients who do not fall into the GACNS or BACNS categories, an empirically derived therapy based on the severity of disease manifestations and the rate of illness progression is justified. The secondary forms of CNS vasculitis include those caused by infections, drugs, neoplasms, systemic vasculitides, and connective tissue diseases. Various infectious agents, including bacteria, fungi, mycobacteria, viruses, spirochetes, and other atypical agents are capable of causing a vascular inflammatory disease within the CNS. The most commonly implicated drugs with CNS vasculitis are cocaine, amphetamines, ephedrine, phenylpropanolamine, and other sympathomimetric agents. Vasculitis of the CNS has been associated with various neoplasms, particularly with lymphoproliferative diseases.
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Vasculitis of the CNS is found in patients with various connective tissue diseases and vasculitic syndromes, particularly systemic lupus erythematosus and Sjogren's syndrome. 1 figure, 1 table, and 13 references. •
Complications of Cochlear Implant Surgery Source: in Waltzman, S.B. and Cohen, N.L., eds. Cochlear Implants. New York, NY: Thieme. 2000. p. 171-184. Contact: Available from Thieme. 333 Seventh Avenue, New York, NY 10001. (800) 7823488. Fax (212) 947-0108. E-mail:
[email protected]. PRICE: $89.00 plus shipping and handling. ISBN: 0865778825. Summary: This chapter on complications of cochlear implant surgery is from a book that incorporates original chapters on relevant topics with related papers. The papers were presented at the Fifth International Cochlear Implant Conference held in New York, in May, 1997. The book provides professionals involved in the field of cochlear implants with a comprehensive reference text. All aspects of implantation are covered including the effects of electrical stimulation, processing capabilities, preoperative criteria, medical, surgical and radiological issues, results and postoperative programming, rehabilitation, and education. In this chapter, the author outlines complications related to cochlear implantation and provides suggestions for prevention of these complications. Surgical and medical complications discussed include scalp flap, otitis media (ear infection) and meningitis (brain infection), facial nerve paralysis, tinnitus (ringing in the ears), vertigo, and device migration. Device related complications covered include device failure and facial nerve stimulation. Accompanying the chapter are five articles covering: surgical complications and equipment failures of the University of Navarra cochlear implant program; insertional trauma with different types of electrodes in Combi 40 cochlear implantation; reimplantation of Ineraid cochlear implants; the practical and ethical considerations of facial nerve monitoring during cochlear implant surgery; and nonauditory stimulation in cochlear implant patients. 1 figure. 5 tables. 36 references.
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Medical and Surgical Treatment of Cochlear Hearing Loss Source: in Valente, M. Hosford-Dunn, H. Roeser, R.J., eds. Audiology: Treatment. New York, NY: Thieme. 2000. p. 377-396. Contact: Available from Thieme. 333 Seventh Avenue, New York, NY 10001. (800) 7823488. Fax (212) 947-0108. E-mail:
[email protected]. PRICE: $69.00 plus shipping and handling. ISBN: 0865778590. Summary: This chapter on the medical and surgical management of cochlear hearing loss is from a textbook that provides a comprehensive overview of the numerous treatment options available to help patients relieve the clinical symptoms seen in an audiology practice. Cochlear hearing loss may be caused by a wide variety of medical problems; it is the responsibility of the practitioner to identify the cause of hearing loss and to evaluate the other potential associated medical ramifications to treat the patient as a whole. Topics covered include metabolic disorders, including Meniere's disease, diabetes mellitus, renal disease, hypothyroidism, and cochlear otosclerosis; immunologic disorders, including autoimmune inner ear disease, Cogan's syndrome, polyarteritis nodosa, Vogt Koyanagi Harada syndrome, Wegener's granulomatosis, sarcoidosis, and postapedectomy granuloma; ototoxicity, including that from aminoglycoside antibiotics, erythromycin, vancomycin, other antibiotics, loop diuretics, antineoplastic (chemotherapy) agents, antiinflammatory agents, and antimalarials;
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trauma, including temporal bone fractures, noise trauma, and barotrauma (from barometric pressure changes); infections, including cytomegalovirus, toxoplasmosis, congenital rubella, mumps, measles, Varicella Zoster virus, HIV, other viruses and Mycoplasma, meningitis, labyrinthitis, fungal infections, and syphilis; malignancy; presbycusis; sudden idiopathic sensorineural hearing loss; and hereditary or development causes. The authors stress that complete audiological assessments are crucial in the initial evaluation and subsequent therapeutic monitoring of sensorineural hearing losses. The chapter includes an outline of the topic covered, a list of references, a summary outline of the related preferred practice guidelines, and various 'pearls and pitfalls' offering practical advice to the reader. 11 figures. 1 table. 67 references. •
Otosclerosis Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 467-487. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: Otosclerosis is a bone disease limited to the temporal bone and primarily affecting the otic capsule. The growth of spongy bone usually results in stapes fixation but may also involve the cochlea and other parts of the labyrinth. This chapter on the clinical features of otosclerosis is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. Topics include definition; historical perspective; epidemiology; pathogenesis; pathology; history and physical findings; audiometry, including tuning fork tests, standard audiometry, the Carhart notch, and acoustic impedance; radiographic studies; differential diagnosis; medical management; surgical management, including candidate selection and preoperative management; surgical techniques, including stapedioplasty, stapedectomy, stapedotomy, laser stapedectomy, bilateral stapedectomy, closure, and postoperative care; intraoperative problems and complications, including intraoperative vertigo(dizziness), tympanic membrane (eardrum) perforation, obliterative otosclerosis, cerebrospinal fluid otorrhea (fluid from the ear), dehiscence of the facial nerve, floating footplate, and subluxation of the incus; postoperative complications, including vertigo, tinnitus (ringing or other sounds in the ears), cochlear hearing loss, facial paralysis, otitis media (middle ear infection), taste disturbance and oral dryness, perilymph fistula, incus necrosis, middle ear fibrosis, granuloma, postoperative labyrinthitis, meningitis, and recurrence; the evaluation of the results of stapes surgery; results of primary stapes surgery; stapedectomy (removal of the stapes of the middle ear and insertion of a graft and prosthesis) in children; revision stapedectomy; fenestration (surgical opening) and postfenestration stapedectomy; nonotosclerotic lesions of the stapes, including Paget's disease, osteogenesis imperfecta, tympanosclerosis, and degenerative arthritis; and other causes of ossicular fixation, including lateral ossicular fixation and incus annulus fusion. 31 figures. 112 references.
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Possible Causes Source: in Haybach, P.J. Meniere's Disease: What You Need to Know. Portland, OR: Vestibular Disorders Association. 1998. p. 53-60.
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Contact: Available from Vestibular Disorders Association. P.O. Box 4467, Portland, OR 97208-4467. (800) 837-8428. E-mail:
[email protected]. Website: www.vestibular.org. PRICE: $24.95 plus shipping and handling. ISBN: 0963261118. Summary: The cause of Meniere's disease is unknown, however many theories have been proposed to explain the symptoms of Meniere's or the factors that may aggravate those symptoms. This chapter is from a book that provides information for people who have or suspect they have Meniere's disease want to know more about its diagnosis and treatment, as well as strategies for coping with its effects. Written in nontechnical language, this chapter discusses the possible causes of Meniere's disease. Listed in alphabetical order, they include: abnormal circulation, adrenal-pituitary insufficiency, allergy, autoimmune disease, autonomic nervous system malfunction, bacterial infection, blockage of endolymph, estrogen insufficiency, head injury, heredity, hormonal imbalance, malformed or small endolymphatic sac, malfunction in the use of foods by the body (high cholesterol, triglycerides, or lipids), meningitis, menstrual or premenstrual problems, noise pollution (noise trauma or acoustic trauma), otosclerosis, stress, and viral infection. The author discusses the most widely accepted theories of the causes of Meniere's disease and then briefly considers specific conditions that are known or thought to sometimes cause symptoms like those of Meniere's disease. 24 references. •
Acquired Hearing Loss Due to Other Infections and Causes Source: in Pappas, D.G. Diagnosis and Treatment of Hearing Impairment in Children. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1998. p. 115-168. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545. Fax (800) 774-8398. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $55.00 plus shipping and handling. ISBN: 1565938658. Summary: This chapter on acquired hearing loss due to other infections (non viral) and causes is from a text that discusses the prevention, diagnosis, and treatment of hearing impairment in children. A follow up to the chapter on viral infections, this chapter focuses on serous otitis media (otitis media with effusion, or OME), the incidence of OME, complications from chronic otitis media, preexisting sensorineural hearing loss (SNHL) and negative middle ear pressure, organism (i.e., bacteria) and drug related factors, the pathogenesis of OME, the benefits of ventilation tubes, the surgical management of chronic otitis media (with ventilation tube placement), complications with ventilation tubes, when to remove a ventilation tube, protection from water when tubes are in place, the technique of closure of posttympanotomy perforation (when a tympanotomy tube perforates the eardrum), congenital cholesteatoma, bacterial meningitis (including routes of infections, diagnosis, treatment, pathophysiology, and vestibular involvement), complications of hearing loss associated with meningitis, perilymph fistula in children with preexisting SNHL, autoimmune inner ear disease, and SNHL in children with autoimmune inner ear disease. In each case, the authors focus on the diagnostic tests and treatment options for children with that particular condition. 11 figures. 7 tables. 133 references.
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Acquired Hearing Impairment Source: in Mencher, G.T. Gerber, S.E. McCombe, A. Audiology and Auditory Dysfunction. Needham Heights, MA: Allyn and Bacon. 1997. p. 143-165.
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Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02194-2310. (800) 278-3525; Fax (617) 455-7024; E-mail:
[email protected]; http://www.abacon.com. PRICE: $46.95 plus shipping and handling. ISBN: 0205161014. Summary: This chapter on acquired hearing impairment is from an audiology textbook on auditory dysfunction. The author notes that, from a clinical perspective, the auditory behavior of an acquired loss is not very different from that of a congenital loss, and the audiological treatment thus may be similar. The overt results of systemic disturbances, diseases, and hereditary degenerative disorders, all acquired, are often quite similar and difficult to tell apart, and therefore lend themselves to combined study. On the other hand, ototoxicity, noise trauma, and presbycusis (hearing loss due to aging) each has its own special effect on hearing and thus are discussed in separate chapters. This chapter covers tinnitus and recruitment; acquired disease, including cytomegalovirus, mumps, AIDS, herpes, meningitis, and syphilis; sudden onset and degenerative disorders; trauma; and hearing loss associated with systemic disease, including thyroid disease, diabetes mellitus, kidney disease, multiple sclerosis, connective tissue disease, and Meniere's disease. Hearing impairment after viral or bacterial disease is usually unchanging, that is, the hearing loss should not get worse. Metabolic disorders often display fluctuating hearing losses. Except for Meniere's disease, there is little that can be done surgically specifically for acquired sensory hearing impairments. They are not subject to surgical intervention, nor are they usually amenable to medical otologic treatment. Of course, the underlying disease is a medical problem that needs to be treated, and that treatment may have a beneficial effect on the hearing impairment. 6 figures. 1 table. •
Special Considerations for Children with Fluctuating-Progressive Hearing Loss Source: in Bess, F.H. Gravel, J.S. Tharpe, A.M., eds. Amplification for Children with Auditory Deficits. Nashville, TN: Bill Wilkerson Center Press. 1996. p. 339-365. Contact: Available from Bill Wilkerson Center Press. 1114 19th Avenue South, Nashville, TN 37212-2197. (615) 936-5023. Fax (615) 936-5013. PRICE: $55.00 plus shipping and handling. ISBN: 096314393X. Summary: This chapter, from a textbook on amplification for children with auditory deficits, discusses special considerations for children with fluctuating or progressive hearing loss. One consideration, particularly for younger children, is that audiologists may assume that changes in audiometric results reflect attention or nonsensory factors, as opposed to true changes in hearing sensitivity. The author attempts to raise the reader's level of suspicion for fluctuating or progressive hearing loss in children by reviewing several causes and patterns of such changes. The causes discussed include genetic hearing loss without associated abnormalities, including autosomal dominant progressive SNHL, x-linked progressive hearing loss, and otosclerosis; genetic hearing loss with associated abnormalities, including Albers-Schonberg disease, Alport's syndrome, branchio-oto-renal (BOR) syndrome, CHARGE syndrome, mucopolysaccharidosis syndrome (MPS), neurofibromatosis, osteogenesis imperfecta, retinitis pigmentosa, Stickler syndrome, and Waardenburg's syndrome; acquired hearing loss, including prenatal causes such as infections or inner ear malformations, perinatal causes such as hyperbilirubinemia and persistent pulmonary hypertension of the newborn, and postnatal causes, such as autoimmune inner ear disease, Meniere's disease, meningitis, otitis media, and perilymphatic fistula. The author makes recommendations for the audiologic management of children with fluctuating or progressive hearing loss. The chapter concludes with the presentation of three relevant case reports. 4 figures. 124 references.
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Management in Bilaterally Obliterated Cochleae Source: in Uziel, A.S. Mondain, M., eds. Cochlear Implants in Children: Advances in Otorhinolaryngology, Volume 50. Basel, Switzerland: S. Karger AG. 1995. p. 54-58. Contact: Available from S. Karger AG. 26 West Avon Road, P.O. Box 529, Framington, CT 06085. (800) 828-5479 or (203) 675-7834. PRICE: $99.50 plus shipping and handling, unless prepaid. ISBN: 3805560958. Summary: Bacterial meningitis is known to lead to a bony or scar tissue obliteration of the inner ear. In this chapter from a text on cochlear implants in children, the authors recommend a strategy for the management of meningitis deafness. Topics covered include the need for early diagnosis; diagnostic and screening tests used; determining cochlear implant candidacy; informing and working with the child's parents; and long term monitoring of the child. The authors present their experiences with three young children and one adolescent. They stress that early diagnosis of postmeningitic deafness is possible by watchful pediatricians. Only close cooperation among pediatrician, otologist, and radiologist allows satisfactory management of imminent cochlear obliteration. 5 figures. 5 references. (AA-M).
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Cochlear Implantation in Children with Malformation of the Cochlea Source: in Uziel, A.S. Mondain, M., eds. Cochlear Implants in Children: Advances in Otorhinolaryngology, Volume 50. Basel, Switzerland: S. Karger AG. 1995. p. 59-65. Contact: Available from S. Karger AG. 26 West Avon Road, P.O. Box 529, Framington, CT 06085. (800) 828-5479 or (203) 675-7834. PRICE: $99.50 plus shipping and handling, unless prepaid. ISBN: 3805560958. Summary: This chapter explores cochlear implantation in children with malformation of the cochlea. The authors review the data on 9 children with implanted, malformed cochleas and 3 further cases of unilateral malformations that were implanted in the contralateral, nonmalformed cochlea. They describe the types of malformations that can be implanted successfully and safely and those that cannot; the appropriate imaging necessary for implantation in cochlear malformations; surgical modifications and precautions that might prove necessary; and complications to be expected, including otogenic meningitis. The authors conclude that the use of cochlear implants may be rewarding even in inner ear malformations; indeed, they did not report a single type of malformation that is unacceptable for implantation provided that the cochlear nerve was present. However, they caution that their patients were very carefully selected out of a larger group of patients with malformations. 2 figures. 1 table. 18 references.
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Systemic Disorders Source: in Blakley, B.W. Siegel, M.E. Feeling Dizzy: Understanding and Treating Dizziness, Vertigo, and Other Balancing Disorders. New York, NY: Macmillan Publishing. 1995. p. 129-144. Contact: Available from Macmillan Publishing. 201 West 103rd Street, Indianapolis, IN 46290. (800) 428-5331; Fax (800) 882-8583. PRICE: $21.95 plus shipping and handling. ISBN: 0028600096. Summary: This chapter is from a layperson's guide to vertigo, imbalance, fainting, and other balance disorders. This chapter describes the role of systemic disorders in vestibular problems. Topics covered include cardiovascular diseases, arrythmia, and valve problems; bacterial and viral diseases including herpes zoster, tuberculosis,
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syphilis, meningitis, encephalitis, and Lyme disease; connective tissue and arthritic problems; blood disorders including anemia, sickle-cell anemia, leukemia, and polycythemia; diabetes mellitus; chronic kidney disease; thyroid disorders; allergies; temporomandibular joint disorders; medications that can cause dizziness; and other factors including malnutrition and pollution. For each disorder discussed, the authors consider symptoms, role in causing dizziness, diagnosis, etiology, natural course, and treatment options. •
Maxillofacial Trauma and Head Injury Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 454-469. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail:
[email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: This chapter on maxillofacial trauma and head injury is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. Topics include the initial management of the patient with maxillofacial injuries, including airway and breathing, and hemorrhage; head injury, including taking the patient history, the examination, the admission of conscious patients to hospital, analgesia, clinical examination, radiography, blood analyses, observation, medical complication of head injuries, late sequelae of head injury, posttraumatic syndrome, and diabetes insipidus; complications of maxillofacial injuries, including cranial nerve injuries, orbital injuries, burns, adult respiratory distress syndrome (ARDS), injuries to the spinal cord, and atlanto-axial subluxation; the general and dental management of paraplegics; stab wounds; gunshot wounds; prevention of infection, including meningitis, wound infection, tetanus, and management of the wounded patient; and sports injuries. Child abuse is covered in a separate chapter. For each condition, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. 8 tables. 42 references.
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Infections Source: in Grundy, M.C. Shaw, L. and Hamilton, D.V. Illustrated Guide to Dental Care for the Medically Compromised Patient. St. Louis, MO: Mosby-Year Book, Inc. 1993. p. 105-110. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-9934. (800) 426-4545 or (314) 872-8370; Fax (800) 535-9935 or (314) 4321380; E-mail:
[email protected]; http://www.mosby.com. PRICE: $24.95 plus shipping and handling. ISBN: 0815140223. Summary: This chapter, from an illustrated guide to dental care for medically compromised patients, discusses infections. Topics covered include rubella (German measles), encephalitis, meningitis, human immunodeficiency virus (HIV), hepatitis, and infectious mononucleosis. For each condition, the authors provide a brief description, the components of medical management, and suggestions for dental care. Illustrations, including photographs, are included. 3 figures.
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CHAPTER 8. MULTIMEDIA ON MENINGITIS Overview In this chapter, we show you how to keep current on multimedia sources of information on meningitis. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on meningitis is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “meningitis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “meningitis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on meningitis: •
Yon Seri Videyo Sou Swen Lasante Pou Fanmi Ayisyen. [A Video Series About Health Care for Haitian Families.] Contact: National Pediatric and Family HIV Resource Center, 30 Bergen St ADMC #4, Newark, NJ, 07107, (973) 972-0410, http://www.pedhivaids.org. Summary: This videorecording is designed to help Haitian parents understand the importance of obtaining prompt health care for their children who are HIV-positive. The video, in Haitian Creole with English subtitles, provides general guidance on medical procedures, nutrition, resources, and specific information on negotiating the health care system for families affected by HIV/AIDS. The first segment, Pran Swen Pitit Ou (Take Care of Your Child) features Haitian women in a beauty shop setting discussing the necessity of obtaining a spinal tap for a child with suspected meningitis. It acknowledges the problems immigrant families encounter in accessing health care, and reassures and encourages the parents to ask questions of health care providers. In the second segment, Menje Byen Viv Byen (Eat Well Live Well), a mother and daughter are choosing healthy foods at a grocery store. Later, a nutritionist discusses the healthy
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aspects of a traditional Haitian diet. The final segment, Ou Pa Poukont Ou (You're Not Alone), reinforces the messages to parents to seek health care, to ask questions about procedures they do not understand, and to trust their health care providers. •
Issues of Dementia: In - Service Training With Brian Smith Contact: Shanti, 730 Polk St, San Francisco, CA, 94109-7813, (415) 674-4700, http://www.shanti.org. Summary: In this videorecording, the moderator and participants in a volunteer training program discuss the cognitive and motor problems resulting from neurological diseases and disorders associated with Acquired immunodeficiency syndrome (AIDS). Psychologically, potential dementia and other disorders pose one of the most frightening prospects for Persons with AIDS (PWA's). The symptoms may include seizures, headaches, and short-term memory loss. Specific diagnoses, including meningitis, lymphoma of the brain, PML, and toxoplasmosis are discussed. Volunteers are given some guidance on what to expect from clients in terms of denial, confusion, and personality changes; they are urged to attempt to breach communication barriers with their clients and talk about the possibility of Human immunodeficiency virus (HIV) infection of the brain. The videorecording briefly describes the apparent effect of Azidothymidine (AZT) on the manifestations of HIV-brain infection.
Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “meningitis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on meningitis: •
AIDS and the Internist -- Part II Contact: California Medical Association, Audio Digest Foundation, 1577 E Chevy Chase Dr, Glendale, CA, 91206, (213) 245-8505. Summary: This sound recording contains the transcripts of talks in the second part of the program on the role of the internist in managing patients with HIV infection. In this segment, Dr. Constance Wofsy discusses the epidemiology and concerns of HIV infection in women. Transmission and diagnosis are examined; gynecological issues and pregnancy are explored. Dr. Harry Hollander discusses neurological syndromes and dementia in HIV disease. He presents information on AIDS dementia complex, progressive multifocal leukoencephalopathy, toxoplasmosis, cerebral ischemia, vacuolar myelopathy, tropical spastic parapesis and CMV polyradiculopathy. Meningitis and HIV-related neuropathies are also discussed.
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What's New With AIDS? Contact: California Medical Association, Audio Digest Foundation, 1577 E Chevy Chase Dr, Glendale, CA, 91206, (213) 245-8505. Summary: This sound recording contains the transcripts of speeches given by three physicians that discuss HIV infection. The first speaker, Dr. Mitchell Katz, traces the
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scope of HIV infection in the United States and examines the consequences or the new definition of AIDS. He then poses epidemiologic considerations, factors affecting CD4 staging, and the drugs approved for treating HIV infection, AZT and ddI. Other drugs that inhibit reverse transcriptase are also included, as well as the efficacy of antiviral combination therapy. The second speaker, Dr. Neil Flynn, expands on the management of HIV and opportunistic infections. He discusses herpes, bacterial pneumonia, mycobacterium infection, cryptococcal meningitis, PCP, toxoplasmosis, and Kaposi's sarcoma. The concluding speaker, Dr. Faith Fitzgerald, shares some thoughts on the epidemic, including the public perceptions of AIDS and the differing response to this epidemic as opposed to previous ones.
Bibliography: Multimedia on Meningitis The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in meningitis (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on meningitis: •
Bacterial meningitis [motion picture] Source: Wayne State University School of Medicine; produced by the Division of Medical Communication; Year: 1972; Format: Motion picture; Detroit: The University; [Atlanta: for loan by National Medical Audiovisual Center, 1972]
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Bacterial meningitis [slide] Source: University of Michigan Medical Center; Year: 1974; Format: Slide; [Ann Arbor, Mich.]: The University: [for sale by Univ. of Michigan Medical Center, Media Library], c1974
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Bacterial meningitis [videorecording] Source: Dept. of Continuing Education, Harvard Medical School and the Massachusetts General Hospital, Emergency Training Course; produced by Health Education Programs, Inc; Year: 1973; Format: Videorecording; [Minneapolis]: Institute for Continuing Physician Education, c1973
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Bacterial meningitis [videorecording] Source: Wayne State University School of Medicine; produced by the Division of Medical Communication; Year: 1972; Format: Videorecording; Detroit: The University, 1972
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Bacterial meningitis [videorecording]: new concepts in pathogenesis and therapies Source: the University of Texas Medical School at Houston; Year: 1990; Format: Videorecording; [Houston, Tex.: UT/TV], c1990
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Diagnosing meningitis and encephalitis [videorecording] Source: a presentation of Films for the Humanities & Sciences; Sheffield University Television; produced for the Department of Medical Microbiology, University of Sheffield; Year: 1999; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c1999
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Gram-negative meningitis [videorecording] Source: [produced by] Hahnemann Medical College & Hospital and World Video Corp; Year: 1980; Format: Videorecording; [S.l.]: Medcare Associates, c1980
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Meningitis [videorecording] Source: developed by Michael S. Shaw, Herbert R. Karp; [produced by] National Medical Audiovisual Center; Year: 1979; Format: Videorecording; [Bethesda, Md.]: Dept. of Health, Education, and Welfare, Public
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Health Service, National Institutes of Health, National Library of Medicine; [Washington: for sale by National Audiovisual Center] 1979 •
Meningitis [videorecording] Source: [presented by] CME Productions, Inc., in cooperation with the Infectious Disease Section, Yale University, School of Medicine; Year: 1981; Format: Videorecording; [S.l.]: CME Productions, c1981
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Meningitis [videorecording] Source: Mosby; Year: 1997; Format: Videorecording; St. Louis, Mo.: Mosby-Year Book, c1997
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Meningitis [videorecording]: pathological-clinical correlation Source: [produced by] Hahnemann Medical College & Hospital and World Video Corp; Year: 1981; Format: Videorecording; [Philadelphia, Pa.]: Medcare Associates, c1981
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Meningitis [videorecording]: the sudden illness Source: a presentation of Films for the Humanities & Sciences; Year: 1996; Format: Videorecording; [United States]: Information Television Network, c1996
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Meningitis [videorecording]: the urgent diagnosis Source: a Touch Productions film for Channel Four Television; Year: 1994; Format: Videorecording; Princeton, N.J.: Films for the Humanities and Sciences, c1994
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Meningitis and central nervous system infection [slide] Source: Mark H. Kaplan; Year: 9999; Format: Slide; [New York]: Medcom, c1979-
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Meningococcal meningitis [videorecording]: the disease and its control Source: Brooke Army Medical Center; Year: 1970; Format: Videorecording; Fort Sam Houston, Tex.: Academy of Health Sciences, c1970
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Neuropsychological sequellae of h-flu meningitis [videorecording] Source: [presented by] Marshfield Video Network, in cooperation with Marshfield Clinic, St. Joseph's Hospital, and Marshfield Medical Research Foundation; Year: 1988; Format: Videorecording; Marshfield, WI: The Network, c1988
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Pediatric meningitis [videorecording]: a diagnostic dilemma Source: produced in association with the Galtney Group of Companies; CME-TV; Year: 1991; Format: Videorecording; Hagerman, Idaho: CME-TV, c1991
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Pediatric meningitis [videorecording]: avoiding the menace of malpractice Source: produced in association with CME-TV; the Galtney Group of Companies; produced in cooperation with University of Arizona Health Sciences Center; Year: 1991; Format: Videorecording; Houston, Tex.: Western Indemnity Insurance Co., c1991
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The diagnosis of viral meningitis [motion picture] Source: The National Foundation; [made by] University of Kansas Medical School with the assistance of Churchill-Wexler Films; Year: 1961; Format: Motion picture; [Chicago: American Medical Association], 1961
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The meningitis epidemic case study [electronic resource] Source: prepared and distributed by the Liverpool Epidemiology Programme, Liverpool School of Tropical Medicine; Year: 1993; Format: Electronic resource; Liverpool, UK: B. Moody, 1993
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The Treatment of meningitis [videorecording] Source: [presented by] CME Productions, Inc. in cooperation with the Infectious Disease Section, Yale University School of Medicine; Year: 1981; Format: Videorecording; Philadelphia, PA: Medical Video Marketing, c1981
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CHAPTER 9. PERIODICALS AND NEWS ON MENINGITIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover meningitis.
News Services and Press Releases One of the simplest ways of tracking press releases on meningitis is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “meningitis” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to meningitis. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “meningitis” (or synonyms). The following was recently listed in this archive for meningitis: •
Aventis eyes billion euro meningitis vaccine sales Source: Reuters Industry Breifing Date: September 26, 2003 http://www.reutershealth.com/archive/2003/09/26/business/links/20030926inds003. html
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UN seeks vaccine cash for African "meningitis belt" Source: Reuters Health eLine Date: September 25, 2003
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Meningitis vaccine not good for some kids Source: Reuters Health eLine Date: August 08, 2003
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Hearing implants rarely linked with meningitis Source: Reuters Health eLine Date: July 30, 2003
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Cochlear implants raise risk of bacterial meningitis in children Source: Reuters Medical News Date: July 30, 2003
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Ertapenem effective in animal model of pneumococcal meningitis Source: Reuters Industry Breifing Date: July 01, 2003
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Meningitis a concern in kids with cochlear implants Source: Reuters Health eLine Date: June 23, 2003
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Bacterial meningitis a concern among children with cochlear implants Source: Reuters Medical News Date: June 23, 2003
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Infant meningitis linked to teen behaviour problems Source: Reuters Health eLine Date: April 24, 2003
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New meningitis vaccine said promising for Africa Source: Reuters Health eLine Date: March 17, 2003
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New meningitis vaccine holds promise for Africa Source: Reuters Industry Breifing Date: March 17, 2003
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Meningitis kills over 500 in W. Africa this year Source: Reuters Health eLine Date: March 06, 2003
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Meningitis death toll exceeds 500 in West Africa Source: Reuters Medical News Date: March 06, 2003
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Lysozyme levels in CSF useful for early diagnosis of TB meningitis Source: Reuters Medical News Date: February 28, 2003
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Kids in government care miss out on meningitis shot Source: Reuters Health eLine Date: February 14, 2003
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Children in care less likely to get meningitis vaccine in UK Source: Reuters Medical News Date: February 13, 2003
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WHO says new meningitis vaccine ready for shipment Source: Reuters Health eLine Date: February 06, 2003
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WHO says new GlaxoSmithKline meningitis vaccine ready for shipment Source: Reuters Industry Breifing Date: February 06, 2003
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Austria launches meningitis awareness campaign Source: Reuters Health eLine Date: January 23, 2003
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Protein S deficiency, meningitis associated with stroke in HIV-positive Africans Source: Reuters Medical News Date: January 13, 2003
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Northern Italy begins meningitis vaccine campaign Source: Reuters Medical News Date: January 09, 2003
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Italy region launches meningitis vaccine campaign Source: Reuters Health eLine Date: January 09, 2003
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Meningitis outbreak prompts Italian region to consider mass vaccination Source: Reuters Medical News Date: December 11, 2002
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Italy region mulls mass vaccination for meningitis Source: Reuters Health eLine Date: December 11, 2002
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Steep increase in meningitis C seen in France Source: Reuters Health eLine Date: December 05, 2002
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Steroid may cut death risk of bacterial meningitis Source: Reuters Health eLine Date: November 13, 2002
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Dexamethasone benefits adults with bacterial meningitis Source: Reuters Industry Breifing Date: November 13, 2002
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UN, aid groups seek funds for meningitis vaccine Source: Reuters Health eLine Date: November 05, 2002
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Two Scottish children die from meningitis Source: Reuters Health eLine Date: October 28, 2002
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Five-factor diagnostic rule differentiates tuberculous from bacterial meningitis Source: Reuters Medical News Date: October 28, 2002
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Pediatric tubercular meningitis linked to ADHD in the long-term Source: Reuters Medical News Date: October 23, 2002
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Pneumococcal meningitis tied to cognitive impairment even after good recovery Source: Reuters Medical News Date: October 07, 2002
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Drug firms urged to make cheap meningitis vaccine Source: Reuters Health eLine Date: September 19, 2002
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Antibody detection in CSF a promising early indicator of TB meningitis Source: Reuters Medical News Date: August 30, 2002
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Meningitis outbreak has killed 65 in Rwanda, one million at risk Source: Reuters Medical News Date: August 23, 2002
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Meningitis kills 65 in Rwanda, 1 million at risk Source: Reuters Health eLine Date: August 23, 2002
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Hajj pilgrims, contacts should get meningitis shot Source: Reuters Health eLine Date: August 16, 2002
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Hajj pilgrims and household contacts at risk of meningitis Source: Reuters Medical News Date: August 15, 2002
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Cochlear plays down implant meningitis risk Source: Reuters Industry Breifing Date: July 26, 2002
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FDA warns of possible meningitis risk with cochlear implants Source: Reuters Medical News Date: July 25, 2002
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Australians quarantined after Rome meningitis death Source: Reuters Health eLine Date: July 22, 2002
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Steroids not useful for childhood meningitis in developing countries Source: Reuters Industry Breifing Date: July 19, 2002
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Classic meningeal signs not useful in diagnosing meningitis Source: Reuters Medical News Date: July 12, 2002
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Meningitis may have long-term effects on brain Source: Reuters Health eLine Date: June 26, 2002
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Meningitis vaccine based on harmless nose bug Source: Reuters Health eLine Date: April 10, 2002
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Death toll rises in Burkina meningitis epidemic Source: Reuters Health eLine Date: April 01, 2002
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Meningitis outbreak kills 148 in Niger Source: Reuters Medical News Date: March 26, 2002
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Meningitis kills 148 in West Africa's Niger Source: Reuters Health eLine Date: March 26, 2002 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “meningitis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “meningitis” (or synonyms). If you know the name of a company that is relevant to meningitis, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.
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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “meningitis” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “meningitis” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on meningitis: •
Understanding the AIDS Dementia Complex Source: Family Survival Project Update. [Newsletter] 10(3): 6. Fall, 1991. Contact: Family Survival Project. 425 Bush Street, Suite 500, San Francisco, CA 94108. (415) 434-3388 or (800) 445-8106 (in California). PRICE: Call for price information. Summary: This newsletter article for the nonprofessional caregiver reviews the types of neurological problems that may develop in people infected with the human immunodeficiency virus (HIV). Neurological disorders in people with acquired immune deficiency syndrome (AIDS) consist of two broad types: opportunistic infections such as Cryptococcal meningitis and Toxoplasmosis, and the AIDS Dementia Complex. The AIDS Dementia Complex is caused by direct infection of the brain by the HIV virus. Early cognitive symptoms include poor concentration, slowed mental processing, impaired initiation, and forgetfulness. Behavioral symptoms include withdrawal, apathy, and personality changes. Early motor problems include difficulty with balance, clumsiness, and leg weakness. There is no treatment for AIDS Dementia Complex, but some patients have benefitted from the anti-viral drug, AZT (Azidothymidine or Retrovir). Caregivers should be aware of the common early signs of cognitive impairment so that patients can be quickly referred for diagnosis and treatment. 4 references.
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Delirium in the Medically Ill Elderly Source: Center for the Study of Aging Newsletter. 12(3): 3, 13.Fall 1990. Contact: Available from University of Pennsylvania, Center for the Study of Aging. 3615 Chestnut Street, Philadelphia, PA 19104-6006. (215) 898-3163 or FAX (215) 898-0580. PRICE: Call for price information. Summary: This newsletter articles examines the etiology and treatment of delirium, which affects approximately twenty percent of older adults hospitalized for medical illness. Delirium is an acute phenomenon that has no confirmed etiology or risk factors. Because it is acute, it should not be confused with chronic diseases like Alzheimer's disease or dementia. Recognition of delirium is essential in order to treat underlying medical illnesses. A rapid change in mental function or sudden confusion indicates the
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need for an evaluation. Medical disorders associated with delirium include acute infections such as urinary tract infections, pneumonia, or meningitis. Medications that affect the central nervous system such as those for Parkinson's disease and drugs to treat peptic ulcers, hypertension, and cardiovascular disease have also been implicated. People who have Alzheimer's disease appear to be at a greater risk for delirium, although older people without cognitive impairment may develop delirium when in a hospital. A prospective study of medically hospitalized elderly persons found that 16 percent of the patients admitted for acute medical care developed delirium while in the hospital. Researchers hope to use information about the development of delirium to more effectively determine its cause and develop new treatments. •
Headaches After Acoustic Neuroma Surgery Source: ANA Notes. Number 75: 1, 8-10. March 2001. Contact: Available from Acoustic Neuroma Association (ANA). 600 Peachtree Parkway, Suite 108, Cumming, GA 30041-8211. (770) 205-8211. Fax (770 www.ANAUSA.org. Summary: This newsletter article reports on the incidence of headaches after acoustic neuroma surgery. The author notes that although headaches as a symptom prior to treatment are relatively uncommon for vestibular schwannoma, they occur with surprising frequency after treatment and can have a profound impact upon quality of life in acoustic neuroma patients. The pain often persists for prolonged periods of time and does not always respond well to a number of medical and surgical treatments directed at the headache. The author discusses the frequency of headache following neuroma surgery, the nature of the headache, their causes, and current therapies. Causes of the headaches can include the surgical approach (craniectomy versus craniotomy), aspetic meningitis, muscle pain, nerve entrapment, and low cerebrospinal fluid pressure. The best treatment is prevention, since these headaches have proven to be difficult to treat once they occur. The author also discusses the use of cranioplasty, medication, local therapy to neck muscles, nerve block or section, stress reduction and antidepressants, and care from a multidisciplinary pain center. The author notes that most surgeons are aware of the need to prevent these headaches and take measures to minimize muscle incisions, to replace skull bone whenever possible, and to limit the distribution of bone dust within the operative field.
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Inner Ear Infections Source: Otoscope. 9(3): 1-3. Winter 1994. Contact: Available from Ear Foundation. 2000 Church Street, Box 111, Nashville, TN 37236. (800) 545-HEAR; (615) 329-7809; TTY (615) 329-7849. PRICE: Reprints are available for $25.00/200 copies. Summary: This newsletter article describes the physiology involved in inner ear infections. After a brief description of the evolutionary development of hearing and ear structure, the author discusses the defenses of the inner ear; how those defenses may be overcome; the anatomy of the ear; middle ear infections; complications of inner ear infection, including hearing loss, loss of balance function, and meningitis; chronic infections of the middle ear; cholesteatomas; and infections transmitted through the bloodstream to the inner ear. The author emphasizes the importance of preventive efforts and the medical and surgical management of causative ear infections.
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Academic Periodicals covering Meningitis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to meningitis. In addition to these sources, you can search for articles covering meningitis that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for meningitis. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with meningitis. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to meningitis: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202911.html •
Systemic - U.S. Brands: Tetramune http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202911.html
Mumps Virus Vaccine Live •
Systemic - U.S. Brands: Mumpsvax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202382.html
Pneumococcal Conjugate Vaccine •
Systemic - U.S. Brands: Prevnar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500121.html
Rifampin •
Systemic - U.S. Brands: Rifadin; Rimactane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202511.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
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Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to meningitis by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “meningitis” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for meningitis: •
Busulfan (trade name: Spartajet-Busulfan) http://www.rarediseases.org/nord/search/nodd_full?code=1096
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Busulfan (trade name: Spartajet-Busulfan) http://www.rarediseases.org/nord/search/nodd_full?code=1101
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Busulfan (trade name: Spartajet-Busulfan) http://www.rarediseases.org/nord/search/nodd_full?code=1154
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Depofoam encapsulated cytarabine http://www.rarediseases.org/nord/search/nodd_full?code=464
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Amphotericin B lipid complex (trade name: Abelcet) http://www.rarediseases.org/nord/search/nodd_full?code=547
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Liposomal amphotericin B (trade name: AmBisome) http://www.rarediseases.org/nord/search/nodd_full?code=820
If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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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 Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
12
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
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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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.13 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:14 •
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
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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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
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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/
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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
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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/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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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
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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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
13
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). 14 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
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “meningitis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “meningitis” (or synonyms) into the “For these words:” box. The following is a sample result: •
AIDS - Related Cryptococcal Meningitis Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, 31 Center Dr MSC 2520, Bethesda, MD, 20892-2520, (301) 496-5717, http://www.niaid.nih.gov. Summary: This report describes cryptococcal meningitis that is related to Acquired immunodeficiency syndrome (AIDS). It says that cryptococcal disease accounts for 5-8 percent of all opportunistic infections, and that it is caused by cryptococcus neoformans, a yeastlike fungus found in soil contaminated with bird excrement. Exposure is quite common, but it only manifests as a disease in those individuals with compromised immune systems. The fungus may infect numerous organs, particularly the skin, lungs, and meninges. As meningitis, it has the following symptoms: Fever, headache, fatigue, nausea, and vomiting. It may also cause changes in behavior or personality, memory loss or confusion, and difficulty with coordination. Unless maintenance therapy continues, the relapse rate after initial treatment is 50-90 percent. Standard treatment consists of Amphotericin B intravenously for 10 weeks, possibly combined with oral flucytosine. Side effects may include kidney damage, high fever, severe chills, low blood pressure, a decrease in potassium levels, and depressed levels of red and white blood cells, and platelets. Another drug called fluconazole was recently approved for oral or intravenous use, and one called SCH 39304 is under study. At present, the National Institute of Allergy and Infectious Diseases (NIAID) has four meningitis clinical trials underway.
The NLM Gateway15 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, 15
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
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providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “meningitis” (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 40435 373 34 642 3 41487
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “meningitis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists20 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.21 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.22 This site has new articles 16 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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18
The HSTAT URL is http://hstat.nlm.nih.gov/.
19
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. 20 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 21
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. 22 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
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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/.
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.
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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 meningitis 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 meningitis. 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 meningitis. 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 “meningitis”:
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Guides on meningitis Meningitis http://www.nlm.nih.gov/medlineplus/meningitis.html
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Other guides Childhood Immunization http://www.nlm.nih.gov/medlineplus/childhoodimmunization.html Hearing Disorders & Deafness http://www.nlm.nih.gov/medlineplus/hearingdisordersdeafness.html Hydrocephalus http://www.nlm.nih.gov/medlineplus/hydrocephalus.html West Nile Virus http://www.nlm.nih.gov/medlineplus/westnilevirus.html
Within the health topic page dedicated to meningitis, the following was listed: •
General/Overviews Meningitis http://www.nlm.nih.gov/medlineplus/tutorials/meningitisloader.html What Is Meningitis? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00118
•
Diagnosis/Symptoms Blood Cultures Source: American Association for Clinical Chemistry http://labtestsonline.org/understanding/analytes/blood_culture/test.html Spinal Tap (Lumbar Puncture) Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01414
•
Specific Conditions/Aspects Arachnoiditis http://www.ninds.nih.gov/health_and_medical/disorders/arachnoi_doc.htm Bacterial Meningitis Source: Association of State and Territorial Directors of Health Promotion and Public Health Education http://www.astdhpphe.org/infect/bacmeningitis.html Meningitis: How Do You Catch It? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00285
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Meningococcal Disease: Health Information for International Travel Source: Centers for Disease Control and Prevention http://www.cdc.gov/travel/diseases/menin.htm Use of Vaccines for the Prevention Meningitis in Persons with Cochlear Implants Source: National Immunization Program http://www.cdc.gov/nip/issues/cochlear/cochlear-gen.htm Viral (Aseptic) Meningitis Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/dvrd/virlmen.htm •
Children Lumbar Puncture (Spinal Tap) Source: Nemours Foundation http://kidshealth.org/parent/general/sick/lumbar_puncture.html Meningitis Source: Nemours Foundation http://kidshealth.org/parent/infections/lung/meningitis.html Pneumococcal Vaccine: When Is It Appropriate for Older Children Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00170 Risk of Bacterial Meningitis in Children with Cochlear Implants: Question and Answers Source: National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/ehdi/cochlear/questions.htm
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Latest News Children with Cochlear Implants at Increased Risk for Bacterial Meningitis Source: 07/30/2003, Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r030730.htm
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Organizations National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases http://www.cdc.gov/ncidod/dbmd/ National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/
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Prevention/Screening Importance of Haemophilus Influenzae Type B Vaccine Source: American Academy of Pediatrics http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZZOBA0B7C& sub_cat=24
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Meningococcal Disease Among College Students Source: National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_college.htm Meningococcal Vaccine: What You Need to Know http://www.cdc.gov/nip/publications/VIS/vis-mening.pdf Pneumococcal Conjugate Vaccine: What You Need to Know Source: National Immunization Program http://www.cdc.gov/nip/publications/VIS/vis-PneumoConjugate.pdf •
Research Risk of Bacterial Meningitis in Children with Cochlear Implants Source: National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/ehdi/cochlear/default.htm
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Statistics Percent of Adults Aged 65 Years and Over Who Had Ever Received Pneumococcal Vaccine, by Race/Ethnicity: United States, Quarter One 2002 Source: National Center for Health Statistics http://www.cdc.gov/nchs/about/major/nhis/released200209/figures05_15_3.htm
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Teenagers Meningitis Source: Nemours Foundation http://kidshealth.org/teen/infections/bacterial_viral/meningitis.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on meningitis. 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:
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Cryptococcal Meningitis Contact: University of New Mexico School of Medicine, New Mexico AIDS Education and Training Center, New Mexico AIDS InfoNet, PO Box 810, Arroyo Seco, NM, 87514, (505) 776-8032, http://www.aidsinfonet.org. Summary: This information sheet discusses cryptococcal meningitis, an opportunistic infection caused by a fungus often found in the soil. It enters the body when breathed in as dust and affects the lining of the spinal cord or brain, causing illness or death. The risk of cryptococcal infection increases when T-cell counts fall below 100. The information sheet explains the symptoms, diagnosis, treatment, and prevention of this disease. Cryptococcal meningitis is often diagnosed using lab tests that involve samples of spinal fluid, which are drawn through a spinal tap. Meningitis is treated using antifungal medications such as amphotericin B, fluconazole, and flucytosine used by themselves or in combinations. Repeat cases of meningitis may be reduced if individuals keep taking anti-fungal drugs. Taking fluconazole can help to reduce the likelihood of cryptococcal meningitis when CD4 cell counts are below 50.
•
Meningitis Criptocococica Contact: University of New Mexico School of Medicine, New Mexico AIDS Education and Training Center, New Mexico AIDS InfoNet, PO Box 810, Arroyo Seco, NM, 87514, (505) 776-8032, http://www.aidsinfonet.org. Summary: This information sheet discusses cryptococcal meningitis, an opportunistic infection caused by a fungus often found in the soil. It enters the body when breathed in as dust and affects the lining of the spinal cord or brain, causing illness or death. The risk of cryptococcal infection increases when T-cell counts fall below 100. The information sheet explains the symptoms, diagnosis, treatment, and prevention of this disease. Cryptococcal meningitis is often diagnosed using lab tests that involve samples of spinal fluid, which are drawn through a spinal tap. Meningitis is treated using antifungal medications such as amphotericin B, fluconazole, and flucytosine used by themselves or in combinations. Repeat cases of meningitis may be reduced if individuals keep taking anti-fungal drugs. Taking fluconazole can help to reduce the likelihood of cryptococcal meningitis when CD4 cell counts are below 50.
Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Encephalitis and Meningitis Summary: A general overview of encephalitis and meningitis that includes a description of the disorder, and treatment, prognosis and research information. Source: National Institute of Neurological Disorders and Stroke, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1089
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•
Meningococcal Disease Summary: A consumer fact sheet provides basic information about meningococcal disease -- bacterial meningitis. Topics covered include symptoms, diagnosis, prevention (vaccines) and treatment. Source: National Center for Infectious Diseases, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2138 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 meningitis. 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. NORD (The National Organization of Rare Disorders, Inc.) NORD provides an invaluable service to the public by publishing short yet comprehensive guidelines on over 1,000 diseases. NORD primarily focuses on rare diseases that might not be covered by the previously listed sources. NORD’s Web address is http://www.rarediseases.org/. A complete guide on meningitis can be purchased from NORD for a nominal fee. 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
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
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Associations and Meningitis The following is a list of associations that provide information on and resources relating to meningitis: •
Back Pain Association of America, Inc Telephone: (410) 255-3633 Fax: (410) 255-7338 Email:
[email protected] Background: The Back Pain Association of America, Inc. (BPAA) is a national nonprofit organization dedicated to providing information and support to people who are affected by back and neck pain, their family members, friends, and health care professionals. Established in 1991 and consisting of nearly 4,000 members, BPAA offers programs and information to help affected individuals learn more about their spinal disorders and ways to cope with them. The organization also has a program to help individuals prevent back injuries. BPAA publishes a self-titled quarterly newsletter that helps readers stay informed of updated information and new forms of treatment. The organization s 'Friends Across America' networking program enables affected individuals to exchange information and support via telephone. BPAA also has a physician referral service as well as an information service for physicians who treat back and neck pain. In addition, the Association also promotes research and offers a variety of fact sheets including 'The Relationship Between Nerve Damage and Leg Pain,' 'Urinary Problems and Diseases of the Spine,' 'Arachnoiditis, Questions and Answers,' and 'A Guide to Abdominal and Stretching Exercises.'. Relevant area(s) of interest: Meningitis
•
Meningitis Foundation of America Telephone: (317) 595-6383 Toll-free: (800) 668-1129 Fax: (317) 595-6370 Email:
[email protected] Web Site: http://www.musa.org Background: The Meningitis Foundation of America (MFA) is a voluntary not-for-profit organization dedicated to providing information and support to individuals who have had personal experience with meningitis, their families, health care professionals, and the general public. Established in 1997, the Foundation is committed to alerting the public and the medical communities about the initial symptoms of meningitis and the need for early diagnosis and immediate treatment. Meningitis is an inflammation of the protective membranes surrounding the brain and/or spinal cord (meninges). In most cases, meningitis results due to viral or bacterial infection. Viral meningitis is more common than bacterial meningitis and may often be mild. Bacterial meningitis may be extremely serious, rapidly causing potentially life-threatening complications. The Meningitis Foundation of America is committed to providing support and resources to those affected by meningitis and their families, promoting professional and public education, and supporting the development of vaccines and other means of treating and/or preventing meningitis. The Foundation offers a 24-hour hot line, provides networking services for affected individuals and families, engages in lobbying, and is working to produce an educational poster that will be distributed to pediatricians, general practitioners, and school nurses as well as to emergency rooms, daycare centers,
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and other appropriate locations throughout the country. In addition, the Foundation provides educational brochures, publishes a regular newsletter, and has a web site on the Internet. Relevant area(s) of interest: Meningitis •
Meningitis Research Foundation (UK) Telephone: 01454 281811 Toll-free: 0808 8800 3344 Fax: 01 454 281094 Email:
[email protected] Web Site: http://www.meningitis.org Background: Meningitis Research Foundation is a not-for-profit organization in the United Kingdom and Republic of Ireland that fights death and disability from meningitis and septicemia, and supports people affected by these diseases. Meningitis is characterized by inflammation of the protective membranes (meninges) surrounding the brain and spinal cord. The condition is usually due to infection with certain bacteria or viruses. Septicemia is systemic disease characterized by the presence of invading microorganisms or their toxins in the bloodstream. Meningitis Research Foundation, which was founded in 1989, funds vital research into the prevention, detection and treatment of meningitis and septicemia, raises awareness of the diseases, and offers support through in-depth information.
•
Meningitis Research Foundation of Canada Telephone: (519) 746-8306 Toll-free: (800) 643-1303 Fax: (519) 746-8306 Email:
[email protected] Web Site: http://www.meningitis.ca Background: The Meningitis Research Foundation of Canada is a not-for-profit organization dedicated to providing research funds in order to prevent life-threatening complications and disability resulting from meningitis, a condition characterized by inflammation of the protective membranes (meninges) surrounding the brain and spinal cord. Meningitis usually results due to infection with certain bacteria or viruses. The Meningitis Research Foundation of Canada was established in 1998 as a grassroots initiative. The Foundation is committed to promoting and supporting research into the prevention, detection, and treatment of meningitis; increasing public awareness; and promoting increased understanding of the disease among health care professionals and policymakers. In addition, the Foundation also provides a network of people affected by meningitis to encourage the exchange of information, resources, and mutual support. The Foundation's web site on the Internet discusses the organization's mission and objectives and provides understandable information on meningitis.
•
The Arc (a national organization on mental retardation) Telephone: (301) 565-3842 Toll-free: (800) 433-5255 Fax: (301) 565-3843 Email:
[email protected] Web Site: http://thearc.org/
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Background: The Arc is the largest organization in the United States that is solely devoted to improving the lives of all children and adults with mental retardation. The organization offers support to families affected by mental retardation and fosters research and educational programs on the prevention of mental retardation. The Arc is committed to securing opportunities for all people with mental retardation. To this end, the organization emphasizes personal opportunities for choice in education, housing, employment, and entertainment. The Arc is further committed to reducing the incidence and limiting the consequences of mental retardation through research, advocacy, and mutual support. The Arc provides leadership in the field of mental retardation and develops necessary human and financial resources to attain its goals. In addition, the Arc provides a wide variety of educational materials for parents, teachers, health care professionals, and others, including a regular newsletter, handbooks, instruction packets, reports, booklets, audio-visual aids, posters, and brochures. Many materials are available in Spanish. Relevant area(s) of interest: Meningitis
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to meningitis. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with meningitis. 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 meningitis. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “meningitis” (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
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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 “meningitis”. 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 “meningitis” (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 “meningitis” (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.23
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
23
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)24: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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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
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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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/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 311
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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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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
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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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/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
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
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
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
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 313
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
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
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
314 Meningitis
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
315
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on meningitis: •
Basic Guidelines for Meningitis Meningitis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000680.htm Meningitis - cryptococcal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000642.htm Meningitis - gram negative Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000610.htm Meningitis - H. influenza Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000612.htm Meningitis - meningococcal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000608.htm Meningitis - pneumococcal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000607.htm
316 Meningitis
Meningitis - staphylococcal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000613.htm Meningitis - tuberculous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000650.htm •
Signs & Symptoms for Meningitis Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Breathing, rapid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003071.htm Chills Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003091.htm Consciousness, decreased Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Convulsions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Deafness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Hallucinations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Irritability Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003214.htm Irritability, Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003214.htm Loss of appetite Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003121.htm Loss of vision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003040.htm
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Mental Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003041.htm Mental status change Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Mental status changes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Opisthotonos Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003195.htm Paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003190.htm Petechiae Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003235.htm Photophobia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003041.htm Pinpoint red spots Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003235.htm Poor feeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003022.htm Rash Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Sensitivity to light Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003041.htm Status changes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Stiff neck Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm
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•
Diagnostics and Tests for Meningitis Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Blood culture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003744.htm Chest X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm CSF cell count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003625.htm CSF cell count. Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003625.htm CSF culture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003769.htm CSF glucose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003633.htm CSF glucose measurement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003633.htm CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003330.htm Gram-stain and culture of CSF (cerebral spinal fluid) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003769.htm Head CT scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003786.htm Lumbar puncture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003428.htm Serology Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003511.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm
•
Surgery and Procedures for Meningitis Shunt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003019.htm
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•
Background Topics for Meningitis Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Antigen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002224.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Fontanelles Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002320.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Injury or trauma to the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm Injury to the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.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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MENINGITIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acatalasia: A rare autosomal recessive disorder resulting from the absence of catalase activity. Though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH]
Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylgalactosamine: The N-acetyl derivative of galactosamine. [NIH] Acetylglucosamine: The N-acetyl derivative of glucosamine. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acinetobacter: A genus of gram-negative bacteria of the family Neisseriaceae, found in soil and water and of uncertain pathogenicity. [NIH] Acoustic: Having to do with sound or hearing. [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] Acremonium: A mitosporic fungal genus with many reported ascomycetous teleomorphs. Cephalosporin antibiotics are derived from this genus. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU]
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Acute Disease: Disease having a short and relatively severe course. [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] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Deaminase: An enzyme that catalyzes the hydrolysis of adenosine to inosine with the elimination of ammonia. Since there are wide tissue and species variations in the enzyme, it has been used as a tool in the study of human and animal genetics and in medical diagnosis. EC 3.5.4.4. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adjuvant Therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy. [NIH]
Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adoptive Transfer: Form of passive immunization where previously sensitized immunologic agents (cells or serum) are transferred to non-immune recipients. When transfer of cells is used as a therapy for the treatment of neoplasms, it is called adoptive immunotherapy (immunotherapy, adoptive). [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a
Dictionary 323
synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, oxidative metabolism, or cell respiration. [NIH] Aerobic Respiration: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as oxidative metabolism, cell respiration, or aerobic metabolism. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Air Sacs: Thin-walled sacs or spaces which function as a part of the respiratory system in birds, fishes, insects, and mammals. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkylating Agents: Highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning. Many are used as antineoplastic agents, but most are very toxic, with carcinogenic, mutagenic, teratogenic, and immunosuppressant actions. They have also been used as components in poison gases.
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[NIH]
Allogeneic: Taken from different individuals of the same species. [NIH] Allografts: A graft of tissue obtained from the body of another animal of the same species but with genotype differing from that of the recipient; tissue graft from a donor of one genotype to a host of another genotype with host and donor being members of the same species. [NIH] Allopurinol: A xanthine oxidase inhibitor that decreases uric acid production. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha-fetoprotein: AFP. A protein normally produced by a developing fetus. AFP levels are usually undetectable in the blood of healthy nonpregnant adults. An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor. [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] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amikacin: A broad-spectrum antibiotic derived from kanamycin. It is reno- and ototoxic like the other aminoglycoside antibiotics. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Motifs: Commonly observed structural components of proteins formed by simple combinations of adjacent secondary structures. A commonly observed structure may be composed of a conserved sequence which can be represented by a consensus sequence. [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] Aminocamptothecin: An anticancer drug that belongs to the family of drugs called topoisomerase inhibitors. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of
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organic materials during a large number of metabolically important reactions. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amnion: The extraembryonic membrane which contains the embryo and amniotic fluid. [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] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]
Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anergic: 1. Characterized by abnormal inactivity; inactive. 2. Marked by asthenia or lack of energy. 3. Pertaining to anergy. [EU]
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Anergy: Absence of immune response to particular substances. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiitis: Inflammation of a vessel, chiefly of a blood or a lymph vessel; called also vasculitis. [EU] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] 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] Anionic: Pertaining to or containing an anion. [EU] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]
Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery. Branches of the anterior cerebral artery supply the caudate nucleus, internal capsule, putamen, septal nuclei, gyrus cinguli, and surfaces of the frontal lobe and parietal lobe. [NIH] 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] 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]
Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [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] Antibodies, Anticardiolipin: Antiphospholipid antibodies found in association with systemic lupus erythematosus (lupus erythematosus, systemic), antiphospholipid syndrome, and in a variety of other diseases as well as in healthy individuals. The antibodies are detected by solid-phase immunoassay employing the purified phospholipid antigen cardiolipin. [NIH] Antibodies, Antiphospholipid: Autoantibodies directed against phospholipids. These antibodies are characteristically found in patients with systemic lupus erythematosus, antiphospholipid syndrome, related autoimmune diseases, some non-autoimmune diseases, and also in healthy individuals. [NIH]
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Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidiuretic: Suppressing the rate of urine formation. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antifungal Agents: Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from fungicides, industrial because they defend against fungi present in human or animal tissues. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] 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]
Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiphospholipid Syndrome: The presence of antibodies directed against phospholipids (antibodies, antiphospholipid). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (antibodies, anticardiolipin). Present also are high levels of lupus anticoagulant (lupus coagulation inhibitor). [NIH] Antiserum: The blood serum obtained from an animal after it has been immunized with a
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particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Aplasia: Lack of development of an organ or tissue, or of the cellular products from an organ or tissue. [EU] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Archaea: One of the three domains of life (the others being bacteria and Eucarya), formerly called Archaebacteria under the taxon Bacteria, but now considered separate and distinct. They are characterized by: 1) the presence of characteristic tRNAs and ribosomal RNAs; 2) the absence of peptidoglycan cell walls; 3) the presence of ether-linked lipids built from branched-chain subunits; and 4) their occurrence in unusual habitats. While archaea resemble bacteria in morphology and genomic organization, they resemble eukarya in their method of genomic replication. The domain contains at least three kingdoms: crenarchaeota, euryarchaeota, and korarchaeota. [NIH] Arenavirus: The only genus in the family Arenaviridae. It contains two groups LCM-Lassa complex viruses and Tacaribe complex viruses, which are distinguished by antigenic relationships and geographic distribution. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Asepsis: The prevention of access by infecting organisms to the locus of potential infection. [NIH]
Aseptic: Free from infection or septic material; sterile. [EU]
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Aspartate: A synthetic amino acid. [NIH] Aspergillosis: Infections with fungi of the genus Aspergillus. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astatine: Astatine. A radioactive halogen with the atomic symbol At, atomic number 85, and atomic weight 210. Its isotopes range in mass number from 200 to 219 and all have an extremely short half-life. Astatine may be of use in the treatment of hyperthyroidism. [NIH] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Audiology: The study of hearing and hearing impairment. [NIH] Audiometry: The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds, and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the
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hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Avidity: The strength of the interaction of an antiserum with a multivalent antigen. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] 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] Back Injuries: General or unspecified injuries to the posterior part of the trunk. It includes injuries to the muscles of the back. [NIH] Bacteraemia: The presence of bacteria in the blood. [EU] 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 Adhesion: Physicochemical property of fimbriated and non-fimbriated bacteria of attaching to cells, tissue, and nonbiological surfaces. It is a factor in bacterial colonization and pathogenicity. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacterial toxin: A toxic substance, made by bacteria, that can be modified to kill specific tumor cells without harming normal cells. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] 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] Barotrauma: Injury following pressure changes; includes injury to the eustachian tube, ear drum, lung and stomach. [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
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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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophil: A type of white blood cell. Basophils are granulocytes. [NIH] Beer: An alcoholic beverage usually made from malted cereal grain (as barley), flavored with hops, and brewed by slow fermentation. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biogenesis: The origin of life. It includes studies of the potential basis for life in organic compounds but excludes studies of the development of altered forms of life through mutation and natural selection, which is evolution. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived 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] Bioterrorism: The use of biological agents in terrorism. This includes the malevolent use of
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bacteria, viruses, or toxins against people, animals, or plants. [NIH] Biotin: Hexahydro-2-oxo-1H-thieno(3,4-d)imidazole-4-pentanoic acid. Growth factor present in minute amounts in every living cell. It occurs mainly bound to proteins or polypeptides and is abundant in liver, kidney, pancreas, yeast, and milk.The biotin content of cancerous tissue is higher than that of normal tissue. [NIH] Biotype: A group of individuals having the same genotype. [NIH] Bladder: The organ that stores urine. [NIH] Blastomycosis: A fungal infection that may appear in two forms: 1) a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2) chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood Substitutes: Substances that can carry oxygen to and carbon dioxide away from the tissues when introduced into the blood stream. They are used to replace hemoglobin in severe hemorrhage and also to perfuse isolated organs. The best known are perfluorocarbon emulsions and various hemoglobin solutions. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]
Body Fluids: Liquid components of living organisms. [NIH] Bone Conduction: Sound transmission through the bones of the skull to the inner ear. [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] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH]
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Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Brain Hypoxia: Lack of oxygen leading to unconsciousness. [NIH] Brain Infarction: The formation of an area of necrosis in the brain, including the cerebral hemispheres (cerebral infarction), thalami, basal ganglia, brain stem (brain stem infarctions), or cerebellum secondary to an insufficiency of arterial or venous blood flow. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] 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] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [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]
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Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Chloride: A salt used to replenish calcium levels, as an acid-producing diuretic, and as an antidote for magnesium poisoning. [NIH] Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA topoisomerase. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity. [NIH] Camptothecin analogue: An anticancer drug related in structure to camptothecin, a topoisomerase inhibitor. One such drug is aminocamptothecin. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Capping: A 7-methyl guanosine cap attached to the 5'-end of eucaryotic mRNAs by a phosphodiester linkage. The cap is believed to increase the stability of the message, since most nucleases require a 5'-3'or 3'-5'bond in order to cleave the RNA. [NIH] Capsid: The outer protein protective shell of a virus, which protects the viral nucleic acid. [NIH]
Capsular: Cataract which is initiated by an opacification at the surface of the lens. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbohydrate Sequence: The sequence of carbohydrates within polysaccharides, glycoproteins, and glycolipids. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiolipins: Acidic phospholipids composed of two molecules of phosphatidic acid covalently linked to a molecule of glycerol. They occur primarily in mitochondrial inner membranes and in bacterial plasma membranes. They are the main antigenic components of the Wassermann-type antigen that is used in nontreponemal syphilis serodiagnosis. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH]
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Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [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] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catalase: An oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. It is present in many animal cells. A deficiency of this enzyme results in acatalasia. EC 1.11.1.6. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cefotaxime: Semisynthetic broad-spectrum cephalosporin. [NIH] Ceftriaxone: Broad-spectrum cephalosporin antibiotic with a very long half-life and high penetrability to usually inaccessible infections, including those involving the meninges, eyes, inner ears, and urinary tract. [NIH] Cefuroxime: Broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. It has been proposed for infections with gram-negative and gram-positive organisms, gonorrhea, and haemophilus. [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 Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and
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leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cephalosporin Resistance: Non-susceptibility of an organism to the action of the cephalosporins. [NIH] Cephalosporins: A group of broad-spectrum antibiotics first isolated from the Mediterranean fungus Acremonium (Cephalosporium acremonium). They contain the betalactam moiety thia-azabicyclo-octenecarboxylic acid also called 7-aminocephalosporanic acid. [NIH] Ceramide: A type of fat produced in the body. It may cause some types of cells to die, and is being studied in cancer treatment. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord.
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Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrospinal Fluid Pressure: Manometric pressure of the cerebrospinal fluid as measured by lumbar, cerebroventricular, or cisternal puncture. Within the cranial cavity it is called intracranial pressure. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [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] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapeutics: Noun plural but singular or plural in constructions : chemotherapy. [EU]
Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholera: An acute diarrheal disease endemic in India and Southeast Asia whose causative agent is vibrio cholerae. This condition can lead to severe dehydration in a matter of hours unless quickly treated. [NIH] Cholesteatoma: A non-neoplastic keratinizing mass with stratified squamous epithelium, frequently occurring in the meninges, central nervous system, bones of the skull, and most commonly in the middle ear and mastoid region. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially
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the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorioamnionitis: An inflammatory process involving the chorion, its fetal blood vessels, the umbilical cord, and the amnion by extension of the inflammation, as the amnion itself has no blood supply. This inflammatory process is potentially fatal to mother and fetus. [NIH]
Chorion: The outermost extraembryonic membrane. [NIH] Chorioretinitis: Inflammation of the choroid in which the sensory retina becomes edematous and opaque. The inflammatory cells and exudate may burst through the sensory retina to cloud the vitreous body. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] 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 Disease: Disease or ailment of long duration. [NIH] Chronic granulocytic leukemia: A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myelogenous leukemia or chronic myeloid leukemia. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Cilastatin: A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, imipenem, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukeotriene E4. [NIH]
Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH]
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Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] 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] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Cleave: A double-stranded cut in DNA with a restriction endonuclease. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [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. [NIH]
Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
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Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cochlear Duct: Spiral tube in the bony canal of the cochlea, lying on its outer wall between the scala vestibuli and scala tympani. [NIH] Cochlear Implantation: Surgical insertion of an electronic device implanted beneath the skin with electrodes to the cochlear nerve to create sound sensation in persons with sensorineural deafness. [NIH] Cochlear Implants: Electronic devices implanted beneath the skin with electrodes to the cochlear nerve to create sound sensation in persons with sensorineural deafness. [NIH] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Cochlear Nucleus: The brain stem nucleus that receives the central input from the cochlear nerve. The cochlear nucleus is located lateral and dorsolateral to the inferior cerebellar peduncles and is functionally divided into dorsal and ventral parts. It is tonotopically organized, performs the first stage of central auditory processing, and projects (directly or indirectly) to higher auditory areas including the superior olivary nuclei, the medial geniculi, the inferior colliculi, and the auditory cortex. [NIH] Cod Liver Oil: Oil obtained from fresh livers of the cod family, Gadidae. It is a source of vitamins A and D. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colistin: Cyclic polypeptide antibiotic from Bacillus colistinus. It is composed of Polymyxins E1 and E2 (or Colistins A, B, and C) which act as detergents on cell membranes. Colistin is less toxic than Polymyxin B, but otherwise similar; the methanesulfonate is used orally. [NIH] Colitis: Inflammation of the colon. [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] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Surgery: A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the colon, rectum, and anal canal. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Commensal: 1. Living on or within another organism, and deriving benefit without injuring
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or benefiting the other individual. 2. An organism living on or within another, but not causing injury to the host. [EU] Communicable disease: A disease that can be transmitted by contact between persons. [NIH] Communication Barriers: Those factors, such as language or sociocultural relationships, which interfere in the meaningful interpretation and transmission of ideas between individuals or groups. [NIH] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complement Activation: The sequential activation of serum components C1 through C9, initiated by an erythrocyte-antibody complex or by microbial polysaccharides and properdin, and producing an inflammatory response. [NIH] Complementarity Determining Regions: Three regions (CDR1, CDR2 and CDR3) of amino acid sequence in theimmunoglobulin variable region that are highly divergent. Together the CDRs from the light and heavy immunoglobulin chains form a surface that is complementary to the antigen. These regions are also present in other members of the immunoglobulin superfamily, for example, T-cell receptors (receptors, antigen, T-cell). [NIH] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementation: The production of a wild-type phenotype when two different mutations are combined in a diploid or a heterokaryon and tested in trans-configuration. [NIH]
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Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [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] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Conserved Sequence: A sequence of amino acids in a polypeptide or of nucleotides in DNA or RNA that is similar across multiple species. A known set of conserved sequences is represented by a consensus sequence. Amino acid motifs are often composed of conserved sequences. [NIH]
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Consolidation therapy: Chemotherapy treatments given after induction chemotherapy to further reduce the number of cancer cells. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contact Tracing: Identification of those persons (or animals) who have had such an association with an infected person, animal, or contaminated environment as to have had the opportunity to acquire the infection. Contact tracing is a generally accepted method for the control of sexually transmitted diseases. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast Sensitivity: The ability to detect sharp boundaries (stimuli) and to detect slight changes in luminance at regions without distinct contours. Psychophysical measurements of this visual function are used to evaluate visual acuity and to detect eye disease. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] 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] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal
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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] Coumarins: Synthetic or naturally occurring substances related to coumarin, the deltalactone of coumarinic acid. Coumarin itself occurs in the tonka bean. The various coumarins have a wide range of proposed actions and uses including as anticoagulants, pharmaceutical aids, indicators and reagents, photoreactive substances, and antineoplastic agents. [NIH] Counterimmunoelectrophoresis: Immunoelectrophoresis in which immunoprecipitation occurs when antigen at the cathode is caused to migrate in an electric field through a suitable medium of diffusion against a stream of antibody migrating from the anode as a result of endosmotic flow. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Craniotomy: An operation in which an opening is made in the skull. [NIH] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cryoelectron Microscopy: Electron microscopy involving rapid freezing of the samples. The imaging of frozen-hydrated molecules and organelles permits the best possible resolution closest to the living state, free of chemical fixatives or stains. [NIH] Cryptococcosis: Infection with a fungus of the species Cryptococcus neoformans. [NIH] Cryptococcus: A mitosporic Tremellales fungal genus whose species usually have a capsule and do not form pseudomycellium. Teleomorphs include Filobasidiella and Fidobasidium. [NIH]
Cryptococcus neoformans: A species of the fungus Cryptococcus, which causes cryptococcosis. Its teleomorph is Filobasidiella neoformans. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cystitis: Inflammation of the urinary bladder. [EU]
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Cytarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]
Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [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] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Dacarbazine: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]
De novo: In cancer, the first occurrence of cancer in the body. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment.
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Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] 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] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [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] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Deoxyguanosine: A nucleoside consisting of the base guanine and the sugar deoxyribose. [NIH]
Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Developing Countries: Countries in the process of change directed toward economic
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growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [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] Diphtheria Toxin: A 60 kD single chain protein elaborated by Corynebacterium diphtheriae that causes the sign and symptoms of diphtheria; it can be broken into two unequal fragments, the smaller (A fragment) inhibits protein synthesis and is the lethal moiety that needs the larger (B fragment) for entry into cells. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [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
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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] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] 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] Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH] Dosimetry: All the methods either of measuring directly, or of measuring indirectly and computing, absorbed dose, absorbed dose rate, exposure, exposure rate, dose equivalent, and the science associated with these methods. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH]
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Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Eardrum: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Echovirus 9: A species of enterovirus associated with outbreaks of aseptic meningitis. [NIH] Echoviruses: A group of enteroviruses isolated from man and originally thought not to be associated with disease, whence the name ECHO (enteric cytopathic human orphan); however, several serotypes have been found to cause meningitis, diarrhea, and respiratory disease. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ehrlichia: Small, often pleomorphic, coccoid to ellipsoidal organisms occurring intracytoplasmically in circulating lymphocytes. They are the etiologic agents of tick-borne diseases of humans, dogs, cattle, sheep, goats, and horses. [NIH] Ehrlichiosis: A tick-borne disease characterized by fever, headache, myalgias, anorexia, and occasionally rash. In humans the disease is caused by Ehrlichia chaffeensis, in dogs it is caused by E. canis, and in horses, E. equi. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [NIH] Ellagic Acid: A fused four ring compound occurring free or combined in galls. Isolated from the kino of Eucalyptus maculata Hook and E. Hemipholia F. Muell. Activates Factor XII of
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the blood clotting system which also causes kinin release; used in research and as a dye. [NIH]
Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Encephalocele: Cerebral tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. [NIH]
Encephalomyelitis: A general term indicating inflammation of the brain and spinal cord, often used to indicate an infectious process, but also applicable to a variety of autoimmune and toxic-metabolic conditions. There is significant overlap regarding the usage of this term and encephalitis in the literature. [NIH] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin
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system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endolymph: The fluid contained in the membranous labyrinth of the ear. [NIH] Endolymphatic Duct: Duct connecting the endolymphatic sac with the membranous labyrinth. [NIH] Endolymphatic Sac: The blind pouch at the end of the endolymphatic duct. [NIH] Endophthalmitis: Suppurative inflammation of the tissues of the internal structures of the eye; not all layers of the uvea are affected. Fungi, necrosis of intraocular tumors, and retained intraocular foreign bodies often cause a purulent endophthalmitis. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enterobacter: Gram-negative gas-producing rods found in feces of man and other animals, sewage, soil, water, and dairy products. [NIH] Enterococcus: A genus of gram-positive, coccoid bacteria consisting of organisms causing variable hemolysis that are normal flora of the intestinal tract. Previously thought to be a member of the genus Streptococcus, it is now recognized as a separate genus. [NIH] Enterovirus: A genus of the family Picornaviridae whose members preferentially inhabit the intestinal tract of a variety of hosts. The genus contains many species. Newly described members of human enteroviruses are assigned continuous numbers with the species designated "human enterovirus". [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [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] Enzyme-Linked Immunosorbent Assay: An immunoassay utilizing an antibody labeled
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with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [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] Epidemiological: Relating to, or involving epidemiology. [EU] Epidemiology, Molecular: The application of molecular biology to the answering of epidemiological questions. The examination of patterns of changes in DNA to implicate particular carcinogens and the use of molecular markers to predict which individuals are at highest risk for a disease are common examples. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] 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] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epilepticus: Repeated and prolonged epileptic seizures without recovery of consciousness between attacks. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epistasis: The degree of dominance exerted by one gene on the expression of a non-allelic gene. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an
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antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]
Epitope Mapping: Methods used for studying the interactions of antibodies with specific regions of protein antigens. Important applications of epitope mapping are found within the area of immunochemistry. [NIH] Equipment Failure: Failure of equipment to perform up to standards. The failure may be due to defects or improper use. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [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] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Perforation: A dilated vessel in the lower end of the esophagus that result from portal hypertension. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estrogen: One of the two female sex hormones. [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Eustachian tube: The middle ear cavity is in communication with the back of the nose through the Eustachian tube, which is normally closed, but opens on swallowing, in order to maintain equal air pressure. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH]
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Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] 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] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial
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paralysis or paresis. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from death, the physiological cessation of life and from mortality, an epidemiological or statistical concept. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Febrile: Pertaining to or characterized by fever. [EU] 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] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetal Blood: Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the placenta. The cord blood is blood contained in the umbilical vessels at the time of delivery. [NIH] Fetoprotein: Transabdominal aspiration of fluid from the amniotic sac with a view to detecting increases of alpha-fetoprotein in maternal blood during pregnancy, as this is an important indicator of open neural tube defects in the fetus. [NIH] 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] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process
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whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fixatives: Agents employed in the preparation of histologic or pathologic specimens for the purpose of maintaining the existing form and structure of all of the constituent elements. Great numbers of different agents are used; some are also decalcifying and hardening agents. They must quickly kill and coagulate living tissue. [NIH] Flaccid: Weak, lax and soft. [EU] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Flucytosine: A fluorinated cytosine analog that is used as an antifungal agent. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Frameshift: A type of mutation which causes out-of-phase transcription of the base sequence; such mutations arise from the addition or delection of nucleotide(s) in numbers other than 3 or multiples of 3. [NIH] Frameshift Mutation: A type of mutation in which a number of nucleotides not divisible by three is deleted from or inserted into a coding sequence, thereby causing an alteration in the reading frame of the entire sequence downstream of the mutation. These mutations may be induced by certain types of mutagens or may occur spontaneously. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [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] Fungicides, Industrial: Chemicals that kill or inhibit the growth of fungi in agricultural applications, on wood, plastics, or other materials, in swimming pools, etc. [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
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chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma knife: Radiation therapy in which high-energy rays are aimed at a tumor from many angles in a single treatment session. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gangrenous: A circumscribed, deep-seated, suppurative inflammation of the subcutaneous tissue of the eyelid discharging pus from several points. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]
Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gelsolin: A 90-kD protein produced by macrophages that severs actin filaments and forms a cap on the newly exposed filament end. Gelsolin is activated by calcium ions and participates in the assembly and disassembly of actin, thereby increasing the motility of some cells. [NIH] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]
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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 Deletion: A genetic rearrangement through loss of segments of DNA or RNA, bringing sequences which are normally separated into close proximity. This deletion may be detected using cytogenetic techniques and can also be inferred from the phenotype, indicating a deletion at one specific locus. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]
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] Glioma: A cancer of the brain that comes from glial, or supportive, cells. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomeruli: Plural of glomerulus. [NIH] Glottis: The vocal apparatus of the larynx, consisting of the true vocal cords (plica vocalis) and the opening between them (rima glottidis). [NIH]
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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] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glyceraldehyde 3-Phosphate: An aldotriose which is an important intermediate in glycolysis and in tryptophan biosynthesis. [NIH] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Glycosyltransferases: Enzymes that catalyze the transfer of glycosyl groups to an acceptor. Most often another carbohydrate molecule acts as an acceptor, but inorganic phosphate can also act as an acceptor, such as in the case of phosphorylases. Some of the enzymes in this group also catalyze hydrolysis, which can be regarded as transfer of a glycosyl group from the donor to water. Subclasses include the hexosyltransferases, pentosyltransferases, sialyltransferases, and those transferring other glycosyl groups. EC 2.4. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related
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to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] 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] Gp120: 120-kD HIV envelope glycoprotein which is involved in the binding of the virus to its membrane receptor, the CD4 molecule, found on the surface of certain cells in the body. [NIH]
Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] 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] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Grafting: The operation of transfer of tissue from one site to another. [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-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] 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] Granule: A small pill made from sucrose. [EU] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanine: One of the four DNA bases. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Guinea Pigs: A common name used for the family Caviidae. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research. [NIH]
Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH]
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Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemophilus: A genus of Pasteurellaceae that consists of several species occurring in animals and humans. Its organisms are described as gram-negative, facultatively anaerobic, coccobacillus or rod-shaped, and nonmotile. [NIH] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [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] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Helminthiasis: Infestation with parasitic worms of the helminth class. [NIH] Hematogenous: Originating in the blood or spread through the bloodstream. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Hemin: Chloro(7,12-diethenyl-3,8,13,17-tetramethyl-21H,23H-porphine-2,18dipropanoato(4-)-N(21),N(22),N(23),N(24)) ferrate(2-) dihydrogen. [NIH]
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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] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemoperitoneum: Hemorrhage into the peritoneal cavity. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatic Encephalopathy: A condition that may cause loss of consciousness and coma. It is usually the result of advanced liver disease. Also called hepatic coma. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [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] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] 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] Hexosyltransferases: Enzymes that catalyze the transfer of hexose groups. EC 2.4.1.-. [NIH]
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Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histamine Release: The secretion of histamine from mast cell and basophil granules by exocytosis. This can be initiated by a number of factors, all of which involve binding of IgE, cross-linked by antigen, to the mast cell or basophil's Fc receptors. Once released, histamine binds to a number of different target cell receptors and exerts a wide variety of effects. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] 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] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Horseradish Peroxidase: An enzyme isolated from horseradish which is able to act as an antigen. It is frequently used as a histochemical tracer for light and electron microscopy. Its antigenicity has permitted its use as a combined antigen and marker in experimental immunology. [NIH] Hospitals, Public: Hospitals controlled by various types of government, i.e., city, county, district, state or federal. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent,
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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] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hyperreflexia: Exaggeration of reflexes. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hypoxic: Having too little oxygen. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Idiotype: The unique antigenic determinant in the variable region. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH]
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Imipenem: Semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. It is stable to beta-lactamases. Clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. Its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor. [NIH] Immaturity: The state or quality of being unripe or not fully developed. [EU] Immune adjuvant: A drug that stimulates the immune system to respond to disease. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunization Programs: Organized services to administer immunization procedures in the prevention of various diseases. The programs are made available over a wide range of sites: schools, hospitals, public health agencies, voluntary health agencies, etc. They are administered to an equally wide range of population groups or on various administrative levels: community, municipal, state, national, international. [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunocompromised Host: A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunodominant Epitopes: Subunits of the antigenic determinant that are most easily recognized by the immune system and thus most influence the specificity of the induced antibody. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunogen: A substance that is capable of causing antibody formation. [NIH]
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Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunoglobulin Variable Region: That region of the immunoglobulin (antibody) molecule that varies in its amino acid sequence and composition, confers the antigenic specificity, and is thought to comprise the binding site for the antigen. It is located at the N-terminus of the Fab fragment of the immunoglobulin. It includes hypervariable regions (complementarity determining regions) and framework regions. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Immunotoxin: An antibody linked to a toxic substance. Some immmunotoxins can bind to cancer cells and kill them. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incidental: 1. Small and relatively unimportant, minor; 2. Accompanying, but not a major part of something; 3. (To something) Liable to occur because of something or in connection with something (said of risks, responsibilities, .) [EU] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] 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] Incus: One of three ossicles of the middle ear. It conducts sound vibrations from the malleus to the stapes. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a
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specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
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] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [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] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been
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identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insertional: A technique in which foreign DNA is cloned into a restriction site which occupies a position within the coding sequence of a gene in the cloning vector molecule. Insertion interrupts the gene's sequence such that its original function is no longer expressed. [NIH] 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] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-12: A heterodimeric cytokine that stimulates the production of interferon gamma from T-cells and natural killer cells, and also induces differentiation of Th1 helper cells. It is an initiator of cell-mediated immunity. [NIH] Interleukin-16: Cytokine produced by activated T-lymphocytes that stimulates the migration of CD4-positive lymphocytes and monocytes. It has been reported to suppress HIV replication. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interneurons: Most generally any neurons which are not motor or sensory. Interneurons may also refer to neurons whose axons remain within a particular brain region as contrasted with projection neurons which have axons projecting to other brain regions. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU]
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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] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial Hypotension: A condition in which there is a diminution or loss of muscular tonicity, in consequence of which the muscles may be stretched beyond their normal limits. [NIH]
Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intracranial tumors: Tumors that occur in the brain. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intramuscular injection: IM. Injection into a muscle. [NIH] Intraocular: Within the eye. [EU] 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]
Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [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] Isoelectric: Separation of amphoteric substances, dissolved in water, based on their isoelectric behavior. The amphoteric substances are a mixture of proteins to be separated and of auxiliary "carrier ampholytes". [NIH] Isoelectric Point: The pH in solutions of proteins and related compounds at which the
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dipolar ions are at a maximum. [NIH] Isoenzymes: One of various structurally related forms of an enzyme, each having the same mechanism but with differing chemical, physical, or immunological characteristics. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kanamycin: Antibiotic complex produced by Streptomyces kanamyceticus from Japanese soil. Comprises 3 components: kanamycin A, the major component, and kanamycins B and C, the minor components. [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] Keratoconjunctivitis: Simultaneous inflammation of the cornea and conjunctiva. [NIH] Keratoconjunctivitis Sicca: Drying and inflammation of the conjunctiva as a result of insufficient lacrimal secretion. When found in association with xerostomia and polyarthritis, it is called Sjogren's syndrome. [NIH] Ketorolac: A drug that belongs to a family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in cancer prevention. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetic: Pertaining to or producing motion. [EU] Kyphosis: A deformity of the spine characterized by extensive flexion. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Labyrinthine: A vestibular nystagmus resulting from stimulation, injury, or disease of the labyrinth. [NIH] Labyrinthitis: Inflammation of the inner ear. [NIH] Laceration: 1. The act of tearing. 2. A torn, ragged, mangled wound. [EU] Lacrimal: Pertaining to the tears. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH]
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Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] 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] Leptomeningeal metastases: Cancer that has spread from the original (primary) tumor to the tissues that cover the brain and spinal cord. [NIH] Leptospirosis: Infections with bacteria of the genus Leptospira. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukoencephalopathy: A condition with spongy holes in the brain's white matter. [NIH] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Levofloxacin: A substance used to treat bacterial infections. It belongs to the family of drugs called quinolone antibiotics. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligase: An enzyme that repairs single stranded discontinuities in double-stranded DNA molecules in the cell. Purified DNA ligase is used in gene cloning to join DNA molecules together. [NIH] Ligase Chain Reaction: A DNA amplification technique based upon the ligation of oligonucleotide probes. The probes are designed to exactly match two adjacent sequences of a specific target DNA. The chain reaction is repeated in three steps in the presence of excess probe: (1) heat denaturation of double-stranded DNA, (2) annealing of probes to target DNA, and (3) joining of the probes by thermostable DNA ligase. After the reaction is repeated for 20-30 cycles the production of ligated probe is measured. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [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] Lipid: Fat. [NIH]
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Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [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] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]
Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] 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] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Local therapy: Treatment that affects cells in the tumor and the area close to it. [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] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically
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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] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] 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] Lymphocyte Subsets: A classification of lymphocytes based on structurally or functionally different populations of cells. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphocytic Choriomeningitis Virus: The type species of arenavirus, part of the LCMLassa complex viruses, producing an inapparent infection in house and laboratory mice. In humans, infection with LCMV can be inapparent, or can present with an influenza-like illness, a benign aseptic meningitis, or a severe meningoencephalomyelitis. The virus can also infect monkeys, dogs, field mice, guinea pigs, and hamsters, the latter an epidemiologically important host. [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] Lymphoproliferative: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Lysosome: A sac-like compartment inside a cell that has enzymes that can break down cellular components that need to be destroyed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macroglia: A type of neuroglia composed of astrocytes. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH]
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Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
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] Malignant tumor: A tumor capable of metastasizing. [NIH] Malleus: The largest of the auditory ossicles, and the one attached to the membrana tympani (tympanic membrane). Its club-shaped head articulates with the incus. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] Mastitis: Inflammatory disease of the breast, or mammary gland. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillofacial Injuries: General or unspecified injuries involving the face and jaw (either upper, lower, or both). [NIH] Measles-Mumps-Rubella Vaccine: A combined vaccine used to prevent measles, mumps, and rubella. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU]
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Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Errors: Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (diagnostic errors), errors in the administration of drugs and other medications (medication errors), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from malpractice in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medication Errors: Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage. [NIH]
MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [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] Melphalan: An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meningeal: Refers to the meninges, the tissue covering the brain and spinal cord. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU]
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Meningocele: A congenital or acquired protrusion of the meninges, unaccompanied by neural tissue, through a bony defect in the skull or vertebral column. [NIH] Meningococcal Infections: Infections with bacteria of the species neisseria meningitidis. [NIH]
Meningococcal Vaccines: Vaccines or candidate vaccines used to prevent infection with Neisseria meningitidis. [NIH] Meningoencephalitis: An inflammatory process involving the brain (encephalitis) and meninges (meningitis), most often produced by pathogenic organisms which invade the central nervous system, and occasionally by toxins, autoimmune disorders, and other conditions. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [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] Metastasize: To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH]
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Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microfilaments: The smallest of the cytoskeletal filaments. They are composed chiefly of actin. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [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] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microvilli: Minute projections of cell membranes which greatly increase the surface area of the cell. [NIH] Migrans: Infestation of the dermis by various larvae, characterized by bizarre red irregular lines which are broad at one end and fade at the other, produced by burrowing larvae. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mixed Connective Tissue Disease: A syndrome with overlapping clinical features of systemic lupus erythematosus, scleroderma, polymyositis, and Raynaud's phenomenon. The disease is differentially characterized by high serum titers of antibodies to ribonucleasesensitive extractable (saline soluble) nuclear antigen and a "speckled" epidermal nuclear staining pattern on direct immunofluorescence. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which
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the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular mass: The sum of the atomic masses of all atoms in a molecule, based on a scale in which the atomic masses of hydrogen, carbon, nitrogen, and oxygen are 1, 12, 14, and 16, respectively. For example, the molecular mass of water, which has two atoms of hydrogen and one atom of oxygen, is 18 (i.e., 2 + 16). [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH]
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Multivalent: Pertaining to a group of 5 or more homologous or partly homologous chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Mutagenic: Inducing genetic mutation. [EU] Myalgia: Pain in a muscle or muscles. [EU] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH]
Mycoplasma: A genus of gram-negative, facultatively anaerobic bacteria bounded by a plasma membrane only. Its organisms are parasites and pathogens, found on the mucous membranes of humans, animals, and birds. [NIH] Mycoplasma Infections: Infections with species of the genus Mycoplasma. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelitis: Inflammation of the spinal cord. Relatively common etiologies include infections; autoimmune diseases; spinal cord; and ischemia (see also spinal cord vascular diseases). Clinical features generally include weakness, sensory loss, localized pain, incontinence, and other signs of autonomic dysfunction. [NIH] Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [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] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] Natural selection: A part of the evolutionary process resulting in the survival and reproduction of the best adapted individuals. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training,
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health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Nebramycin: A complex of antibiotic substances produced by Streptomyces tenebrarius. [NIH]
Neck Muscles: The neck muscles consist of the platysma, splenius cervicis, sternocleidomastoid(eus), longus colli, the anterior, medius, and posterior scalenes, digastric(us), stylohyoid(eus), mylohyoid(eus), geniohyoid(eus), sternohyoid(eus), omohyoid(eus), sternothyroid(eus), and thyrohyoid(eus). [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [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] Negative Staining: The technique of washing tissue specimens with a concentrated solution of a heavy metal salt and letting it dry. The specimen will be covered with a very thin layer of the metal salt, being excluded in areas where an adsorbed macromolecule is present. The macromolecules allow electrons from the beam of an electron microscope to pass much more readily than the heavy metal; thus, a reversed or negative image of the molecule is created. [NIH] Neisseria: A genus of gram-negative, aerobic, coccoid bacteria whose organisms are part of the normal flora of the oropharynx, nasopharynx, and genitourinary tract. Some species are primary pathogens for humans. [NIH] Neisseria meningitidis: A species of gram-negative, aerobic bacteria found in cerebrospinal fluid as the causative agent of cerebrospinal meningitis (meningitis, meningococcal) as well as in venereal discharges and blood. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] 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] Neoplastic meningitis: Tumor cells that have spread from the original (primary) tumor to the tissue that covers the brain, spinal cord, or both. [NIH] 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] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural tube defects: These defects include problems stemming from fetal development of the spinal cord, spine, brain, and skull, and include birth defects such as spina bifida, anencephaly, and encephalocele. Neural tube defects occur early in pregnancy at about 4 to 6 weeks, usually before a woman knows she is pregnant. Many babies with neural tube defects have difficulty walking and with bladder and bowel control. [NIH]
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Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuraminidase: An enzyme that catalyzes the hydrolysis of alpha-2,3, alpha-2,6-, and alpha-2,8-glycosidic linkages (at a decreasing rate, respectively) of terminal sialic residues in oligosaccharides, glycoproteins, glycolipids, colominic acid, and synthetic substrate. (From Enzyme Nomenclature, 1992) EC 3.2.1.18. [NIH] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurogenic Inflammation: Inflammation caused by an injurious stimulus of peripheral neurons and resulting in release of neuropeptides which affect vascular permeability and help initiate proinflammatory and immune reactions at the site of injury. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Diseases: A general term encompassing lower motor neuron disease; peripheral nervous system diseases; and certain muscular diseases. Manifestations include muscle weakness; fasciculation; muscle atrophy; spasm; myokymia; muscle hypertonia, myalgias, and musclehypotonia. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptides: Peptides released by neurons as intercellular messengers. Many neuropeptides are also hormones released by non-neuronal cells. [NIH] Neuroretinitis: Inflammation of the optic nerve head and adjacent retina. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Neurosurgical Procedures: Surgery performed on the nervous system or its parts. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]
Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU]
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Neutrophil: A type of white blood cell. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Night Blindness: Anomaly of vision in which there is a pronounced inadequacy or complete absence of dark-adaptation. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Non-small cell lung cancer: A group of lung cancers that includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleolus: A small dense body (sub organelle) within the nucleus of eukaryotic cells, visible by phase contrast and interference microscopy in live cells throughout interphase. Contains RNA and protein and is the site of synthesis of ribosomal RNA. [NIH]
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Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nurseries: Facilities which provide care for infants. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Odontoid Process: The toothlike process on the upper surface of the axis, which articulates with the atlas above. [NIH] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Oligonucleotide Probes: Synthetic or natural oligonucleotides used in hybridization studies in order to identify and study specific nucleic acid fragments, e.g., DNA segments near or within a specific gene locus or gene. The probe hybridizes with a specific mRNA, if present. Conventional techniques used for testing for the hybridization product include dot blot assays, Southern blot assays, and DNA:RNA hybrid-specific antibody tests. Conventional labels for the probe include the radioisotope labels 32P and 125I and the chemical label biotin. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic disc: The circular area (disc) where the optic nerve connects to the retina. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Optic Neuritis: Inflammation of the optic nerve. Commonly associated conditions include autoimmune disorders such as multiple sclerosis, infections, and granulomatous diseases. Clinical features include retro-orbital pain that is aggravated by eye movement, loss of color vision, and contrast sensitivity that may progress to severe visual loss, an afferent pupillary defect (Marcus-Gunn pupil), and in some instances optic disc hyperemia and swelling. Inflammation may occur in the portion of the nerve within the globe (neuropapillitis or
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anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis). [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Oropharynx: Oral part of the pharynx. [NIH] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] 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] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] 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] Osteotomy: The surgical cutting of a bone. [EU] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Otitis Media with Effusion: Inflammation of the middle ear with a clear pale yellowcolored transudate. [NIH] Otolaryngologist: A doctor who specializes in treating diseases of the ear, nose, and throat. Also called an ENT doctor. [NIH] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Otorrhea: A discharge from the ear, especially a purulent one. [EU] Otosclerosis: The formation of spongy bone in the labyrinth capsule. The ossicles can become fixed and unable to transmit sound vibrations, thereby causing deafness. [NIH] Ototoxic: Having a deleterious effect upon the eighth nerve, or upon the organs of hearing and balance. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oval Window: Fenestra of the vestibule; an oval opening in the medial wall of the middle ear leading into the vestibule. Normally it is covered by the base of the stapes. [NIH]
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Overexpress: An excess of a particular protein on the surface of a cell. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oximetry: The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] 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] Panophthalmitis: Acute suppurative inflammation of the inner eye with necrosis of the sclera (and sometimes the cornea) and extension of the inflammation into the orbit. Pain may be severe and the globe may rupture. In endophthalmitis the globe does not rupture. [NIH]
Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] 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] 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] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paresis: A general term referring to a mild to moderate degree of muscular weakness,
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occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] 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] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Partial Thromboplastin Time: Test of the intrinsic (factors VIII, IX, XI, and XII) and common (fibrinogen, prothrombin, factors V and X) pathways of coagulation in which a mixture of plasma and phospholipid platelet substitute (e.g., crude cephalins, soybean phosphatides) is recalcified and the time required for the appearance of fibrin strands measured. Activation may be provided by contact with the glass tube or exposure to activators (e.g., ellagic acid, particulate silicates such as diatomaceous earth or kaolin) before addition of the calcium chloride. It is used as a screening test and to monitor heparin therapy. [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] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] 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]
Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Pentosyltransferases: Enzymes of the transferase class that catalyze the transfer of a pentose group from one compound to another. (Dorland, 28th ed) EC 2.4.2. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of
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proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Peptide T: N-(N-(N(2)-(N-(N-(N-(N-D-Alanyl L-seryl)-L-threonyl)-L-threonyl) L-threonyl)L-asparaginyl)-L-tyrosyl) L-threonine. Octapeptide sharing sequence homology with HIV envelope protein gp120. It is potentially useful as antiviral agent in AIDS therapy. The core pentapeptide sequence, TTNYT, consisting of amino acids 4-8 in peptide T, is the HIV envelope sequence required for attachment to the CD4 receptor. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Perilymph: The fluid contained within the space separating the membranous from the osseous labyrinth of the ear. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Periplasm: The space between the inner and outer membranes of a cell that is shared with the cell wall. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH]
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Perivascular: Situated around a vessel. [EU] Periventricular Leukomalacia: Rare form of epilepsy. [NIH] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [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] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] 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] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [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] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of
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norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Phosphorylcholine: Calcium and magnesium salts used therapeutically in hepatobiliary dysfunction. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Photophobia: Abnormal sensitivity to light. This may occur as a manifestation of eye diseases; migraine; subarachnoid hemorrhage; meningitis; and other disorders. Photophobia may also occur in association with depression and other mental disorders. [NIH] Physicochemical: Pertaining to physics and chemistry. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Picornavirus: Any of a group of tiny RNA-containing viruses including the enteroviruses and rhinoviruses. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]
Pilot study: The initial study examining a new method or treatment. [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] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] 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,
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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] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activating Factor: A phospholipid derivative formed by platelets, basophils, neutrophils, monocytes, and macrophages. It is a potent platelet aggregating agent and inducer of systemic anaphylactic symptoms, including hypotension, thrombocytopenia, neutropenia, and bronchoconstriction. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pneumococcal Infections: Infections with bacteria of the species Streptococcus pneumoniae. [NIH]
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Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Poliomyelitis: An acute viral disease, occurring sporadically and in epidemics, and characterized clinically by fever, sore throat, headache, and vomiting, often with stiffness of the neck and back. In the minor illness these may be the only symptoms. The major illness, which may or may not be preceded by the minor illness, is characterized by involvement of the central nervous system, stiff neck, pleocytosis in the spinal fluid, and perhaps paralysis. There may be subsequent atrophy of groups of muscles, ending in contraction and permanent deformity. The major illness is called acute anterior p., infantile paralysis and Heine-Medin disease. The disease is now largely controlled by vaccines. [EU] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polyarteritis Nodosa: A form of necrotizing vasculitis involving small- and medium-sized arteries. The signs and symptoms result from infarction and scarring of the affected organ system. [NIH] Polyarthritis: An inflammation of several joints together. [EU] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polyneuritis: Inflammation of several peripheral nerves at the same time. [NIH] Polyradiculopathy: Disease or injury involving multiple spinal nerve roots. Polyradiculitis refers to inflammation of multiple spinal nerve roots. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars
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ventralis. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Portal Hypertension: High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis. [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] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [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] Preclinical: Before a disease becomes clinically recognizable. [EU] 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] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [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]
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Premenstrual: Occurring before menstruation. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Preoperative: Preceding an operation. [EU] Presbycusis: Progressive bilateral loss of hearing that occurs in the aged. Syn: senile deafness. [NIH] 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] Prion: Small proteinaceous infectious particles that resist inactivation by procedures modifying nucleic acids and contain an abnormal isoform of a cellular protein which is a major and necessary component. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [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] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] 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] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH]
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Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [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] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]
Prothrombin Time: Measurement of clotting time of plasma recalcified in the presence of excess tissue thromboplastin. Factors measured are fibrinogen, prothrombin, and factors V, VII, and X. It is used for monitoring anticoagulant therapy with coumarins. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Protozoan Infections: Infections with unicellular organisms of the subkingdom Protozoa. [NIH]
Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudomonas: A genus of gram-negative, aerobic, rod-shaped bacteria widely distributed in nature. Some species are pathogenic for humans, animals, and plants. [NIH] Pseudotumor Cerebri: A condition marked by raised intracranial pressure and characterized clinically by headaches; nausea; papilledema, peripheral constriction of the visual fields, transient visual obscurations, and pulsatile tinnitus. Obesity is frequently associated with this condition, which primarily affects women between 20 and 44 years of age. Chronic papilledema may lead to optic nerve injury (optic nerve diseases) and visual loss (blindness). [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
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psoriasis. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Punctures: Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures. [NIH] Pupil: The aperture in the iris through which light passes. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Pyramidal Cells: Projection neurons in the cerebral cortex and the hippocampus. Pyramidal cells have a pyramid-shaped soma with the apex and an apical dendrite pointed toward the pial surface and other dendrites and an axon emerging from the base. The axons may have local collaterals but also project outside their cortical region. [NIH] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Pyrexia: A fever, or a febrile condition; abnormal elevation of the body temperature. [EU] Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH]
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Pyridoxal Phosphate: 3-Hydroxy-2-methyl-5-((phosphonooxy)methyl)-4pyridinecarboxaldehyde. An enzyme co-factor vitamin. [NIH] Pyrogenic: Inducing fever. [EU] Quadriplegia: Severe or complete loss of motor function in all four limbs which may result from brain diseases; spinal cord diseases; peripheral nervous system diseases; neuromuscular diseases; or rarely muscular diseases. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper brain stem which injures the descending cortico-spinal and cortico-bulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quercetin: Aglucon of quercetrin, rutin, and other glycosides. It is widely distributed in the plant kingdom, especially in rinds and barks, clover blossoms, and ragweed pollen. [NIH] 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] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiologist: A doctor who specializes in creating and interpreting pictures of areas inside the body. The pictures are produced with x-rays, sound waves, or other types of energy. [NIH]
Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in
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the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] 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] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] 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] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] 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] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH]
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Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Respiratory Mucosa: The mucous membrane lining the respiratory tract. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Respiratory syncytial virus: RSV. A virus that causes respiratory infections with cold-like symptoms. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent
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on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinitis Pigmentosa: Hereditary, progressive degeneration of the neuroepithelium of the retina characterized by night blindness and progressive contraction of the visual field. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retrobulbar: Behind the pons. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Reversion: A return to the original condition, e. g. the reappearance of the normal or wild type in previously mutated cells, tissues, or organisms. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Ribonuclease: RNA-digesting enzyme. [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribonucleoproteins: Proteins conjugated with ribonucleic acids (RNA) or specific RNA. Many viruses are ribonucleoproteins. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH]
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Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ristocetin: An antibiotic mixture of two components, A and B, obtained from Nocardia lurida (or the same substance produced by any other means). It is no longer used clinically because of its toxicity. It causes platelet agglutination and blood coagulation and is used to assay those functions in vitro. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubella: An acute, usually benign, infectious disease caused by a togavirus and most often affecting children and nonimmune young adults, in which the virus enters the respiratory tract via droplet nuclei and spreads to the lymphatic system. It is characterized by a slight cold, sore throat, and fever, followed by enlargement of the postauricular, suboccipital, and cervical lymph nodes, and the appearances of a fine pink rash that begins on the head and spreads to become generalized. Called also German measles, roetln, röteln, and three-day measles, and rubeola in French and Spanish. [EU] Rural Population: The inhabitants of rural areas or of small towns classified as rural. [NIH] Rutin: 3-((6-O-(6-Deoxy-alpha-L-mannopyranosyl)-beta-D-glucopyranosyl)oxy)-2-(3,4dihydroxyphenyl)-5,7-dihydroxy-4H-1-benzopyran-4-one. Found in many plants, including buckwheat, tobacco, forsythia, hydrangea, pansies, etc. It has been used therapeutically to decrease capillary fragility. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salmonella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that utilizes citrate as a sole carbon source. It is pathogenic for humans, causing enteric fevers, gastroenteritis, and bacteremia. Food poisoning is the most common clinical manifestation. Organisms within this genus are separated on the basis of antigenic characteristics, sugar fermentation patterns, and bacteriophage susceptibility. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH]
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Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Schwannoma: A tumor of the peripheral nervous system that begins in the nerve sheath (protective covering). It is almost always benign, but rare malignant schwannomas have been reported. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] 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] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the
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quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Septicaemia: A term originally used to denote a putrefactive process in the body, but now usually referring to infection with pyogenic micro-organisms; a genus of Diptera; the severe type of infection in which the blood stream is invaded by large numbers of the causal. [NIH] Septicemia: Systemic disease associated with the presence and persistence of pathogenic microorganisms or their toxins in the blood. Called also blood poisoning. [EU] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Sequence Homology: The degree of similarity between sequences. Studies of amino acid and nucleotide sequences provide useful information about the genetic relatedness of certain species. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] 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] Seroconversion: The change of a serologic test from negative to positive, indicating the development of antibodies in response to infection or immunization. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotypes: A cause of haemorrhagic septicaemia (in cattle, sheep and pigs), fowl cholera of birds, pasteurellosis of rabbits, and gangrenous mastitis of ewes. It is also commonly found in atrophic rhinitis of pigs. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shedding: Release of infectious particles (e. g., bacteria, viruses) into the environment, for example by sneezing, by fecal excretion, or from an open lesion. [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
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circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Sialic Acids: A group of naturally occurring N-and O-acyl derivatives of the deoxyamino sugar neuraminic acid. They are ubiquitously distributed in many tissues. [NIH] Sialyltransferases: A group of enzymes with the general formula CMP-Nacetylneuraminate:acceptor N-acetylneuraminyl transferase. They catalyze the transfer of Nacetylneuraminic acid from CMP-N-acetylneuraminic acid to an acceptor, which is usually the terminal sugar residue of an oligosaccharide, a glycoprotein, or a glycolipid. EC 2.4.99.-. [NIH]
Sicca: Failure of lacrimal secretion, keratoconjunctivitis sicca, failure of secretion of the salivary glands and mucous glands of the upper respiratory tract and polyarthritis. [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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Skull Base: The inferior region of the skull consisting of an internal (cerebral), and an external (basilar) surface. [NIH] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH]
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Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Snails: Marine, freshwater, or terrestrial mollusks of the class Gastropoda. Most have an enclosing spiral shell, and several genera harbor parasites pathogenic to man. [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] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Security: Government sponsored social insurance programs. [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] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In
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taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrophotometry: The art or process of comparing photometrically the relative intensities of the light in different parts of the spectrum. [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] Speech Perception: The process whereby an utterance is decoded into a representation in terms of linguistic units (sequences of phonetic segments which combine to form lexical and grammatical morphemes). [NIH] Sperm: The fecundating fluid of the male. [NIH] Sphenoid: An unpaired cranial bone with a body containing the sphenoid sinus and forming the posterior part of the medial walls of the orbits. [NIH] Sphenoid Sinus: One of the paired paranasal sinuses, located in the body of the sphenoid bone and communicating with the highest meatus of the nasal cavity on the same side. [NIH] Sphenoid Sinusitis: Inflammation of the sphenoid sinus. This condition usually is accompanied by pansinusitis and may present itself in an acute or chronic form. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal Cord Vascular Diseases: Hypoxic-ischemic and hemorrhagic disorders of the spinal cord. Arteriosclerosis, emboli, and vascular malformations are potential causes of these conditions. [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Spiral Ganglion: The sensory ganglion of the cochlear nerve. The cells of the spiral ganglion send fibers peripherally to the cochlear hair cells and centrally to the cochlear nuclei of the brain stem. [NIH] 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]
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Splenectomy: An operation to remove the spleen. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous Epithelium: Tissue in an organ such as the esophagus. Consists of layers of flat, scaly cells. [NIH] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Stapes: One of the three ossicles of the middle ear. It transmits sound vibrations from the incus to the internal ear. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between
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the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Streptavidin: A 60kD extracellular protein of Streptomyces avidinii with four high-affinity biotin binding sites. Unlike AVIDIN, streptavidin has a near neutral isoelectric point and is free of carbohydrate side chains. [NIH] Streptococcal: Caused by infection due to any species of 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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stria: 1. A streak, or line. 2. A narrow bandlike structure; a general term for such longitudinal collections of nerve fibres in the brain. [EU] Stria Vascularis: A layer of highly vascular pigmented granular cells on the outer wall of the cochlear duct. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subdural Effusion: Leakage and accumulation of cerebrospinal fluid in the subdural space which may be associated with an infectious process; craniocerebral trauma; brain neoplasms; intracranial hypotension; and other conditions. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [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]
Substrate: A substance upon which an enzyme acts. [EU] Substrate Specificity: A characteristic feature of enzyme activity in relation to the kind of substrate on which the enzyme or catalytic molecule reacts. [NIH] Sulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus
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extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]
Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] 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] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] 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]
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Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temozolomide: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [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] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [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] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thermoregulation: Heat regulation. [EU] Thoracic: Having to do with the chest. [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] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also
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called platelets. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombopenia: Reduction in the number of platelets in the blood. [NIH] Thrombophlebitis: Inflammation of a vein associated with thrombus formation. [NIH] Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation. [NIH] Thromboses: The formation or presence of a blood clot within a blood vessel during life. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Tick-Borne Diseases: Bacterial, viral, or parasitic diseases transmitted to humans and animals by the bite of infected ticks. The families Ixodidae and Argasidae contain many bloodsucking species that are important pests of man and domestic birds and mammals and probably exceed all other arthropods in the number and variety of disease agents they transmit. Many of the tick-borne diseases are zoonotic. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a
Dictionary 411
specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH] Tobramycin: An aminoglycoside, broad-spectrum antibiotic produced by Streptomyces tenebrarius. It is effective against gram-negative bacteria, especially the Pseudomonas species. It is a 10% component of the antibiotic complex, nebramycin, produced by the same species. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Topical: On the surface of the body. [NIH] Topotecan: An antineoplastic agent used to treat ovarian cancer. It works by inhibiting DNA topoisomerase. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Toxoid: The material resulting from the treatment of toxin in such a way that the toxic properties are inactivated whilst the antigenic potency remains intact. [NIH] Toxoplasma: A genus of protozoa parasitic to birds and mammals. T. gondii is one of the most common infectious pathogenic animal parasites of man. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]
Trachea: The cartilaginous and membranous tube descending from the larynx and
412 Meningitis
branching into the right and left main bronchi. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transitional cell carcinoma: A type of cancer that develops in the lining of the bladder, ureter, or renal pelvis. [NIH] Translating: Conversion from one language to another language. [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] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Translocate: The attachment of a fragment of one chromosome to a non-homologous chromosome. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transposons: Discrete genetic elements capable of inserting, in a non-permuted fashion, into the chromosomes of many bacteria. [NIH] Trastuzumab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. Trastuzumab blocks the effects of the growth factor protein HER2, which transmits growth signals to breast cancer cells. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of
Dictionary 413
management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Triad: Trivalent. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Tropism: Directed movements and orientations found in plants, such as the turning of the sunflower to face the sun. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tryptophan Synthase: An enzyme that catalyzes the conversion of L-serine and 1-(indol-3yl)glycerol 3-phosphate to L-tryptophan and glyceraldehyde 3-phosphate. It is a pyridoxal phosphate protein that also catalyzes the conversion of serine and indole into tryptophan and water and of indoleglycerol phosphate into indole and glyceraldehyde phosphate. (From Enzyme Nomenclature, 1992) EC 4.2.1.20. [NIH] Tubercular: Of, pertaining to, or resembling tubercles or nodules. [EU] Tuberculoma: A tumor-like mass resulting from the enlargement of a tuberculous lesion. [NIH]
Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]
Turpentine: The concrete oleoresin obtained from Pinus palustris Mill. (Pinaceae) and other species of Pinus. It contains a volatile oil, to which its properties are due, and to which form it is generally used. (Dorland, 28th ed) Turpentine is used as a solvent and an experimental irritant in biomedical research. Turpentine toxicity is of medical interest. [NIH] Tympanic membrane: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] TYPHI: The bacterium that gives rise to typhoid fever. [NIH] Typhimurium: Microbial assay which measures his-his+ reversion by chemicals which cause base substitutions or frameshift mutations in the genome of this organism. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Tyrosine Phenol-Lyase: An enzyme that catalyzes the cleavage of tyrosine to phenol, pyruvate, and ammonia. It is a pyridoxal phosphate protein. The enzyme also forms pyruvate from D-tyrosine, L-cysteine, S-methyl-L-cysteine, L-serine, and D-serine, although
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at a slower rate. EC 4.1.99.2. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Umbilical Cord: The flexible structure, giving passage to the umbilical arteries and vein, which connects the embryo or fetus to the placenta. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urbanization: The process whereby a society changes from a rural to an urban way of life. It refers also to the gradual increase in the proportion of people living in urban areas. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]
Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]
Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH]
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Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] 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] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Varicella: Chicken pox. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] 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] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventriculostomy: Surgical creation of an opening in a cerebral ventricle. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth
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surface directed toward the vestibule of the mouth. [EU] Vestibular Aqueduct: A small bony canal linking the vestibule of the inner ear to the posterior part of the internal surface of the petrous temporal bone. It surrounds the endolymphatic duct. [NIH] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vinculin: A cytoskeletal protein associated with cell-cell and cell-matrix interactions. The amino acid sequence of human vinculin has been determined. The protein consists of 1066 amino acid residues and its gene has been assigned to chromosome 10. [NIH] Vinorelbine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Proteins: Proteins found in any species of virus. [NIH] 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] Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [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] Virus Replication: The process of intracellular viral multiplication, consisting of the synthesis of proteins, nucleic acids, and sometimes lipids, and their assembly into a new infectious particle. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called
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retinoids. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [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] Voluntary Health Agencies: Non-profit organizations concerned with various aspects of health, e.g., education, promotion, treatment, services, etc. [NIH] Voriconazole: A drug that treats infections caused by fungi. [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] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] West Nile Virus: A species of Flavivirus, one of the Japanese encephalitis virus group, which produces encephalitis experimentally when inoculated into some rodents, chicks, birds, or monkeys. In humans, it is seen most frequently in Africa, Asia, and Europe presenting as a silent infection or undifferentiated fever (West Nile fever). It is transmitted by Culex spp mosquitoes. [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] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]
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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] Zoonosis: Disease of animals, e. g. rabies, that can be transmitted to humans. A risk in major disasters; any disease and/or infection which is likely to be naturally transmitted from animals to man; disease caused by animal parasites. [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] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
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INDEX A Abdominal, 136, 305, 321, 357, 376, 385, 387 Abortion, 137, 321, 327 Abscess, 87, 136, 145, 172, 217, 224, 262, 321 Acatalasia, 321, 335 Acceptor, 321, 359, 372, 385, 403, 412 ACE, 49, 321 Acetylcholine, 321, 338, 381, 382 Acetylgalactosamine, 321, 359 Acetylglucosamine, 49, 321, 359 Acidity, 321, 388 Acinetobacter, 105, 170, 171, 177, 202, 321 Acoustic, 195, 267, 268, 284, 321, 416 Acquired Immunodeficiency Syndrome, 52, 175, 229, 245, 247, 321 Acremonium, 321, 336 Actin, 24, 42, 66, 67, 321, 357, 377 Acuity, 321, 329, 343 Acute Disease, 248, 322 Acute lymphoblastic leukemia, 113, 322 Acute lymphocytic leukemia, 322 Acute renal, 322, 362 Acyl, 322, 403 Adaptability, 322, 335 Adaptation, 322, 382, 390 Adenine, 322 Adenocarcinoma, 136, 221, 322, 382 Adenosine, 92, 195, 196, 207, 322, 389 Adenosine Deaminase, 195, 196, 207, 322 Adenovirus, 27, 322 Adjunctive Therapy, 84, 192, 322 Adjuvant, 20, 32, 44, 205, 222, 322 Adjuvant Therapy, 222, 322 Adolescence, 7, 322, 386 Adoptive Transfer, 21, 322 Adrenergic, 322, 348, 352, 389, 408 Adverse Effect, 323, 403 Aerobic, 323, 365, 379, 380, 385, 394 Aerobic Metabolism, 323, 385 Aerobic Respiration, 323, 385 Afferent, 323, 354, 383, 405 Affinity, 7, 14, 74, 75, 323, 329, 404, 407 Agar, 323, 389 Agonist, 323, 348, 352, 382, 389 Air Sacs, 323, 324 Airway, 271, 323
Algorithms, 323, 331 Alimentary, 323, 385, 386 Alkaline, 41, 323, 324, 334, 388 Alkaline Phosphatase, 41, 323 Alkaloid, 323, 334, 339, 382 Alkylating Agents, 56, 323, 345, 409 Allogeneic, 140, 324, 360 Allografts, 181, 324 Allopurinol, 203, 324 Alopecia, 324, 344 Alpha-fetoprotein, 324, 355 Alternative medicine, 282, 324 Alum, 32, 324, 339 Aluminum, 324 Alveoli, 51, 324, 415 Amikacin, 73, 171, 210, 222, 324 Amine, 324, 363 Amino Acid Motifs, 50, 324 Amino Acid Sequence, 324, 326, 341, 366, 416 Aminocamptothecin, 324, 334 Ammonia, 322, 324, 413 Amnestic, 265, 325 Amnion, 325, 338 Amoxicillin, 72, 93, 170, 325 Amphetamine, 325 Ampicillin, 73, 106, 170, 325 Amplification, 9, 22, 186, 269, 325, 371 Ampulla, 325, 351 Amyloid, 151, 153, 325 Anaerobic, 30, 157, 325, 361, 365, 379, 400 Anaesthesia, 141, 156, 198, 325, 367 Anal, 325, 340, 355 Analog, 86, 325, 356 Analogous, 60, 325, 348, 391, 412 Analytes, 300, 325 Anaphylatoxins, 325, 341 Anaplastic, 197, 325 Anatomical, 42, 325, 337, 366, 372, 377, 401 Anemia, 25, 260, 271, 325, 374, 378, 388, 409 Anergic, 44, 325 Anergy, 52, 325, 326 Anesthesia, 96, 127, 146, 156, 198, 200, 209, 323, 326 Aneurysm, 147, 326 Angiitis, 265, 326 Angiogenesis, 326, 374
420 Meningitis
Animal model, 13, 19, 20, 26, 31, 39, 46, 47, 49, 52, 57, 60, 67, 140, 233, 278, 326 Anionic, 14, 326 Annealing, 326, 371, 391 Anode, 326, 344 Anorexia, 260, 326, 349, 357 Anterior Cerebral Artery, 326, 336 Anthrax, 87, 95, 184, 326 Antibacterial, 10, 14, 62, 79, 326, 339, 365, 405, 407, 415 Antibiotic Prophylaxis, 195, 326 Antibodies, Anticardiolipin, 326, 327 Antibodies, Antiphospholipid, 326, 327 Anticoagulant, 55, 327, 393, 394 Antidiuretic, 109, 208, 327 Antifungal, 5, 14, 29, 46, 53, 59, 96, 242, 245, 248, 327, 356, 370 Antifungal Agents, 46, 59, 327 Antigen, 7, 8, 10, 18, 35, 46, 49, 50, 57, 65, 83, 133, 142, 150, 170, 215, 319, 323, 326, 327, 328, 330, 334, 341, 344, 346, 352, 358, 363, 364, 365, 366, 367, 375, 377 Antigen-Antibody Complex, 327, 341 Antigen-presenting cell, 327, 346 Anti-infective, 327, 364, 369 Anti-inflammatory, 17, 18, 38, 67, 84, 187, 204, 327, 344, 347, 359, 370, 392 Anti-Inflammatory Agents, 327, 344, 370 Antimetabolite, 327, 376, 399 Antineoplastic, 266, 323, 327, 344, 348, 375, 376, 391, 411, 416 Antineoplastic Agents, 323, 327, 344, 416 Antioxidant, 174, 221, 223, 327, 385 Antiphospholipid Syndrome, 149, 326, 327 Antiserum, 65, 327, 330 Antiviral, 17, 22, 53, 67, 122, 230, 232, 260, 275, 328, 368, 387, 399 Anxiety, 265, 328 Apathy, 283, 328 Aphasia, 325, 328 Aplasia, 126, 328 Apoptosis, 11, 34, 73, 82, 83, 84, 104, 179, 328 Aqueous, 328, 331, 345, 350, 363, 371, 372 Arachidonic Acid, 66, 328, 371, 393 Archaea, 328, 377 Arenavirus, 328, 373 Arginine, 325, 328, 382, 414 Arterial, 116, 327, 328, 333, 336, 364, 394, 408
Arteries, 328, 332, 343, 376, 391, 395, 410, 414 Arterioles, 328, 332, 377 Artery, 147, 326, 328, 343, 374, 386, 395 Asepsis, 180, 328 Aspartate, 47, 329 Aspergillosis, 329, 370 Asphyxia, 47, 329 Aspiration, 51, 329, 355 Assay, 12, 28, 83, 88, 116, 142, 186, 206, 224, 255, 329, 365, 400, 413 Astatine, 15, 55, 329 Asthenia, 325, 329 Astrocytes, 40, 45, 53, 329, 373, 377 Asymptomatic, 7, 35, 51, 321, 329 Ataxia, 5, 329, 409 Atrophy, 329, 381, 391 Atypical, 98, 265, 329, 367 Audiology, 266, 268, 269, 329 Audiometry, 131, 267, 329 Auditory, 4, 17, 103, 131, 234, 268, 269, 329, 340, 349, 353, 361, 374, 413 Autoimmune disease, 268, 326, 329, 378, 379 Autologous, 113, 214, 329 Autonomic, 268, 321, 329, 379, 382, 387, 404, 405, 408 Autonomic Nervous System, 268, 329, 387, 404, 408 Autoradiography, 18, 330 Avidity, 46, 51, 330 Axonal, 13, 67, 92, 330 Axons, 330, 346, 368, 383, 395, 405 Azithromycin, 99, 330 B Bacillus, 42, 99, 191, 230, 326, 330, 333, 340 Back Injuries, 305, 330 Bacteraemia, 129, 165, 189, 200, 330 Bacteremia, 9, 27, 32, 42, 49, 51, 55, 57, 58, 63, 72, 92, 99, 198, 330, 400 Bacterial Adhesion, 63, 330 Bacterial Infections, 18, 19, 25, 31, 55, 63, 103, 257, 330, 336, 371 Bacterial toxin, 66, 330 Bactericidal, 7, 8, 9, 10, 17, 49, 57, 72, 73, 82, 101, 143, 330 Bacteriophage, 86, 330, 389, 400, 412, 416 Bacteriostatic, 17, 330, 353 Bacterium, 19, 43, 70, 229, 231, 253, 330, 341, 362, 413 Barotrauma, 267, 330 Basal Ganglia, 102, 329, 330, 333, 357
Index 421
Basal Ganglia Diseases, 329, 330 Base, 36, 322, 331, 345, 346, 356, 370, 384, 388, 395, 409, 413 Basement Membrane, 331, 354 Basophil, 331, 363 Beer, 59, 331 Benign, 265, 331, 333, 357, 361, 373, 380, 397, 400, 401 Beta-Lactamases, 331, 365, 407 Beta-pleated, 325, 331 Bilateral, 5, 102, 194, 267, 331, 385, 386, 393, 399 Bile, 331, 357, 363, 370, 372, 406 Bile Pigments, 331, 370 Bilirubin, 331, 364 Binding Sites, 43, 331, 407 Biochemical, 11, 30, 48, 50, 51, 57, 61, 69, 84, 192, 327, 331, 359, 371, 402 Biogenesis, 12, 331 Biological response modifier, 331, 368 Biopsy, 265, 318, 331 Biotechnology, 22, 71, 86, 263, 282, 295, 331 Bioterrorism, 10, 331 Biotin, 13, 332, 383, 407 Biotype, 157, 332 Bladder, 236, 332, 342, 344, 356, 366, 378, 380, 381, 398, 412, 414 Blastomycosis, 332, 370 Blood Cell Count, 332, 388 Blood Coagulation, 332, 334, 400, 410 Blood Glucose, 332, 362 Blood pressure, 296, 332, 335, 364, 378, 392, 395, 404 Blood Substitutes, 34, 332 Blood-Brain Barrier, 20, 24, 38, 41, 45, 58, 65, 101, 155, 332 Blot, 67, 186, 224, 332, 383 Body Fluids, 332, 404 Bone Conduction, 329, 332 Bone Marrow, 113, 322, 332, 338, 358, 365, 373, 375, 378, 379, 404, 406 Bone scan, 332, 400 Bowel, 325, 332, 333, 347, 367, 369, 380, 387 Bowel Movement, 333, 347 Bradykinin, 333, 382, 390 Brain Diseases, 333, 396 Brain Hypoxia, 333, 409 Brain Infarction, 333 Brain Ischemia, 65, 333 Brain Neoplasms, 333, 407, 409
Brain Stem, 333, 336, 340, 396, 405 Branch, 135, 313, 333, 358, 373, 374, 386, 395, 404, 409 Broad-spectrum, 78, 324, 325, 333, 335, 336, 411 Bronchi, 333, 352, 412 Bronchial, 333, 363 Bronchioles, 324, 333 Bronchiseptica, 180, 333, 388 Bronchitis, 11, 333 Bronchoconstriction, 333, 390 Buccal, 333, 373 Bulbar, 333, 396 Burns, 25, 177, 271, 333 Burns, Electric, 333 C Calcium, 42, 334, 341, 357, 374, 386, 389, 394, 403 Calcium Chloride, 334, 386 Camptothecin, 13, 334 Camptothecin analogue, 13, 334 Candidiasis, 334, 356 Capping, 42, 334 Capsid, 29, 65, 334 Capsular, 10, 13, 16, 19, 30, 40, 46, 49, 51, 52, 57, 62, 63, 66, 257, 334 Capsules, 70, 334 Carbohydrate, 13, 45, 334, 343, 359, 391, 402, 407 Carbohydrate Sequence, 13, 334 Carbon Dioxide, 105, 332, 334, 345, 356, 357, 364, 398, 415 Carboxy, 57, 334 Carcinogen, 334, 375 Carcinogenic, 323, 334, 367, 393, 406 Carcinoma, 6, 56, 154, 334, 382, 406 Cardiac, 334, 350, 352, 357, 379, 406 Cardiolipins, 327, 334 Cardiovascular, 43, 260, 270, 284, 325, 334, 335, 371, 402, 404 Cardiovascular disease, 270, 284, 335 Carotene, 335, 398 Carrier Proteins, 253, 335, 390 Case series, 335, 339 Catalase, 232, 321, 335 Catecholamine, 335, 348, 388 Cathode, 326, 335, 344 Caudal, 335, 364, 392 Causal, 335, 362, 402, 409 Cause of Death, 44, 335 Cefotaxime, 73, 78, 83, 101, 132, 335
422 Meningitis
Ceftriaxone, 74, 78, 82, 84, 85, 101, 106, 130, 146, 180, 186, 195, 335 Cefuroxime, 198, 335 Cell Adhesion, 50, 335 Cell Count, 303, 318, 335 Cell Death, 25, 34, 328, 335, 353, 358 Cell Differentiation, 335, 403 Cell Division, 330, 336, 353, 360, 377, 389, 401 Cell membrane, 61, 335, 336, 340, 346, 354, 377, 389 Cell proliferation, 336, 403 Cell Respiration, 323, 336, 385, 398 Cell Transplantation, 336 Cellulose, 336, 357, 389 Central Nervous System Infections, 146, 336, 361 Cephalosporin Resistance, 189, 336 Cephalosporins, 78, 115, 172, 210, 255, 331, 336 Ceramide, 38, 336 Cerebellar, 147, 329, 336, 340, 397 Cerebellum, 333, 336, 391, 397 Cerebral Cortex, 329, 333, 336, 353, 354, 355, 395 Cerebral Infarction, 135, 333, 336 Cerebral Palsy, 40, 261, 336, 404 Cerebrospinal fluid, 4, 19, 20, 69, 72, 73, 79, 89, 92, 97, 98, 99, 101, 105, 106, 108, 116, 120, 121, 122, 125, 131, 132, 135, 136, 139, 142, 145, 148, 150, 151, 153, 155, 163, 164, 167, 169, 170, 174, 182, 183, 185, 187, 191, 196, 205, 207, 215, 216, 217, 223, 225, 231, 234, 248, 252, 254, 256, 265, 267, 284, 336, 337, 372, 380, 403, 405, 407 Cerebrospinal Fluid Pressure, 284, 337 Cerebrovascular, 105, 208, 221, 222, 331, 335, 337, 409 Cerebrum, 336, 337, 409 Cervical, 337, 380, 400 Cervix, 321, 337, 356 Chancroid, 44, 337 Character, 337, 345 Chemokines, 52, 252, 256, 337 Chemotactic Factors, 337, 341 Chemotaxis, 33, 52, 54, 252, 256, 337 Chemotherapeutics, 15, 337 Chin, 79, 96, 147, 165, 181, 184, 337, 376 Chlorophyll, 337, 357 Cholera, 337, 402 Cholesteatoma, 110, 268, 337
Cholesterol, 268, 331, 337, 343, 372, 375, 406 Choline, 51, 338 Cholinergic, 338, 382 Chorioamnionitis, 32, 338 Chorion, 338 Chorioretinitis, 338, 398 Choroid, 338, 398, 414 Chromatin, 328, 338, 352 Chromosomal, 20, 82, 180, 325, 338, 390 Chromosome, 30, 78, 338, 361, 371, 401, 412, 416 Chronic, 8, 32, 52, 54, 82, 88, 98, 104, 106, 107, 132, 140, 152, 168, 177, 181, 194, 225, 233, 245, 265, 268, 271, 283, 284, 332, 338, 347, 367, 370, 394, 401, 403, 405, 407, 408, 417 Chronic Disease, 283, 338 Chronic granulocytic leukemia, 338 Chronic myelogenous leukemia, 181, 338 Cilastatin, 225, 338, 365 Ciprofloxacin, 202, 338 Circulatory system, 338, 350, 369 Cirrhosis, 32, 338, 392 CIS, 23, 29, 338, 398 Cisplatin, 220, 226, 230, 236, 339 Clarithromycin, 103, 132, 339 Clavulanic Acid, 143, 170, 339 Clear cell carcinoma, 339, 346 Cleave, 334, 339 Clinical Medicine, 141, 255, 339, 392 Clinical study, 88, 108, 339 Clinical trial, 6, 10, 15, 68, 178, 241, 249, 260, 295, 296, 339, 348, 394, 397 Clone, 8, 25, 37, 78, 85, 163, 339 Cloning, 126, 331, 339, 368, 371 Coagulation, 11, 56, 327, 332, 339, 386, 390, 410 Coca, 339 Cocaine, 265, 339 Cochlea, 4, 17, 267, 270, 339, 340, 367 Cochlear Diseases, 340, 410 Cochlear Duct, 340, 407 Cochlear Implantation, 3, 17, 80, 156, 159, 177, 266, 270, 340 Cochlear Implants, 109, 183, 191, 266, 270, 278, 281, 301, 302, 340 Cochlear Nerve, 270, 340, 405, 416 Cochlear Nucleus, 340, 416 Cod Liver Oil, 340, 350 Cofactor, 340, 394, 410 Colistin, 105, 202, 340
Index 423
Colitis, 340, 367 Collagen, 324, 331, 340, 342, 354, 374, 390 Colloidal, 72, 85, 340, 388 Colon, 340, 367, 370 Colorectal, 133, 340 Colorectal Surgery, 133, 340 Combination Therapy, 275, 340 Commensal, 70, 340 Communicable disease, 260, 341 Communication Barriers, 274, 341 Competency, 260, 341 Complement Activation, 46, 325, 341 Complementarity Determining Regions, 341, 366 Complementary and alternative medicine, 229, 238, 341 Complementary medicine, 229, 341 Complementation, 20, 29, 30, 341 Complete remission, 342, 398 Compliance, 27, 342 Computational Biology, 295, 342 Computed tomography, 196, 342, 400 Computerized tomography, 342 Conception, 321, 342, 355, 406 Concomitant, 65, 217, 342 Conduction, 329, 342 Cones, 342, 398 Confounding, 60, 342 Congestion, 342, 353 Conjugated, 13, 253, 257, 342, 399 Conjunctiva, 342, 367, 370 Conjunctivitis, 23, 342 Connective Tissue, 265, 269, 271, 327, 332, 340, 342, 346, 355, 357, 373, 394, 399, 400, 408 Connective Tissue Cells, 342 Connective Tissue Diseases, 265, 327, 342 Consciousness, 253, 316, 342, 345, 346, 348, 352, 362, 395, 396 Conserved Sequence, 324, 342 Consolidation therapy, 205, 343 Constitutional, 343, 399 Constriction, 343, 369, 394 Consumption, 343, 346, 347, 357, 398 Contact Tracing, 213, 343 Contraindications, ii, 343 Contralateral, 270, 343, 397 Contrast Sensitivity, 343, 383 Conventional therapy, 56, 343 Conventional treatment, 343 Coordination, 63, 296, 336, 343, 378 Cornea, 343, 370, 385, 401, 418
Coronary, 335, 343, 376 Coronary heart disease, 335, 343 Coronary Thrombosis, 343, 376 Corpus, 343, 393, 417 Cortex, 66, 340, 343, 351, 353, 384, 393, 397 Cortical, 24, 66, 265, 343, 353, 395, 401, 409 Corticosteroid, 111, 343, 392 Cortisone, 344, 347, 392 Coumarins, 344, 394 Counterimmunoelectrophoresis, 116, 231, 344 Craniocerebral Trauma, 331, 344, 361, 407, 409, 410 Craniotomy, 140, 284, 344 Critical Care, 100, 116, 125, 163, 179, 181, 191, 202, 344 Crossing-over, 344, 397 Cryoelectron Microscopy, 61, 344 Cryptococcosis, 14, 34, 52, 104, 344 Cryptococcus, 5, 14, 28, 38, 46, 48, 52, 53, 59, 60, 113, 114, 221, 244, 248, 296, 344 Cryptococcus neoformans, 5, 14, 28, 38, 46, 48, 52, 53, 59, 60, 113, 114, 221, 244, 296, 344 Cryptosporidiosis, 330, 344 Curative, 344, 382, 409 Cutaneous, 326, 332, 334, 344, 364, 372 Cyclic, 66, 340, 344, 360, 382 Cyclophosphamide, 265, 344 Cyst, 158, 344 Cystitis, 130, 344 Cytarabine, 94, 97, 147, 241, 289, 345 Cytokine, 11, 21, 35, 38, 41, 53, 54, 65, 67, 79, 115, 121, 345, 368 Cytomegalovirus, 260, 267, 269, 345 Cytoplasm, 42, 43, 328, 336, 345, 352, 399 Cytosine, 185, 345, 356 Cytoskeleton, 24, 345 Cytotoxic, 15, 37, 53, 56, 74, 80, 82, 85, 345, 396, 397, 403 Cytotoxicity, 45, 46, 56, 339, 345 D Dacarbazine, 56, 345 Dairy Products, 345, 351 Daunorubicin, 345, 348 De novo, 56, 345 Decarboxylation, 345, 363 Decompression, 5, 345 Defense Mechanisms, 57, 345 Degenerative, 267, 269, 345, 362 Dehydration, 42, 337, 345 Deletion, 20, 59, 66, 328, 345, 358
424 Meningitis
Delirium, 265, 283, 345 Delivery of Health Care, 346, 361 Dementia, 261, 264, 274, 283, 321, 346, 381 Denaturation, 346, 371, 391 Dendrites, 346, 381, 395 Dendritic, 69, 346, 375 Dendritic cell, 69, 346 Dental Care, 271, 346 Dentate Gyrus, 34, 73, 346, 363 Deoxyguanosine, 174, 346 Depolarization, 346, 403 Dermis, 346, 377 DES, 45, 325, 346 Detergents, 340, 346 Deuterium, 346, 363 Developed Countries, 4, 346 Developing Countries, 106, 257, 261, 281, 346 Dexamethasone, 4, 11, 75, 78, 117, 118, 122, 192, 235, 245, 280, 347 Diabetes Insipidus, 224, 225, 271, 347 Diabetes Mellitus, 32, 266, 269, 271, 347, 359, 362 Diagnostic Errors, 347, 375 Diagnostic procedure, 251, 282, 347 Diarrhea, 42, 344, 347, 349 Diastolic, 347, 364 Digestion, 323, 331, 332, 347, 369, 372, 386, 406 Digestive system, 249, 347 Dilatation, 321, 326, 347, 393 Diphtheria, 253, 347 Diphtheria Toxin, 253, 347 Diploid, 341, 347, 389 Discrete, 28, 42, 347, 412, 418 Discrimination, 255, 347 Disease Progression, 12, 41, 347 Disorientation, 345, 347 Dissociation, 323, 347, 369 Distal, 23, 26, 330, 348, 387, 394 Dizziness, 267, 270, 271, 348, 415 Domesticated, 348, 360 Dominance, 78, 348, 352 Dopamine, 325, 339, 348, 381, 388 Dorsal, 340, 348, 392, 405 Dose-limiting, 220, 230, 348 Dosimetry, 55, 348 Double-blind, 32, 90, 348 Doxorubicin, 226, 236, 348 Drug Design, 16, 46, 289, 348 Drug Interactions, 288, 348 Drug Tolerance, 348, 411
Duodenum, 331, 349, 351, 407 Dura mater, 349, 375, 385 Dyes, 325, 349 Dysplasia, 150, 349 Dystonia, 212, 349 E Eardrum, 267, 268, 349 Echovirus 9, 164, 349 Echoviruses, 61, 67, 173, 349 Edema, 232, 349, 369, 383 Effector, 17, 53, 321, 341, 349 Effector cell, 53, 349 Efferent, 349, 354, 405 Ehrlichia, 20, 230, 349 Ehrlichiosis, 20, 349 Elastin, 340, 342, 349, 354 Elective, 84, 137, 349 Electrocoagulation, 339, 349 Electrolyte, 343, 346, 349, 392, 404 Electron microscope, 349, 380 Ellagic Acid, 349, 386 Emaciation, 321, 350 Embryo, 321, 325, 335, 350, 367, 384, 391, 414 Empiric, 105, 205, 350 Emulsion, 220, 225, 330, 350, 356 Encapsulated, 5, 11, 30, 49, 50, 52, 53, 70, 289, 350, 372 Encephalitis, Viral, 350 Encephalocele, 100, 189, 350, 380 Encephalomyelitis, 91, 350 Encephalopathy, 69, 350 Endemic, 7, 21, 36, 232, 257, 261, 337, 350, 374, 406 Endocarditis, 11, 32, 149, 157, 334, 350 Endocardium, 350 Endocrine System, 350, 381 Endogenous, 38, 58, 66, 102, 348, 351, 354, 412 Endolymph, 25, 268, 351 Endolymphatic Duct, 351, 416 Endolymphatic Sac, 268, 351 Endophthalmitis, 102, 351, 385 Endoscope, 351 Endoscopic, 36, 126, 351 Endothelial cell, 11, 20, 23, 42, 58, 65, 72, 123, 332, 350, 351, 410 Endothelium, 23, 65, 78, 137, 351, 382, 390 Endothelium, Lymphatic, 351 Endothelium, Vascular, 351 Endothelium-derived, 351, 382 Endotoxin, 38, 48, 253, 351, 413
Index 425
Enterobacter, 93, 124, 171, 351 Enterococcus, 127, 202, 216, 351 Enterovirus, 22, 23, 81, 102, 111, 122, 127, 131, 163, 173, 349, 351 Entorhinal Cortex, 351, 363 Environmental Health, 224, 294, 296, 351 Enzymatic, 7, 324, 334, 335, 341, 351, 363, 375, 391, 398 Enzyme-Linked Immunosorbent Assay, 52, 233, 351 Eosinophilia, 148, 352 Eosinophilic, 86, 94, 111, 127, 128, 142, 210, 220, 232, 352 Eosinophils, 352, 360, 371 Ephedrine, 265, 352 Epidemic, 21, 64, 73, 77, 85, 93, 125, 129, 134, 162, 257, 263, 275, 276, 282, 352, 406 Epidemiological, 22, 52, 81, 93, 164, 264, 352, 355 Epidemiology, Molecular, 22, 352 Epidermal, 352, 375, 377 Epidermis, 346, 352, 395 Epidural, 136, 197, 209, 221, 230, 352 Epilepticus, 60, 352 Epinephrine, 322, 348, 352, 381, 382, 413 Epistasis, 39, 352 Epithelial, 10, 19, 25, 32, 49, 51, 70, 72, 322, 352, 362 Epithelial Cells, 10, 25, 49, 51, 352, 362 Epithelium, 11, 19, 70, 331, 351, 352, 357, 418 Epitope, 24, 31, 44, 352, 353 Epitope Mapping, 24, 353 Equipment Failure, 266, 353 Erythema, 20, 130, 353 Erythrocytes, 325, 332, 353, 362, 397 Erythromycin, 266, 330, 339, 353 Esophageal, 197, 353 Esophageal Perforation, 197, 353 Esophagus, 347, 353, 388, 406, 407 Estrogen, 268, 353 Etoposide, 222, 234, 353 Eukaryotic Cells, 10, 353, 382, 384 Eustachian tube, 330, 353 Evoke, 353, 406 Evoked Potentials, 103, 353 Excitation, 353, 381 Excitatory, 34, 40, 47, 353, 354, 359 Excitatory Amino Acids, 34, 40, 354 Exhaustion, 74, 354, 374 Exocytosis, 24, 354, 363 Exogenous, 65, 351, 354
Extensor, 354, 394 Extracellular, 44, 45, 325, 329, 342, 354, 374, 377, 384, 404, 407 Extracellular Matrix, 45, 342, 354, 374, 384 Extracellular Matrix Proteins, 354, 374 Extracellular Space, 354, 377 Extrapyramidal, 184, 265, 348, 354 Extravasation, 54, 64, 354, 361 Extremity, 11, 354, 385, 386 Eye Infections, 322, 354 Eye Movements, 354, 396 F Facial, 20, 214, 266, 267, 354, 374, 386, 404 Facial Expression, 354 Facial Nerve, 20, 266, 267, 354, 386 Facial Paralysis, 214, 267, 354 Family Planning, 295, 355 Fat, 214, 328, 332, 335, 336, 343, 355, 371, 372, 378, 380, 399, 404 Fatal Outcome, 213, 355, 380, 396 Fatigue, 296, 355, 361 Febrile, 35, 253, 355, 374, 395 Feces, 5, 351, 355 Fermentation, 331, 355, 400 Fetal Blood, 338, 355 Fetoprotein, 158, 355 Fetus, 321, 324, 338, 355, 393, 414 Fibrin, 332, 355, 386, 390, 409, 410, 411 Fibrinogen, 355, 386, 390, 394, 409 Fibrosis, 17, 267, 355, 400, 401 Fissure, 346, 355 Fistula, 93, 99, 267, 268, 269, 355 Fixation, 57, 131, 267, 355 Fixatives, 344, 356 Flaccid, 23, 134, 356 Flexion, 252, 256, 356, 370 Fluconazole, 72, 74, 75, 135, 205, 229, 238, 242, 243, 244, 245, 246, 247, 296, 303, 356 Flucytosine, 59, 72, 74, 75, 243, 246, 296, 303, 356 Fluorescence, 22, 356 Fold, 13, 50, 355, 356, 376, 385 Forearm, 332, 356 Fovea, 356 Frameshift, 356, 413 Frameshift Mutation, 356, 413 Free Radicals, 45, 327, 347, 356 Frontal Lobe, 326, 336, 356 Fundus, 356 Fungi, 59, 265, 327, 329, 351, 354, 356, 357, 377, 417, 418 Fungicides, Industrial, 327, 356
426 Meningitis
Fungus, 14, 38, 48, 53, 296, 303, 334, 336, 344, 356 G Gallbladder, 321, 347, 356, 357 Gamma knife, 104, 357 Gamma Rays, 357, 396, 397 Ganglia, 321, 330, 357, 380, 387, 405, 408 Ganglion, 357, 383, 405, 416, 418 Gangrenous, 357, 402 Gas, 324, 334, 351, 357, 363, 382, 395, 398, 415 Gas exchange, 357, 398, 415 Gastric, 75, 136, 158, 221, 325, 357, 363, 386 Gastric Juices, 357, 386 Gastric Mucosa, 75, 357, 386 Gastrin, 357, 363 Gastroenteritis, 264, 357, 400 Gastrointestinal, 19, 43, 67, 333, 338, 352, 357, 371, 374, 402, 404, 407 Gelsolin, 42, 357 Gemcitabine, 241, 242, 357 Gene Deletion, 20, 358 Gene Expression, 6, 17, 63, 358 Gene Therapy, 6, 322, 358 General practitioner, 305, 358 Genetic Engineering, 331, 339, 358 Genetic testing, 358, 391 Genetics, 19, 26, 28, 29, 46, 59, 322, 348, 358 Genital, 6, 338, 339, 358, 414 Genomics, 16, 28, 31, 74, 110, 358 Genotype, 148, 324, 332, 358, 388 Gestation, 358, 387 Giant Cells, 358, 400 Gland, 343, 344, 358, 364, 373, 374, 385, 386, 401, 406, 410 Glioma, 15, 56, 204, 358 Glomerular, 358, 398 Glomeruli, 358, 395 Glottis, 358, 388 Glucocorticoid, 347, 359, 392 Glucose, 4, 253, 318, 332, 336, 347, 359, 362, 364, 367, 400 Glucose Intolerance, 347, 359 Glucuronic Acid, 359, 362 Glutamate, 125, 181, 359 Glutathione Peroxidase, 359, 401 Glyceraldehyde 3-Phosphate, 359, 413 Glycerol, 334, 359, 389, 413 Glycerophospholipids, 359, 389 Glycine, 324, 359, 381, 402
Glycoprotein, 20, 355, 358, 359, 360, 403, 410, 413 Glycosaminoglycans, 14, 354, 359, 394 Glycosidic, 359, 381, 383 Glycosylation, 51, 359 Glycosyltransferases, 30, 359 Goats, 345, 349, 359 Gonadal, 360, 406 Gonorrhea, 8, 335, 360 Governing Board, 360, 392 Gp120, 360, 387 Grade, 261, 360 Graft, 46, 177, 214, 267, 324, 360, 363, 366 Graft Rejection, 360, 366 Grafting, 360, 366 Gram-Negative Bacteria, 12, 112, 210, 321, 360, 411 Gram-positive, 18, 26, 30, 42, 62, 112, 253, 335, 351, 360, 365, 379, 407 Granule, 34, 132, 346, 360, 399 Granulocyte, 83, 192, 360 Granuloma, 266, 267, 360 Growth factors, 360, 377 Guanine, 56, 346, 360 Guanylate Cyclase, 360, 382 Guinea Pigs, 71, 360, 373 H Habitat, 360, 379 Haematoma, 197, 361 Haemorrhage, 147, 179, 201, 321, 361 Hair Cells, 25, 340, 361, 405 Hair follicles, 346, 361, 417 Half-Life, 329, 335, 361 Haploid, 29, 60, 361, 389 Haptens, 323, 361 Headache, 125, 162, 198, 223, 252, 253, 256, 265, 284, 296, 316, 349, 361, 364, 367, 391 Headache Disorders, 361 Health Care Costs, 256, 361 Health Expenditures, 361 Heart attack, 335, 361 Heart failure, 352, 361, 383 Helminthiasis, 336, 361 Hematogenous, 19, 23, 57, 361 Hematoma, 230, 361 Hemin, 40, 361 Hemoglobin, 33, 40, 325, 332, 353, 362, 385, 409 Hemoglobinopathies, 358, 362 Hemolysis, 351, 362 Hemolytic, 30, 362, 409 Hemoperitoneum, 81, 172, 362
Index 427
Hemorrhage, 35, 133, 194, 262, 271, 332, 344, 349, 361, 362, 389, 395, 407 Heparin, 14, 362, 386 Hepatic, 87, 346, 362, 372 Hepatic Encephalopathy, 87, 362 Hepatitis, 29, 151, 152, 259, 260, 271, 362, 367 Hepatocytes, 362 Hepatomegaly, 362, 367 Hereditary, 267, 269, 342, 362, 399, 409 Heredity, 268, 358, 362 Herpes, 6, 75, 121, 134, 139, 168, 188, 224, 260, 262, 269, 270, 275, 362 Herpes Zoster, 270, 362 Heterogeneity, 49, 323, 362 Heterotrophic, 356, 362 Hexosyltransferases, 359, 362 Hippocampus, 34, 346, 363, 395, 407 Histamine, 64, 325, 363 Histamine Release, 64, 325, 363 Histidine, 363 Homogeneous, 68, 363 Homologous, 16, 59, 60, 65, 252, 256, 344, 358, 363, 379, 401, 408, 412 Hormonal, 268, 329, 343, 363 Hormone, 109, 194, 208, 225, 322, 343, 344, 346, 352, 357, 363, 369, 375, 393, 399, 403, 410 Hormone therapy, 322, 363 Horseradish Peroxidase, 352, 363 Hospitals, Public, 363, 365 Humoral, 21, 42, 51, 79, 196, 360, 363 Humour, 363 Hybrid, 339, 363, 383 Hybridization, 70, 363, 383 Hydrogen, 65, 321, 324, 331, 334, 335, 346, 354, 359, 363, 372, 378, 382, 385, 388, 394 Hydrogen Peroxide, 65, 335, 359, 363, 372 Hydrolysis, 322, 331, 339, 359, 364, 381, 389, 394 Hydroxyproline, 324, 340, 364 Hyperbilirubinemia, 269, 364, 370 Hyperreflexia, 364, 409 Hypersensitivity, 37, 52, 170, 197, 364, 371, 399 Hypertension, 186, 284, 335, 364, 369, 392 Hyperthyroidism, 329, 364 Hyperventilation, 124, 233, 236, 364 Hypesthesia, 364, 381 Hypoglycaemia, 346, 364 Hypotension, 364, 390 Hypothalamus, 330, 333, 364
Hypothermia, 140, 364, 380 Hypothyroidism, 266, 364 Hypoxia, 24, 40, 47, 346, 364 Hypoxic, 25, 47, 69, 364, 405 I Id, 226, 237, 300, 301, 304, 312, 314, 364 Idiopathic, 222, 233, 267, 364, 400 Idiotype, 35, 364 Illusion, 364, 415 Imidazole, 56, 332, 363, 364 Imipenem, 74, 153, 225, 233, 338, 365 Immaturity, 69, 365 Immune adjuvant, 324, 365 Immune Sera, 365 Immunity, 9, 10, 16, 18, 20, 27, 35, 44, 52, 53, 68, 90, 110, 132, 196, 208, 321, 365, 366, 368, 412 Immunization, 27, 32, 101, 142, 158, 173, 174, 183, 257, 300, 301, 302, 322, 365, 366, 402 Immunization Programs, 173, 365 Immunoassay, 76, 82, 326, 351, 365 Immunochemistry, 45, 353, 365 Immunocompromised, 14, 19, 21, 38, 41, 42, 43, 99, 365 Immunocompromised Host, 19, 365 Immunodeficiency syndrome, 260, 261, 274, 296, 365 Immunodominant Epitopes, 53, 365 Immunofluorescence, 65, 365, 377 Immunogen, 7, 365 Immunogenic, 7, 64, 257, 366 Immunoglobulin, 35, 50, 51, 76, 79, 97, 163, 326, 341, 366, 378 Immunoglobulin Variable Region, 50, 366 Immunohistochemistry, 45, 67, 366 Immunologic, 34, 49, 69, 266, 322, 337, 365, 366, 397 Immunosuppressant, 323, 366, 376 Immunosuppressive, 52, 344, 359, 365, 366 Immunosuppressive therapy, 366 Immunotherapy, 52, 71, 322, 366 Immunotoxin, 79, 220, 366 Impairment, 5, 39, 57, 110, 163, 243, 254, 265, 268, 269, 280, 283, 284, 329, 345, 354, 366, 376 Implantation, 266, 270, 342, 366 In situ, 47, 366 Incidental, 109, 366 Incision, 366, 369, 395 Incontinence, 352, 366, 379 Incubation, 151, 366, 388
428 Meningitis
Incubation period, 151, 366, 388 Incus, 267, 366, 374, 406 Indicative, 252, 256, 262, 366, 386, 415 Induction, 17, 24, 61, 343, 366 Infancy, 7, 80, 138, 150, 152, 160, 194, 213, 235, 367 Infant Mortality, 41, 367 Infarction, 336, 343, 367, 376, 391 Infectious Mononucleosis, 6, 271, 367 Infiltration, 367, 418 Inflammatory bowel disease, 54, 367 Influenza, 65, 142, 315, 367, 373 Infusion, 255, 367 Ingestion, 326, 367, 391 Inhalation, 5, 38, 53, 367, 391 Initiation, 9, 22, 39, 49, 175, 283, 367, 412 Initiator, 367, 368 Inner ear, 25, 183, 266, 268, 269, 270, 284, 332, 335, 340, 367, 370, 415, 416 Innervation, 354, 367 Inorganic, 339, 359, 367 Inositol, 38, 367 Inpatients, 60, 368 Insertional, 266, 368 Insight, 8, 26, 38, 40, 62, 65, 252, 256, 368 Insulator, 368, 378 Intensive Care, 26, 113, 179, 211, 368 Intensive Care Units, 26, 368 Interferon, 78, 79, 82, 89, 152, 242, 368, 373 Interferon-alpha, 368 Interleukin-1, 38, 76, 78, 79, 145, 210, 368 Interleukin-12, 79, 368 Interleukin-16, 210, 368 Interleukin-2, 78, 368 Internal Medicine, 97, 99, 118, 145, 224, 225, 368 Interneurons, 34, 368 Interstitial, 354, 368, 398 Intestinal, 19, 26, 58, 335, 344, 351, 369, 380 Intestine, 67, 332, 369, 370, 407 Intoxication, 346, 369, 417 Intracellular, 11, 33, 36, 42, 43, 53, 367, 369, 375, 382, 392, 401, 403, 416 Intracellular Membranes, 369, 375 Intracranial Hypertension, 210, 215, 245, 361, 369, 385, 410 Intracranial Hypotension, 369, 407 Intracranial Pressure, 4, 90, 119, 122, 146, 207, 245, 337, 369, 394 Intracranial tumors, 13, 369 Intramuscular, 27, 146, 369, 385 Intramuscular injection, 27, 369
Intraocular, 351, 369 Intrinsic, 57, 323, 331, 369, 386 Invasive, 4, 10, 19, 20, 24, 26, 27, 31, 36, 39, 51, 70, 79, 138, 147, 205, 365, 369, 373, 385 Iodine, 68, 369 Ion Channels, 329, 369, 408 Ionization, 45, 369 Ionizing, 369, 397 Ions, 321, 331, 347, 349, 357, 363, 369, 370, 394 Ischemia, 24, 34, 38, 40, 47, 274, 329, 333, 369, 379 Isoelectric, 369, 407 Isoelectric Point, 369, 407 Isoenzymes, 196, 370 Itraconazole, 74, 205, 243, 244, 370 J Jaundice, 35, 364, 370 Joint, 21, 212, 271, 338, 370, 408 K Kanamycin, 324, 370 Kb, 23, 70, 294, 370 Keratoconjunctivitis, 370, 403 Keratoconjunctivitis Sicca, 370, 403 Ketorolac, 235, 370 Kidney Disease, 249, 269, 271, 294, 370 Kidney stone, 370, 414 Kinetic, 47, 369, 370 Kyphosis, 212, 370 L Labile, 341, 370 Labyrinth, 17, 267, 339, 351, 367, 370, 384, 387, 401, 416 Labyrinthine, 17, 150, 370 Labyrinthitis, 4, 17, 267, 370 Laceration, 370, 409 Lacrimal, 354, 370, 403 Large Intestine, 347, 369, 370, 397, 403 Latency, 6, 370 Latent, 44, 45, 204, 370, 392 Lectin, 371, 375 Lens, 334, 371, 417 Leptomeningeal metastases, 241, 242, 371 Leptospirosis, 21, 35, 371 Lethal, 16, 46, 52, 56, 74, 330, 347, 371 Lethargy, 364, 371 Leucocyte, 93, 94, 371, 373 Leukemia, 150, 216, 241, 242, 271, 338, 348, 358, 371 Leukocytes, 9, 41, 44, 52, 97, 332, 337, 352, 368, 371, 413
Index 429
Leukoencephalopathy, 75, 145, 274, 371 Leukotrienes, 328, 371 Levofloxacin, 171, 190, 371 Library Services, 312, 371 Life cycle, 356, 371 Ligament, 17, 371 Ligands, 10, 371 Ligase, 186, 371 Ligase Chain Reaction, 186, 371 Ligation, 67, 371 Linkage, 334, 371, 387 Lipid, 49, 54, 220, 225, 247, 289, 338, 359, 371, 372, 378, 385 Lipid Peroxidation, 372, 385 Lipopolysaccharide, 31, 37, 45, 57, 85, 360, 372 Lipoprotein, 360, 372 Liposomal, 76, 192, 201, 289, 372 Liposomes, 61, 372 Liquor, 372, 395 Liver Cirrhosis, 191, 372 Liver scan, 372, 400 Liver Transplantation, 113, 181, 372 Lobe, 326, 336, 372 Local therapy, 284, 372 Localization, 42, 44, 45, 217, 366, 372 Locomotion, 372, 389 Longitudinal Studies, 21, 372 Loop, 266, 372 Lumbar, 90, 111, 112, 153, 154, 181, 195, 207, 210, 230, 265, 300, 301, 318, 337, 372, 405 Lumbar puncture, 90, 111, 112, 153, 154, 181, 195, 207, 265, 318, 372, 405 Lumen, 17, 351, 372 Lupus, 55, 149, 326, 327, 372, 408 Lymph, 58, 326, 337, 338, 351, 363, 367, 373, 400 Lymph node, 58, 337, 373, 400 Lymphadenitis, 112, 235, 373 Lymphadenopathy, 367, 373 Lymphatic, 351, 367, 373, 383, 400, 404, 405, 410 Lymphatic system, 373, 400, 404, 405, 410 Lymphoblastic, 220, 373 Lymphoblasts, 322, 373 Lymphocyte, 21, 82, 85, 321, 327, 373, 375 Lymphocyte Count, 321, 373 Lymphocyte Subsets, 21, 373 Lymphocytic, 71, 74, 75, 76, 78, 79, 80, 82, 83, 84, 85, 150, 230, 231, 232, 233, 235, 253, 373
Lymphocytic Choriomeningitis Virus, 71, 74, 75, 76, 78, 79, 80, 82, 83, 84, 85, 231, 233, 235, 373 Lymphoid, 326, 371, 373 Lymphoma, 6, 216, 223, 231, 234, 235, 241, 242, 259, 260, 274, 373 Lymphoproliferative, 265, 373 Lysosome, 24, 373 Lytic, 86, 373, 402, 416 M Macroglia, 373, 377 Macrophage, 43, 64, 69, 81, 368, 373 Magnetic Resonance Imaging, 128, 373, 400 Maintenance therapy, 229, 245, 248, 296, 374 Malaise, 253, 374 Malaria, 260, 374 Malaria, Falciparum, 374 Malaria, Vivax, 374 Malformation, 203, 270, 374 Malignancy, 267, 374 Malignant, 15, 56, 154, 204, 221, 222, 234, 236, 321, 322, 327, 333, 374, 378, 380, 397, 400, 401 Malignant tumor, 56, 374, 378 Malleus, 366, 374 Malnutrition, 98, 271, 329, 374 Manifest, 330, 374 Mannans, 357, 374 Mastitis, 374, 402 Matrix metalloproteinase, 45, 132, 151, 155, 222, 374 Maxillofacial Injuries, 271, 374 Measles-Mumps-Rubella Vaccine, 173, 203, 207, 374 Meatus, 349, 374, 405, 413 Medial, 340, 374, 384, 405 Mediate, 18, 23, 28, 33, 49, 51, 63, 82, 179, 340, 348, 374 Mediator, 15, 64, 141, 145, 222, 368, 375, 402 Medical Errors, 60, 375 Medical Records, 375, 399 Medication Errors, 375 MEDLINE, 295, 375 Melanin, 48, 59, 60, 375, 388, 413 Melanocytes, 375 Melanoma, 55, 56, 152, 375 Melphalan, 13, 375 Membrane Lipids, 375, 389 Membrane Proteins, 6, 10, 27, 372, 375
430 Meningitis
Memory, 34, 44, 79, 265, 274, 296, 326, 345, 346, 375 Meningeal, 42, 121, 156, 181, 196, 203, 241, 253, 281, 375 Meninges, 19, 252, 253, 256, 296, 305, 306, 335, 336, 337, 344, 349, 375, 376, 405 Meningocele, 179, 376 Meningococcal Infections, 5, 48, 376 Meningococcal Vaccines, 49, 253, 257, 376 Meningoencephalitis, 38, 42, 46, 52, 53, 92, 376 Menstruation, 376, 393 Mental Disorders, 250, 376, 389, 395 Mental Health, iv, 5, 250, 294, 297, 376, 395 Mental Retardation, 6, 40, 57, 306, 307, 376 Mentors, 22, 376 Mesenteric, 58, 376 Mesentery, 376, 387 Metabolic disorder, 266, 269, 347, 376 Metastasis, 200, 374, 376 Metastasize, 56, 376, 401 Metastatic, 103, 333, 376, 401 Methotrexate, 143, 145, 150, 185, 226, 236, 376 Methylprednisolone, 147, 376 MI, 26, 31, 176, 319, 376 Microbe, 10, 377, 411 Microbiological, 72, 116, 167, 377 Microcirculation, 372, 377, 390 Microdialysis, 66, 377 Microfilaments, 24, 377 Microglia, 40, 45, 53, 64, 329, 377 Microorganism, 340, 377, 386, 417 Micro-organism, 377, 389, 402 Microscopy, 11, 18, 61, 63, 65, 208, 331, 344, 363, 377, 382 Microvilli, 24, 377 Migrans, 20, 130, 377 Migration, 50, 52, 266, 368, 377 Mitosis, 328, 377 Mitotic, 353, 377, 416 Mixed Connective Tissue Disease, 177, 224, 377 Modeling, 14, 80, 348, 377 Modification, 31, 36, 39, 324, 358, 378, 396 Molecular mass, 11, 40, 378 Monitor, 36, 196, 201, 204, 378, 382, 386 Monoclonal, 7, 13, 14, 15, 21, 46, 48, 49, 55, 252, 255, 256, 378, 396, 412 Monoclonal antibodies, 15, 21, 46, 48, 49, 55, 252, 255, 256, 378, 412
Monocyte, 54, 378 Mononuclear, 35, 42, 164, 360, 367, 378, 413 Morphogenesis, 34, 378 Morphological, 350, 357, 375, 378 Morphology, 65, 328, 378 Motility, 24, 43, 357, 378, 402 Motion Sickness, 378, 379 Motor Activity, 378, 396 Mucociliary, 378, 403 Mucosa, 31, 357, 373, 378, 379 Multiple Myeloma, 113, 378 Multiple sclerosis, 46, 65, 155, 269, 378, 383 Multivalent, 330, 379 Muscle Relaxation, 379 Muscular Diseases, 354, 379, 381, 385, 396 Mutagenic, 29, 323, 379 Myalgia, 367, 379 Mycobacterium, 44, 68, 73, 79, 86, 98, 106, 116, 120, 132, 151, 165, 171, 187, 275, 330, 379 Mycoplasma, 9, 216, 267, 336, 379 Mycoplasma Infections, 336, 379 Myelin, 69, 378, 379, 402 Myelitis, 92, 379 Myelogenous, 379 Myeloma, 165, 379 Myocarditis, 16, 29, 65, 67, 347, 379 Myocardium, 376, 379 N Naive, 35, 379 Narcolepsy, 352, 379 Nasal Cavity, 379, 385, 405 Nasal Mucosa, 367, 379 Natural killer cells, 368, 379 Natural selection, 331, 379 Nausea, 296, 317, 357, 379, 394, 414 NCI, 1, 242, 249, 293, 338, 379 Nebramycin, 380, 411 Neck Muscles, 284, 380 Neck Pain, 305, 380 Negative Staining, 11, 380 Neonatorum, 143, 380 Neoplasia, 380 Neoplasm, 56, 380, 400, 413 Nephropathy, 370, 380 Neural, 5, 50, 323, 325, 350, 355, 363, 376, 377, 380 Neural tube defects, 355, 380 Neuralgia, 6, 381 Neuraminidase, 71, 381
Index 431
Neuritis, 172, 381, 384, 416 Neuroendocrine, 221, 381 Neurogenic, 64, 168, 381, 414 Neurogenic Inflammation, 64, 381 Neurologic, 12, 20, 32, 34, 40, 97, 112, 156, 168, 220, 223, 265, 350, 381 Neuroma, 195, 284, 381 Neuromuscular, 321, 354, 381, 396 Neuromuscular Diseases, 381, 396 Neuronal, 11, 12, 13, 38, 40, 84, 168, 176, 381 Neurons, 34, 40, 73, 339, 340, 346, 353, 354, 357, 368, 381, 382, 395, 405, 408, 416 Neuropathy, 20, 65, 381, 387 Neuropeptides, 381 Neuroretinitis, 235, 381, 398 Neurosurgical Procedures, 93, 381 Neurosyphilis, 381, 386 Neurotoxicity, 12, 169, 381 Neurotransmitter, 321, 322, 324, 333, 348, 354, 359, 363, 369, 381, 382, 403, 407, 408 Neutrophil, 18, 78, 81, 90, 137, 382 Niacin, 382, 413 Nicotine, 52, 382 Night Blindness, 382, 399 Nitric Oxide, 38, 40, 53, 64, 83, 222, 225, 382 Nitrogen, 323, 324, 344, 354, 356, 375, 378, 382, 413 Non-small cell lung cancer, 220, 230, 382 Norepinephrine, 322, 348, 352, 381, 382, 389 Nosocomial, 107, 125, 126, 171, 190, 382 Nuclear, 38, 163, 330, 334, 353, 357, 377, 382 Nuclei, 326, 340, 354, 358, 373, 377, 382, 383, 390, 394, 400, 405, 416 Nucleic acid, 334, 345, 363, 382, 383, 393, 399, 416 Nucleic Acid Hybridization, 363, 382 Nucleolus, 382, 399 Nucleus, 326, 328, 331, 338, 340, 344, 345, 346, 352, 353, 357, 378, 382, 383, 394, 404, 407, 409 Nurseries, 26, 383 Nystagmus, 370, 383 O Occult, 158, 203, 383 Odontoid Process, 172, 383 Oedema, 168, 383 Oligonucleotide Probes, 371, 383 Oligosaccharides, 14, 253, 381, 383
Operon, 20, 49, 66, 383, 398 Ophthalmology, 154, 201, 235, 236, 356, 383 Opportunistic Infections, 52, 259, 275, 283, 296, 321, 383 Opsin, 383, 398, 399 Optic disc, 383 Optic Nerve, 381, 383, 385, 394, 398, 401 Optic Neuritis, 97, 140, 220, 383 Oral Health, 271, 384 Orbit, 384, 385 Orbital, 235, 271, 383, 384 Organ Culture, 384, 411 Organelles, 344, 345, 375, 384 Oropharynx, 54, 380, 384 Ossicles, 366, 374, 384, 406 Ossification, 17, 148, 384 Osteoblasts, 17, 384 Osteogenesis, 267, 269, 384 Osteomyelitis, 32, 148, 172, 175, 384 Osteotomy, 212, 384 Otitis Media, 8, 9, 11, 27, 31, 39, 51, 63, 84, 91, 103, 138, 158, 160, 214, 223, 266, 267, 268, 269, 384 Otitis Media with Effusion, 268, 384 Otolaryngologist, 267, 384 Otolaryngology, 4, 5, 17, 25, 36, 93, 148, 150, 172, 183, 267, 384 Otorrhea, 93, 267, 384 Otosclerosis, 266, 267, 268, 269, 384 Ototoxic, 324, 384 Outpatient, 26, 384 Oval Window, 93, 384 Overexpress, 16, 385 Oxidation, 321, 327, 359, 372, 385 Oxidative metabolism, 105, 323, 371, 385 Oxidative Stress, 65, 385 Oximetry, 25, 385 P Pachymeningitis, 221, 222, 233, 375, 385 Palliative, 221, 385, 409 Palsy, 20, 385 Pancreas, 321, 332, 347, 385 Panophthalmitis, 102, 385 Paralysis, 22, 23, 266, 317, 333, 355, 385, 386, 391, 396, 404 Paranasal Sinuses, 385, 403, 405 Paraparesis, 385, 386 Parasite, 36, 260, 385 Parasitic, 344, 361, 385, 410, 411 Parenteral, 153, 385 Paresis, 265, 355, 381, 385
432 Meningitis
Paresthesias, 381, 386 Parotid, 386, 400 Paroxysmal, 361, 386, 388, 417 Partial remission, 386, 398 Partial Thromboplastin Time, 55, 386 Pathogen, 6, 8, 9, 10, 14, 16, 26, 28, 30, 37, 38, 40, 41, 43, 49, 51, 59, 60, 366, 386 Pathologic, 17, 34, 223, 235, 328, 331, 333, 343, 356, 364, 386, 392, 394, 405 Pathologic Processes, 328, 386 Pathophysiology, 41, 57, 64, 83, 84, 176, 268, 386 Patient Education, 302, 310, 312, 319, 386 Pelvis, 372, 386, 395, 414 Pentosyltransferases, 359, 386 Pepsin, 386 Pepsin A, 386 Peptic, 284, 386 Peptic Ulcer, 284, 386 Peptide, 7, 10, 22, 35, 44, 47, 48, 324, 339, 386, 387, 393, 394, 410 Peptide Chain Elongation, 339, 387 Peptide T, 7, 387 Perception, 4, 36, 175, 387, 401 Perforation, 123, 267, 268, 387 Perfusion, 47, 364, 387 Pericardium, 387, 408 Perilymph, 267, 268, 387 Perinatal, 47, 269, 367, 387 Peripheral blood, 35, 44, 64, 368, 387 Peripheral Nervous System, 381, 385, 387, 396, 401, 407 Peripheral Nervous System Diseases, 381, 385, 387, 396 Peripheral Neuropathy, 64, 387 Periplasm, 11, 387 Peritoneal, 102, 109, 362, 383, 387 Peritoneal Cavity, 362, 383, 387 Peritoneum, 376, 387 Perivascular, 377, 388 Periventricular Leukomalacia, 155, 388 Pernicious, 166, 388 Pernicious anemia, 166, 388 Pertussis, 260, 388, 417 Petechiae, 55, 317, 361, 388 Petrolatum, 350, 388 PH, 75, 79, 128, 149, 180, 196, 212, 233, 388 Phagocyte, 18, 53, 388 Phagocytosis, 38, 43, 57, 377, 388 Phallic, 355, 388 Pharmacokinetic, 105, 177, 222, 234, 388 Pharmacologic, 326, 361, 388, 411, 414
Pharmacotherapy, 96, 98, 115, 146, 170, 177, 203, 207, 388 Pharynx, 367, 379, 384, 388 Phenolphthalein, 350, 388 Phenotype, 9, 19, 24, 35, 69, 259, 341, 358, 388 Phenyl, 225, 388 Phenylalanine, 386, 388, 413 Phenylpropanolamine, 265, 388 Phospholipases, 54, 389, 403 Phospholipids, 67, 326, 327, 334, 355, 368, 372, 375, 389 Phosphorus, 334, 389 Phosphorylated, 16, 389 Phosphorylation, 33, 389 Phosphorylcholine, 9, 31, 389 Photocoagulation, 339, 389 Photophobia, 252, 256, 317, 389 Physicochemical, 330, 365, 389 Physiologic, 323, 361, 376, 389, 397 Physiology, 236, 284, 322, 389 Picornavirus, 22, 65, 389 Pigments, 331, 335, 389, 398 Pilot study, 192, 389 Plants, 230, 323, 332, 334, 338, 339, 359, 371, 378, 382, 389, 391, 394, 400, 411, 413 Plaque, 24, 389 Plasma, 13, 24, 64, 67, 326, 334, 336, 351, 355, 359, 362, 378, 379, 386, 389, 390, 394, 397 Plasma cells, 326, 378, 379, 389 Plasma protein, 351, 389, 394 Plasmid, 24, 27, 58, 390, 415 Plasmin, 390, 411, 414 Plasminogen, 192, 390, 411, 414 Plasminogen Activators, 390 Plasticity, 50, 390 Platelet Activating Factor, 10, 390 Platelet Activation, 390, 403 Platelet Aggregation, 325, 382, 390, 410 Platelets, 296, 382, 390, 402, 410 Platinum, 339, 372, 390 Pleomorphic, 349, 390 Pleural, 383, 390 Pleural cavity, 383, 390 Pneumococcal Infections, 39, 51, 390 Podophyllotoxin, 353, 391 Poisoning, 106, 334, 346, 357, 369, 379, 391, 400, 402 Poliomyelitis, 29, 61, 67, 391 Pollen, 391, 396 Polyarteritis Nodosa, 266, 391
Index 433
Polyarthritis, 370, 391, 403 Polymerase, 88, 103, 116, 121, 131, 143, 151, 153, 179, 391, 398 Polymerase Chain Reaction, 88, 103, 116, 121, 131, 143, 151, 153, 391 Polymers, 63, 391, 394 Polymorphic, 346, 391 Polyneuritis, 347, 391 Polyradiculopathy, 274, 391 Polysaccharide, 10, 19, 27, 30, 32, 40, 49, 51, 52, 57, 59, 66, 76, 85, 180, 257, 327, 336, 391, 394 Pons, 138, 333, 354, 391, 399 Port, 38, 225, 392 Port-a-cath, 392 Portal Hypertension, 353, 392 Posterior, 147, 325, 329, 330, 336, 338, 348, 380, 384, 385, 392, 401, 405, 416 Postnatal, 269, 392, 406 Postoperative, 124, 209, 214, 266, 267, 392 Postoperative Complications, 267, 392 Postsynaptic, 392, 403, 408 Potassium, 224, 296, 392 Potentiates, 23, 368, 392 Potentiation, 392, 403 Practicability, 392, 413 Practice Guidelines, 267, 297, 392 Preclinical, 10, 13, 15, 55, 56, 392 Precursor, 57, 328, 338, 344, 348, 349, 351, 382, 388, 390, 392, 394, 413 Predictive factor, 5, 392 Predisposition, 136, 392 Prednisolone, 124, 376, 392 Prednisone, 265, 392 Premenstrual, 268, 393 Prenatal, 269, 350, 393 Preoperative, 266, 267, 393 Presbycusis, 267, 269, 393 Prevalence, 13, 127, 173, 182, 393 Prion, 336, 393 Probe, 42, 187, 371, 377, 383, 393 Progeny, 34, 393 Progesterone, 393, 406 Prognostic factor, 110, 149, 178, 179, 184, 199, 207, 393 Progression, 4, 12, 17, 265, 326, 393 Projection, 345, 368, 382, 383, 393, 395, 397 Promoter, 39, 57, 66, 67, 393 Prone, 54, 393 Prophylaxis, 39, 121, 200, 260, 393, 414 Proportional, 352, 393 Prospective study, 89, 143, 185, 284, 393
Prostaglandins, 328, 393 Prosthesis, 267, 393 Protease, 51, 65, 340, 393, 411 Protein C, 4, 10, 11, 14, 16, 112, 254, 257, 324, 330, 372, 393, 416 Protein S, 7, 263, 279, 331, 339, 347, 353, 394, 399, 409 Proteinuria, 378, 394 Proteoglycan, 152, 394 Proteolytic, 341, 355, 390, 394, 411, 414 Prothrombin, 56, 386, 394, 409 Prothrombin Time, 56, 394 Protocol, 27, 232, 243, 394 Protons, 363, 369, 394, 396 Protozoa, 377, 394, 411 Protozoan, 336, 344, 374, 394 Protozoan Infections, 336, 394 Proximal, 25, 348, 379, 394 Pseudomonas, 13, 37, 171, 190, 233, 236, 253, 394, 411 Pseudotumor Cerebri, 369, 394 Psoriasis, 54, 394 Psychiatry, 91, 102, 115, 144, 170, 183, 192, 213, 223, 232, 263, 355, 395, 415 Psychic, 376, 395, 401 Psychoactive, 395, 417 Psychogenic, 395, 414 Psychomotor, 36, 345, 350, 395 Public Policy, 295, 395 Pulmonary, 5, 76, 104, 130, 168, 269, 332, 343, 352, 364, 371, 395, 398, 415 Pulmonary Artery, 332, 395, 415 Pulmonary hypertension, 269, 395 Pulmonary Ventilation, 364, 395, 398 Pulse, 378, 385, 395 Punctures, 395 Pupil, 343, 383, 395 Purpura, 139, 361, 395 Purulent, 86, 138, 184, 185, 234, 264, 321, 351, 384, 395 Pyelonephritis, 62, 395 Pyogenic, 88, 150, 165, 186, 189, 224, 384, 395, 402 Pyramidal Cells, 346, 395 Pyramidal Tracts, 354, 395 Pyrexia, 213, 395 Pyridoxal, 47, 395, 396, 413 Pyridoxal Phosphate, 396, 413 Pyrogenic, 37, 396 Q Quadriplegia, 134, 396 Quality of Life, 17, 284, 396, 408
434 Meningitis
Quercetin, 42, 396 R Rabies, 396, 418 Race, 302, 375, 377, 396 Racemic, 375, 396 Radiation, 322, 330, 356, 357, 365, 369, 396, 397, 400, 417 Radiation therapy, 322, 357, 396 Radioactive, 329, 330, 332, 361, 363, 366, 369, 372, 378, 382, 396, 400 Radiography, 271, 396 Radioimmunotherapy, 55, 396, 397 Radiolabeled, 46, 55, 152, 396 Radiological, 103, 169, 186, 192, 205, 212, 266, 396 Radiologist, 270, 396 Radiology, 112, 185, 396 Radiotherapy, 15, 220, 230, 396, 397 Randomized, 32, 83, 90, 107, 121, 186, 243, 349, 397 Randomized Controlled Trials, 107, 397 Reactivation, 6, 397 Recombinant, 6, 15, 21, 23, 46, 67, 192, 242, 397, 415 Recombination, 29, 59, 60, 358, 397 Reconstitution, 50, 63, 175, 397 Rectum, 333, 340, 347, 357, 366, 367, 370, 397 Recurrence, 187, 267, 397 Red blood cells, 353, 362, 397, 400 Red Nucleus, 329, 397 Reductase, 376, 397 Refer, 1, 253, 333, 341, 348, 355, 356, 362, 368, 372, 379, 382, 396, 397, 411, 415 Refraction, 397, 405 Refractory, 56, 349, 397 Regeneration, 397 Regimen, 124, 214, 232, 349, 388, 397, 399 Relapse, 46, 244, 245, 246, 247, 248, 296, 397 Remission, 222, 234, 265, 374, 397, 398 Renal failure, 32, 35, 346, 398 Renal pelvis, 370, 398, 412 Repressor, 383, 398 Research Design, 21, 398 Resection, 15, 398 Respiration, 334, 378, 398 Respiratory distress syndrome, 21, 271, 398 Respiratory Mucosa, 11, 51, 398 Respiratory Physiology, 398, 415 Respiratory syncytial virus, 111, 398
Respiratory System, 53, 323, 378, 398 Restoration, 397, 398, 417 Retina, 338, 342, 371, 381, 383, 398, 399, 400, 417 Retinal, 97, 134, 175, 220, 383, 398, 399 Retinitis, 260, 269, 398, 399 Retinitis Pigmentosa, 269, 399 Retinoblastoma, 236, 399 Retinol, 398, 399 Retreatment, 83, 399 Retrobulbar, 384, 399 Retrospective, 90, 106, 160, 168, 220, 399 Retrospective study, 106, 160, 168, 220, 399 Retroviral vector, 358, 399 Reversion, 399, 413 Rheumatism, 399 Rheumatoid, 54, 88, 399 Rheumatoid arthritis, 54, 399 Rhinitis, 333, 352, 399, 402 Rhodopsin, 383, 398, 399 Ribavirin, 152, 399 Ribonuclease, 377, 399 Ribonucleic acid, 399 Ribonucleoproteins, 23, 399 Ribose, 322, 399 Ribosome, 17, 22, 23, 399, 412 Rigidity, 4, 205, 252, 256, 369, 389, 400 Risk factor, 4, 32, 45, 52, 56, 104, 140, 171, 191, 283, 393, 400 Ristocetin, 400, 415 Rod, 330, 361, 394, 400 Rubella, 191, 267, 271, 374, 400 Rural Population, 21, 400 Rutin, 396, 400 S Salivary, 345, 347, 354, 400, 403 Salivary glands, 345, 347, 354, 400, 403 Salmonella, 29, 73, 92, 95, 106, 144, 145, 159, 167, 192, 193, 211, 253, 357, 400 Saponins, 400, 406 Sarcoidosis, 113, 266, 400 Sarcoma, 6, 56, 260, 275, 400 Scans, 128, 400 Schizoid, 401, 417 Schizophrenia, 401, 417 Schizotypal Personality Disorder, 401, 417 Schwannoma, 284, 401 Sclera, 338, 342, 385, 401 Scleroderma, 377, 401 Sclerosis, 8, 12, 75, 378, 401
Index 435
Screening, 12, 27, 37, 69, 270, 301, 339, 386, 401 Sebaceous, 346, 401, 417 Secondary tumor, 376, 401 Secretion, 208, 344, 363, 364, 370, 377, 401, 403 Secretory, 10, 51, 401, 408 Segregation, 397, 401 Seizures, 69, 73, 125, 169, 254, 274, 317, 346, 352, 386, 401 Selenium, 65, 401 Semicircular canal, 367, 401 Semisynthetic, 325, 334, 335, 339, 353, 365, 401 Senile, 393, 401 Sensibility, 325, 401 Sensory loss, 379, 402, 409 Sepsis, 10, 13, 16, 18, 19, 26, 28, 30, 32, 36, 41, 43, 49, 51, 55, 58, 66, 67, 68, 70, 80, 163, 194, 200, 257, 263, 402 Septic, 68, 72, 96, 97, 98, 177, 194, 230, 235, 328, 402 Septicaemia, 123, 157, 176, 193, 194, 264, 402 Septicemia, 11, 27, 37, 39, 84, 86, 87, 133, 148, 170, 196, 200, 306, 402 Sequence Analysis, 65, 402 Sequence Homology, 50, 387, 402 Sequencing, 14, 21, 26, 28, 30, 65, 391, 402 Serine, 402, 411, 413 Seroconversion, 35, 402 Serologic, 365, 402 Serotonin, 381, 388, 402, 413 Serotypes, 7, 8, 10, 30, 31, 40, 66, 209, 253, 349, 402 Serous, 146, 268, 351, 402 Sex Characteristics, 322, 402 Sexually Transmitted Diseases, 343, 402 Shedding, 54, 402 Shock, 21, 38, 177, 194, 319, 402, 412 Shunt, 102, 109, 136, 157, 171, 190, 195, 209, 225, 318, 403 Sialic Acids, 57, 403 Sialyltransferases, 359, 403 Sicca, 166, 403 Side effect, 245, 287, 289, 296, 323, 344, 348, 403, 408, 411 Signal Transduction, 33, 43, 54, 59, 60, 368, 403 Signs and Symptoms, 252, 256, 391, 397, 398, 403 Sinusitis, 11, 51, 79, 147, 196, 403
Skeletal, 378, 379, 403 Skeleton, 321, 370, 403 Skull, 148, 174, 188, 284, 332, 337, 344, 350, 369, 376, 380, 384, 403, 409 Skull Base, 148, 403 Small cell lung cancer, 403 Small intestine, 349, 363, 369, 403 Smooth muscle, 325, 342, 363, 379, 404, 407 Snails, 127, 128, 404 Sneezing, 388, 402, 404 Social Environment, 396, 404 Social Security, 397, 404 Sodium, 202, 404 Soft tissue, 32, 332, 403, 404 Solid tumor, 13, 94, 185, 242, 326, 348, 404 Solitary Nucleus, 330, 404 Solvent, 359, 404, 413 Soma, 92, 395, 404 Somatic, 35, 322, 363, 377, 387, 404 Sound wave, 342, 396, 404 Spasmodic, 388, 404 Spastic, 274, 404 Spasticity, 404 Spatial disorientation, 348, 404 Specialist, 18, 307, 404 Specificity, 14, 35, 47, 69, 257, 323, 365, 366, 405 Spectrophotometry, 47, 405 Spectrum, 23, 32, 35, 115, 130, 178, 197, 365, 377, 405, 408 Speech Perception, 3, 405 Sperm, 338, 391, 405 Sphenoid, 148, 385, 405 Sphenoid Sinus, 148, 405 Sphenoid Sinusitis, 148, 405 Spinal Cord Diseases, 385, 396, 405 Spinal Cord Vascular Diseases, 379, 405 Spinal Nerve Roots, 391, 405 Spinal tap, 273, 303, 372, 405 Spiral Ganglion, 17, 340, 405, 416 Spirochete, 20, 405, 408 Spleen, 13, 58, 345, 373, 400, 405, 406 Splenectomy, 197, 406 Splenomegaly, 367, 406 Sporadic, 399, 406 Squamous, 337, 382, 406 Squamous cell carcinoma, 382, 406 Squamous Epithelium, 337, 406 Stabilization, 5, 406 Staging, 275, 400, 406 Standard therapy, 244, 406
436 Meningitis
Stapes, 267, 366, 384, 406 Statistically significant, 4, 406 Stem cell transplantation, 113, 140, 406 Stem Cells, 406 Sterile, 328, 406 Sterility, 344, 406 Steroid, 205, 280, 344, 400, 406 Stimulant, 325, 363, 406 Stimulus, 54, 349, 353, 367, 369, 370, 381, 386, 406, 409 Stomach, 321, 330, 347, 353, 356, 357, 363, 379, 386, 387, 388, 403, 405, 406 Strand, 29, 391, 407 Streptavidin, 13, 407 Streptococcal, 27, 78, 84, 94, 116, 137, 138, 141, 143, 155, 198, 199, 223, 224, 407 Streptococci, 18, 30, 32, 40, 41, 68, 72, 93, 140, 159, 194, 407 Stress, 39, 66, 174, 177, 223, 267, 268, 270, 284, 329, 335, 357, 379, 385, 392, 399, 407 Stria, 17, 26, 407 Stria Vascularis, 17, 26, 407 Stroke, 47, 60, 124, 250, 279, 294, 301, 303, 335, 407 Subacute, 5, 190, 367, 403, 407 Subarachnoid, 11, 17, 56, 133, 136, 179, 262, 361, 389, 407 Subclinical, 367, 401, 407 Subcutaneous, 55, 349, 357, 380, 383, 385, 407 Subdural Effusion, 138, 407 Subiculum, 363, 407 Subspecies, 404, 407 Substance P, 64, 353, 397, 400, 401, 407 Substrate, 16, 24, 36, 352, 381, 407 Substrate Specificity, 16, 407 Sulbactam, 170, 407 Supportive care, 23, 408 Suppression, 243, 344, 408 Suppressive, 70, 408 Sympathetic Nervous System, 329, 381, 408 Sympathomimetic, 325, 348, 352, 382, 388, 408 Symptomatic, 12, 408 Synaptic, 381, 382, 403, 408 Synaptic Transmission, 382, 408 Syphilis, 259, 267, 269, 271, 334, 381, 408 Systemic disease, 11, 70, 269, 306, 402, 408 Systemic lupus erythematosus, 114, 145, 266, 326, 327, 377, 408 Systolic, 364, 408
T Tachycardia, 330, 408 Tachypnea, 330, 408 Teichoic Acids, 360, 408 Telencephalon, 330, 336, 409 Temozolomide, 56, 204, 409 Temporal, 17, 175, 204, 267, 361, 363, 374, 409, 416 Teratogenic, 323, 409 Tetani, 409 Tetanic, 409 Tetanus, 32, 142, 271, 409 Tetracycline, 46, 409 Thalamic, 329, 409 Thalamic Diseases, 329, 409 Thalassemia, 149, 409 Therapeutics, 15, 22, 26, 58, 288, 409 Thermal, 347, 391, 409 Thermoregulation, 57, 409 Thoracic, 197, 209, 220, 230, 409, 417 Thorax, 372, 409 Threonine, 387, 402, 409 Threshold, 58, 364, 409 Thrombin, 355, 390, 393, 394, 409, 410 Thrombocytes, 390, 409 Thrombocytopenia, 390, 410 Thrombolytic, 390, 410 Thrombomodulin, 393, 410 Thrombopenia, 327, 410 Thrombophlebitis, 216, 410 Thromboplastin, 394, 410 Thromboses, 327, 410 Thrombosis, 217, 394, 407, 410 Thromboxanes, 328, 410 Thrombus, 343, 367, 390, 410, 415 Thymus, 365, 373, 410 Thyroid, 269, 271, 364, 369, 410, 413 Thyrotropin, 364, 410 Tick-Borne Diseases, 349, 410 Tidal Volume, 364, 410 Tin, 387, 390, 410 Tinnitus, 266, 267, 269, 384, 394, 410, 416 Tissue Culture, 16, 19, 23, 47, 70, 411 Tissue Plasminogen Activator, 144, 411 Tobramycin, 177, 411 Tolerance, 85, 247, 322, 359, 411 Tomography, 55, 342, 400, 411 Tone, 38, 404, 411 Tonicity, 349, 362, 369, 411 Tonus, 411 Topical, 68, 364, 388, 411 Topotecan, 178, 411
Index 437
Toxic, iv, 26, 33, 194, 245, 246, 248, 253, 323, 330, 340, 345, 347, 350, 365, 366, 375, 381, 382, 391, 401, 411, 415 Toxicity, 13, 15, 25, 35, 54, 55, 56, 220, 230, 244, 348, 400, 411, 413 Toxicology, 123, 296, 411 Toxin, 13, 347, 351, 409, 411 Toxoid, 32, 411 Toxoplasma, 260, 411 Toxoplasmosis, 267, 274, 275, 283, 330, 411 Trachea, 333, 388, 410, 411 Transcriptase, 275, 412 Transcription Factors, 63, 412 Transcutaneous, 27, 412 Transduction, 33, 43, 59, 403, 412 Transfection, 331, 358, 412 Transfer Factor, 365, 412 Transferases, 359, 412 Transitional cell carcinoma, 226, 236, 412 Translating, 23, 412 Translation, 22, 23, 24, 324, 353, 412 Translational, 22, 31, 412 Translocate, 19, 58, 412 Translocation, 11, 19, 339, 353, 412 Transmitter, 321, 329, 348, 354, 369, 375, 382, 412 Transplantation, 59, 113, 114, 172, 181, 208, 365, 412 Transposons, 31, 412 Trastuzumab, 210, 215, 412 Trauma, 69, 124, 146, 260, 266, 267, 268, 269, 271, 319, 346, 412, 417 Treatment Failure, 102, 412 Treatment Outcome, 171, 412 Triad, 100, 413 Triage, 144, 260, 413 Tropism, 17, 67, 75, 413 Tryptophan, 47, 340, 359, 402, 413 Tryptophan Synthase, 47, 413 Tubercular, 92, 103, 121, 280, 413 Tuberculoma, 146, 413 Tumor Necrosis Factor, 18, 76, 145, 255, 413 Tumour, 98, 222, 357, 413 Tunica, 378, 413 Turpentine, 52, 413 Tympanic membrane, 267, 374, 384, 413 TYPHI, 190, 413 Typhimurium, 73, 92, 106, 167, 193, 413 Typhoid fever, 413 Tyrosine, 47, 348, 413 Tyrosine Phenol-Lyase, 47, 413
U Ulcer, 123, 386, 414 Ultrasonography, 112, 216, 414 Umbilical Cord, 338, 414 Unconscious, 345, 364, 414 Urbanization, 21, 414 Uremia, 398, 414 Ureter, 398, 412, 414 Urethra, 414 Uric, 131, 169, 185, 324, 414 Urinary, 32, 57, 92, 212, 215, 284, 305, 335, 338, 344, 352, 366, 411, 414, 417 Urinary Plasminogen Activator, 411, 414 Urinary Retention, 92, 414 Urinary tract, 32, 57, 212, 284, 335, 414 Urinary tract infection, 32, 57, 284, 414 Urinate, 414 Urine, 35, 231, 327, 332, 347, 366, 370, 394, 398, 414 Urogenital, 360, 414 Urokinase, 192, 414 Uterine Contraction, 321, 414 Uterus, 321, 337, 343, 356, 376, 393, 414, 415 Uvea, 351, 414 V Vagina, 334, 337, 346, 376, 415 Vaginal, 68, 415 Vancomycin, 73, 74, 77, 78, 82, 86, 101, 146, 148, 162, 186, 202, 216, 266, 415 Varicella, 97, 216, 217, 220, 267, 415 Vascular endothelial growth factor, 132, 217, 415 Vasculitis, 151, 265, 326, 391, 415 Vasoactive, 64, 415 Vasodilatation, 64, 415 Vasodilator, 40, 333, 348, 363, 415 Vector, 368, 412, 415 Vein, 326, 369, 382, 386, 392, 410, 414, 415 Venereal, 380, 408, 415 Venous, 124, 217, 327, 332, 333, 336, 383, 394, 415 Venous blood, 332, 333, 336, 415 Venous Thrombosis, 124, 415 Ventilation, 268, 415 Ventricle, 363, 364, 395, 408, 415 Ventriculostomy, 122, 126, 202, 415 Venules, 332, 351, 377, 415 Vertebrae, 405, 415 Vertebral, 376, 415 Vertigo, 266, 267, 270, 384, 415, 416 Vesicular, 188, 362, 415
438 Meningitis
Vestibular, 5, 102, 139, 148, 267, 268, 270, 284, 361, 370, 415, 416 Vestibular Aqueduct, 139, 416 Vestibule, 339, 367, 384, 401, 415, 416 Vestibulocochlear Nerve, 340, 410, 416 Vestibulocochlear Nerve Diseases, 410, 416 Veterinary Medicine, 295, 416 Vinblastine, 226, 236, 416 Vinca Alkaloids, 416 Vinculin, 43, 416 Vinorelbine, 220, 230, 416 Viral Proteins, 29, 416 Virulent, 29, 42, 163, 416 Virus Replication, 67, 416 Visceral, 330, 387, 416 Visceral Afferents, 330, 416 Visual field, 394, 399, 416 Vitamin A, 367, 399, 416 Vitreous, 63, 338, 371, 398, 417 Vitreous Body, 338, 398, 417 Vitro, 10, 11, 19, 20, 21, 24, 25, 29, 33, 35, 37, 41, 44, 45, 46, 48, 50, 52, 55, 57, 58, 61, 63, 64, 65, 68, 70, 74, 85, 143, 230, 358, 362, 366, 391, 400, 411, 417 Vivo, 9, 16, 19, 20, 24, 29, 31, 33, 37, 41, 42, 44, 46, 48, 51, 57, 64, 66, 70, 143, 230, 358, 362, 366, 377, 410, 417
Voluntary Health Agencies, 365, 417 Voriconazole, 70, 201, 417 Vulgaris, 217, 417 W Wakefulness, 345, 417 West Nile Virus, 172, 300, 417 White blood cell, 296, 322, 327, 331, 338, 360, 367, 371, 373, 378, 379, 382, 389, 417 Whooping Cough, 388, 417 Windpipe, 388, 410, 417 Withdrawal, 245, 283, 346, 417 Wound Healing, 374, 417 Wound Infection, 195, 271, 417 X Xanthine, 324, 417 Xanthine Oxidase, 324, 417 Xenograft, 15, 55, 326, 417 X-ray, 14, 16, 61, 233, 318, 335, 342, 356, 357, 382, 396, 397, 400, 417 Y Yeasts, 356, 388, 418 Z Zoonosis, 232, 418 Zoster, 97, 139, 216, 220, 267, 418 Zymogen, 393, 418
Index 439
440 Meningitis
