Mitral Valve Prolapse - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

MITRAL VALVE PROLAPSE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES...

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

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

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Mitral Valve Prolapse: 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: 0-597-83994-8 1. Mitral Valve Prolapse-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on mitral valve prolapse. 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 MITRAL VALVE PROLAPSE ....................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Mitral Valve Prolapse ................................................................... 7 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND MITRAL VALVE PROLAPSE ............................................................. 55 Overview...................................................................................................................................... 55 Finding Nutrition Studies on Mitral Valve Prolapse.................................................................. 55 Federal Resources on Nutrition ................................................................................................... 57 Additional Web Resources ........................................................................................................... 57 CHAPTER 3. ALTERNATIVE MEDICINE AND MITRAL VALVE PROLAPSE ....................................... 59 Overview...................................................................................................................................... 59 National Center for Complementary and Alternative Medicine.................................................. 59 Additional Web Resources ........................................................................................................... 61 General References ....................................................................................................................... 62 CHAPTER 4. DISSERTATIONS ON MITRAL VALVE PROLAPSE ......................................................... 63 Overview...................................................................................................................................... 63 Dissertations on Mitral Valve Prolapse....................................................................................... 63 Keeping Current .......................................................................................................................... 64 CHAPTER 5. BOOKS ON MITRAL VALVE PROLAPSE ....................................................................... 65 Overview...................................................................................................................................... 65 Book Summaries: Federal Agencies.............................................................................................. 65 Book Summaries: Online Booksellers........................................................................................... 66 The National Library of Medicine Book Index ............................................................................. 67 Chapters on Mitral Valve Prolapse.............................................................................................. 68 CHAPTER 6. MULTIMEDIA ON MITRAL VALVE PROLAPSE ............................................................. 69 Overview...................................................................................................................................... 69 Bibliography: Multimedia on Mitral Valve Prolapse................................................................... 69 CHAPTER 7. PERIODICALS AND NEWS ON MITRAL VALVE PROLAPSE .......................................... 71 Overview...................................................................................................................................... 71 News Services and Press Releases................................................................................................ 71 Newsletter Articles ...................................................................................................................... 73 Academic Periodicals covering Mitral Valve Prolapse ................................................................ 73 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 75 Overview...................................................................................................................................... 75 U.S. Pharmacopeia....................................................................................................................... 75 Commercial Databases ................................................................................................................. 76 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 81 Overview...................................................................................................................................... 81 NIH Guidelines............................................................................................................................ 81 NIH Databases............................................................................................................................. 83 Other Commercial Databases....................................................................................................... 85 APPENDIX B. PATIENT RESOURCES ................................................................................................. 87 Overview...................................................................................................................................... 87 Patient Guideline Sources............................................................................................................ 87 Finding Associations.................................................................................................................... 92 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 95 Overview...................................................................................................................................... 95 Preparation................................................................................................................................... 95

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Finding a Local Medical Library.................................................................................................. 95 Medical Libraries in the U.S. and Canada ................................................................................... 95 ONLINE GLOSSARIES................................................................................................................ 101 Online Dictionary Directories ................................................................................................... 105 MITRAL VALVE PROLAPSE DICTIONARY ......................................................................... 107 INDEX .............................................................................................................................................. 141

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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 mitral valve prolapse 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 mitral valve prolapse, 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 mitral valve prolapse, 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 mitral valve prolapse. 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 mitral valve prolapse, 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 mitral valve prolapse. 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 MITRAL VALVE PROLAPSE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on mitral valve prolapse.

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

Reliability of Self-Reported Heart Murmur History: Possible Impact on Antibiotic Use in Dentistry Source: JADA. Journal of the American Dental Association. 129(7): 861-866. July 1998. Summary: Administration of prophylactic antibiotics to a dental patient with a history of heart murmurs, rheumatic fever or mitral valve prolapse should be based on a reliable diagnosis of heart valve disease. This article reports on a study in which the authors investigated 68 patients with diabetes who reported having these heart valve conditions. The results showed that at least 65 percent of these patients actually had no evidence of a pathological heart murmur during two previous physical examinations. One subject was unaware that he had a pathological heart murmur as a result of mitral valve prolapse. These findings raise additional concerns regarding appropriate

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premedication decisions, despite ongoing efforts by the American Heart Association to simplify and standardize the recommendations and indications for their application. The authors conclude that a self-reported history of heart valve disease should not be the sole criterion for antibiotic premedication. However, in an era of managed health care that emphasizes controlling costs, it is becoming more difficult to obtain appropriate evaluations that could confirm or rule out pathological heart valve defects. As a result, dentists may have to continue to empirically prescribe prophylactic antibiotic regimens for many of their patients who may not be at risk of developing endocarditis. This may have negative repercussions relative to the efficacy and future use of antibiotics. 1 figure. 1 table. 24 references. (AA-M). •

Dental and Cardiac Risk Factors for Infective Endocarditis: A Population-Based, Case-Control Study Source: Annals of Internal Medicine. 129(10): 761-769. November 15, 1998. Contact: Available from Annals of Internal Medicine. 190 North Independence Mall West, Philadelphia, PA 19106-1572. (800) 523-1546, ext. 2600. Fax (215) 351-2799. Summary: Although antibiotic prophylaxis against infective endocarditis is recommended, the true risk factors for infective endocarditis are unclear. This article reports on a study undertaken to measure the risk for endocarditis from dental treatment and cardiac abnormalities. In the case control study involving 54 hospitals in the Philadelphia area, persons with community acquired infective endocarditis not associated with intravenous drug use were compared with community residents, matched by age, sex, and neighborhood of residence. Information on demographic characteristics, host risk factors, and dental treatment was obtained from structured telephone interviews, dental records, and medical records. During the preceding 3 months, dental treatment was no more frequent among case patients than among controls. Of 273 case patients, 104 (38 percent) knew of previous cardiac lesions compared with 17 controls (6 percent). Case patients more often had a history of mitral valve prolapse, congenital heart disease, cardiac valvular surgery, rheumatic fever, and heart murmur without other known cardiac abnormalities. Among case patients with known cardiac lesions (the target of prophylaxis), dental therapy was significantly less common than among controls. Few participants received prophylactic antibiotics. The authors conclude that dental treatment does not seem to be a risk factor for infective endocarditis, even in patients with valvular abnormalities, but cardiac valvular abnormalities are strong risk factors. Few cases of infective endocarditis would be preventable with antibiotic prophylaxis, even with 100 percent effectiveness assumed. The authors note that current policies for prophylaxis should be reconsidered. 1 figure. 4 tables. 29 references. (AA-M).

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A Drink to Your Health Source: Health. p.89-92. June 2000. Summary: This article discusses the many health benefits of drinking water. According to Dr. Ferydoon Batmanghelidj, author of "Your Body's Many Cries for Water", chronic dehydration may contribute to heartburn, headache, joint and pack pain, and fatigue. Susan M. Kleiner, assistant professor with the Nutritional Sciences Program at the University of Washington, has also researched the effects of chronic mild dehydration. According to her research, minor water shortage in the body can cause major health problems such as colon, bladder, or breast cancer, overweight, fatigue, and headaches. Other researchers have examined the effects of water on weight control. Researchers

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suggest that drinking water regularly can help to reduce feelings of hunger. Barbara Rolls, professor of Nutrition at Pennsylvania State University, suggests "cooking" water into your diet through eating foods like hot cereal and soup. Water is also helpful in weight-control because it quenches thirst without adding unnecessary calories. Water may also help to alleviate fatigue, particularly for individuals suffering from mitral valve prolapse syndrome. Studies show that headaches are one of the most common side effects of dehydration, so drinking water regularly may help to prevent headaches. To obtain these health benefits and prevent dehydration, experts recommend drinking eight 8 oz. glasses of water every day. •

Prevention of Bacterial Endocarditis: Recommendations By the American Heart Association Source: JADA. Journal of American Dental Association. 128(7): 1142-1151. August 1997. Summary: This article excerpts the American Heart Association's recommendations on the prevention of bacterial endocarditis. These June 1997 recommendations were published to update 1990 guidelines for the prevention of bacterial endocarditis in individuals at risk for this disease. A major change in the update recommendations includes emphasizing that most cases of endocarditis are not attributable to an invasive procedure. The guidelines also stratifies cardiac conditions into high, moderate, and negligible risk categories based on potential outcome if endocarditis develops. Procedures that may cause bacteremia and for which prophylaxis is recommended are more clearly specified. An algorithm was developed to more clearly define when prophylaxis is recommended for patients with mitral valve prolapse. For oral or dental procedures, the initial amoxicillin dose is reduced to 2 g, a follow up antibiotic dose is no longer recommended, and erythromycin is no longer recommended for penicillinallergic individuals, but clindamycin and other alternatives are offered. The authors stress that these guidelines are meant to aid practitioners, but are not intended as the standard of care or as a substitute for clinical judgement. 1 figure. 3 tables. 42 references. (AA-M).

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Dental Management of the Adolescent with Panic Disorder Source: Journal of Dentistry for Children. 60(6): 365-371. November-December 1993. Summary: This article explores the dental management of adolescents with panic disorder (PD), a psychiatric disease characterized by recurrent surges of severe anxiety without obvious cause. Panic disorder has special relevance for dentistry because it is often associated with mitral valve prolapse, a condition that may require endocarditis prophylaxis. In addition, the medications most often used to treat PD are associated with detrimental changes in the oral cavity and adverse interactions with dental therapeutic changes. Topics include characteristics of panic disorder, associated medical problems, epidemiology, etiology, the medical management of PD, and the dental management of children with PD, including anesthesia precautions. 60 references.

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How to Fight Fatigue Source: Diabetes Self-Management. 15(1): 6-8, 10-11. January-February 1998. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article provides people who have diabetes with information about fatigue. With the exception of chronic fatigue syndrome, fatigue is usually a symptom of

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another problem or condition as opposed to a medical problem in and of itself. The author presents the primary causes of fatigue in three categories: lifestyle factors, medical conditions, and mood disorders. Lifestyle factors may include stress, nutrition, dehydration, exercise, and smoking. Among the medical conditions that may cause fatigue are high blood glucose, infection, hypothyroidism, heart disease, mitral valve prolapse, cancer, iron-deficiency anemia, iron overload, sleep disorders, and chronic fatigue syndrome. The author refers to depression and seasonal affective disorder as mood disorders which may cause fatigue. A health care professional should be consulted when fatigue is sudden or severe; is accompanied by symptoms such as fever, shortness of breath, or chest pain; or lasts more than two weeks without obvious cause. A sidebar provides nine tips for sleeping more peacefully. The article lists three organizations as sources of further information about fatigue. (AA-M). •

Improved Chest Expansion in Idiopathic Scoliosis After Intensive, MultipleModality, Nonsurgical Treatment in an Adult Source: Chest. 120(2): 672-674. August 2001. Summary: This journal article provides health professionals with information on the case of a middle aged woman who had stable right thoracic spinal curvature due to idiopathic scoliosis and was treated with traction to improve pulmonary function. The woman had a prominent rib hump, scapular and torso asymmetry, thoracic lordosis, and forward rotation of the right shoulder which were detected at age 11 years. Radiographic analysis revealed a right thoracic curvature of 43 degrees with lesser curvatures in the cervical and lumbar spine. In addition, pectus excavatum and mitral valve prolapse also were present. Daily torso strengthening and conditioning exercises were carried out through February 1992. From 1993 to 2000, the woman underwent intensive psychological and mobilization therapies, including comprehensive manipulative medicine treatments and daily manual traction. During this period, a 6 centimeter increase in resting chest circumference (in the absence of weight gain) and a 7.5 centimeter increase in chest expansion were correlated with a substantial reduction of incidence of respiratory infections. Mechanisms of chest wall expansion probably include altered muscle tonus through neuroreflexive mechanisms and plastic tissue changes from directed applied forces and, over time, self-stretching through deeper breathing. 2 figures and 6 references. (AA-M).

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Water: An Essential But Overlooked Nutrient Source: Journal of the American Dietetic Association. 99(2): 200-206. February 1999. Summary: This review article addresses the current knowledge of the effects of chronic mild dehydration on human performance and health; in it, the author calls for a revival of patient or client education regarding water intake. To be well hydrated, the average sedentary adult man must consume at least 2,900 mL (11 c) of fluid per day, and the average sedentary adult woman at least 2,200 mL (9 c) of fluid per day, in the form of noncaffeinated, nonalcoholic beverages, soups, and foods. Solid foods contribute approximately 1,000 mL (4 c) of water, with an additional 250 mL (1 c) coming from the water of oxidation. The Nationwide Food Consumption Surveys indicate that a portion of the population may be chronically mildly dehydrated. Several factors may increase the likelihood of chronic, mild dehydration, including a poor thirst mechanism, dissatisfaction with the taste of water, common consumption of the natural diuretics caffeine and alcohol, participation in exercise, and environmental conditions. Dehydration of as little as 2 percent loss of body weight results in impaired physiological and performance responses. New research indicates that fluid

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consumption in general and water consumption in particular can have an effect on the risk of urinary stone disease; cancers of the breast, colon, and urinary tract; childhood and adolescent obesity; mitral valve prolapse; salivary gland function; and overall health in the elderly. The author concludes that dietitians should be encouraged to promote and monitor fluid and water intake among all their clients and patients through education and to help them design a fluid intake plan. The influence of chronic mild dehydration on health and disease merits further research. 4 figures. 81 references. (AA).

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

Project Title: COMPUTATIONAL MORPHOGENESIS

STUDY

OF

FIBRILLINS

IN

CV

Principal Investigator & Institution: Rongish, Brenda J.; Assistant Professor; Physiology; University of Kansas Medical Center Msn 1039 Kansas City, Ks 66160 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Cell-extracellular matrix (ECM) interactions are key regulators of developmental morphogenic events. Cardiovascular abnormalities associated with the connective tissue disorders Marfan syndrome and congenital contractural arachnodactyly have been linked genetically and biochemically to the microfibrillar ECM proteins fibrillin 1 and 2 respectively. In addition to ocular and skeletal abnormalities, patients with these disorders manifest aortic root dilatation, aortic insufficiency, and mitral valve prolapse. A neonatal form of Marfan syndrome causes severe cardiovascular defects and leads to death within the first year. Epifluorescence microscopy indicates fibrillin-1 and -2 positive fibrils are present in the epicardium, dorsal mesocardium, and enclocardial cushion tissue/valve primordial of avian embryos, and surround the forming bilateral dorsal aortae; implicating the fibrillins in cardiovascular morphogenesis. These microfibrils may impart stability or provide extensible properties to these regions, which are subject to stress/strain. To address the function(s) of fibrillins during early cardiovascular development we will use 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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time-lapse imaging, fibrillin marker antibodies, and computational analyses to document fibrillin assembly/reorganization and motion in the avian embryo bilateral heart forming tissues, endocardial cushions/valve primordia, and major embryonic vessels in normal embryos. Further, we propose to monitor the effects of experimentally perturbing microfibril assembly on cardiovascular development. Similarly, we will monitor the effects of altering cardiovascular (CV) morphogenesis (at the tissue level) on fibrillin assembly. Finally, we will use a complementary mouse explant culture system to monitor dynamically fibrillin assembly in normal and transgenic CV tissue, We hypothesize that dynamic microfibril assembly is key for normal cardiac development, and that disruption of orderly assembly leads to cardiovascular malformations. Examining fibrillin fibril assembly will lead to a better understanding of connective tissue-related cardiovascular defects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ECHOCARDIOGRAPHIC STROKE PREDICTORS IN A TRI-ETHNIC COMM Principal Investigator & Institution: Di Tullio, Marco R.; Medicine; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2004 Summary: (Adapted From The Applicant's Abstract): The candidate's previous activity has been devoted to patient-oriented research. In recent years, he has focused on the use of echocardiography to identify new cardioembolic sources for ischemic stroke, especially patent foramen ovale and aortic arch plaques, and has`been awarded two R01 grants from NINDS for such efforts. The candidate's overall career goal is to continue his research in the field of cardioembolic stroke, contributing to the explanation of the mechanisms of some cryptogenic strokes and therefore to a rational preventive and therapeutic approach. The candidate is also committed to mentoring young investigators, as documented by his long-standing and successful training of cardiology, fellows. Columbia University is an ideal environment to foster the candidate's career growth because of the strong, infrastructure for clinical research, the presence of world renowned cardiologists and neurologists for consultation and collaboration, and the firm institutional commitment to patient-oriented research. Crucial to the candidate's career development will be the transition from the relatively small case-control studies performed so far to the proposed large prospective study of subclinical echocardiocraphic abnormalities and stroke risk. A population-based prospective cohort study is proposed to determine the independent contribution of left ventricular hypertrophy (LVH) and geometric pattern, decreased LV ejection fraction, segmental wall motion abnormalities and left atrial enlargement to the risk of ischemic stroke and vascular events in a tri-ethnic population, and the existence of a dose-response relationship. The progression of these abnormalities over time will also be assessed. Secondary aims will be to evaluate the modification of risk by traditional stroke risk factors, and the assessment of the risk associated with less frequent abnormalities (patent foramen ovale, mitral annular calcification, mitral valve prolapse). Finally, the prevalence of a patent foramen ovale in each race-ethnic group will be evaluated. A cohort of 2500 white, black and Hispanic adults over age 55 will be enrolled from the ongoing Northern Manhattan Stroke Study (NOMASS), assuring cost-effective recruitment, data collection and follow-up. Two-dimensional echocardiography with contrast injection will be performed. A new three-dimensional technique will also be used to assess LVH. Annual telephone follow-up will be performed to ascertain stroke, myocardial infarction and death. In-person follow-up will be done in subjects with

Studies

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suspected outcome and in a random 10% of the cohort. Kaplan Meier curves and Coxproportional hazard models will be used to calculate adjusted event rates and assess the dependence of exposures of interest on stroke and vascular events adjusting for demographics and stroke risk factors. In a subgroup of 900 subjects, echocardiography will be repeated 3 years after the first test to study the progession of echocardioaraphic abnormalities. This study will be the first prospective cohort study to evaluate the role of multiple echocardiographic risk factors for ischemic stroke in a community of whites, blacks and Hispanics living in the same area. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MVPS: HEALTH CONCERNS, ROLE FUNCTION, HEALTH SERVICE USE Principal Investigator & Institution: Scordo, Kristine A.; None; Wright State University Colonel Glenn Hwy Dayton, Oh 45435 Timing: Fiscal Year 2002; Project Start 15-MAR-2002; Project End 14-MAR-2004 Summary: (provided by applicant) Mitral valve prolapse (MVP) is the most common valvular heart disease with millions of people newly diagnosed each year. Some of these patients have actual structural changes that require mitral valve replacement; others have a constellation of symptoms that are unrelated to these structural changes and are diagnosed with MVP syndrome (MVPS). For these individuals, treatment is aimed at symptom control. While the course for those with anatomical valvular dysfunction is documented, the course for those with MVPS is less well known. Anecdotal reports by individuals with MVPS indicate a variety of frightening symptoms, including chest pain, shortness of breath, palpitations, migraine headaches, lightheadedness, fatigue, dizziness on standing, mood swings, and anxiety or panic attacks. Individuals with these symptoms often seek help in emergency rooms; urgent care centers, and primary care offices. However, little is known about the profile and the effects of these symptoms on the individual's role status, and use of health care services. Thus, the purpose of this study is to develop a profile of health concerns, symptoms and treatments, and to examine the relationships of symptoms to functional and role status and use of health care services for patients diagnosed with MVPS. Specifically, the research questions are: (1) what are the health concerns, symptoms, and treatments reported by patients with MVPS? (2) Are symptoms related to age, time since diagnosis, symptoms, anxiety, social support, diet (magnesium, sodium, water and caffeine), and treatment (beta and calcium channel blockers; anxiolytics; mediation/relaxation therapy; fluid; exercise; activity limitation)? (3) What is the relationship of symptoms to patients' health concerns, functional and role status, and use of health care services? A descriptive cross-sectional design will be used. Questionnaire packets will be mailed to all of the men and women (N = 3022) on The Mitral Valve Prolapse Program of Cincinnati's mailing list diagnosed with MVPS. The self-complete questionnaires will include measures of MVPS symptoms (MVPS symptom checklist); the outcome variables of health concerns (MUIS), functional and role status (SF-36), and healthcare service use (Life History Calendar); and the independent variables of age, time since diagnosis, anxiety (STAI), social support (MOS Social Support), treatment, and diet (Food Frequency Questionnaire). Descriptive statistics and multiple regression analysis will be used to address the study's research questions. The proposed study is the next step in developing data on symptoms of MVPS and their effect on health and functioning. These data are necessary in developing and modifying existing education and self management interventions aimed at reducing anxiety and improving the health and well being of the millions of Americans newly diagnosed with this syndrome annually.

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

Ebstein's Anomaly of the Tricuspid Valve with Associated Mitral Valve Prolapse. by Khan IA.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=101139

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

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A case of mitral valve prolapse presenting with various conduction system abnormalities. Author(s): Dwivedi S. Source: J Assoc Physicians India. 2000 March; 48(3): 358-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229130&dopt=Abstract

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A locus for autosomal dominant mitral valve prolapse on chromosome 11p15.4. Author(s): Freed LA, Acierno JS Jr, Dai D, Leyne M, Marshall JE, Nesta F, Levine RA, Slaugenhaupt SA. Source: American Journal of Human Genetics. 2003 June; 72(6): 1551-9. Epub 2003 April 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707861&dopt=Abstract

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A population-based study of stroke in the setting of mitral valve prolapse: risk factors and infarct subtype classification. Author(s): Petty GW, Orencia AJ, Khandheria BK, Whisnant JP. Source: Mayo Clinic Proceedings. 1994 July; 69(7): 632-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8015325&dopt=Abstract

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Aetiology of mitral valve prolapse. Author(s): Anderson RH. Source: Journal of the Royal Society of Medicine. 1993 June; 86(6): 371. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8315641&dopt=Abstract

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Alarming atrioventricular block and mitral valve prolapse in the Kearns-Sayre syndrome. Author(s): Katsanos KH, Pappas CJ, Patsouras D, Michalis LK, Kitsios G, Elisaf M, Tsianos EV. Source: International Journal of Cardiology. 2002 May; 83(2): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12007693&dopt=Abstract

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An unusual pulsed-wave tissue Doppler pattern in mitral valve prolapse: spikes on systolic velocities. Author(s): Dagdeviren B, Bolca O, Eren M, Akdemir O, Arikan E, Gurlertop Y, Tezel T. Source: Echocardiography (Mount Kisco, N.Y.). 2002 July; 19(5): 367-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174199&dopt=Abstract

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Anatomic explanation of mobile systolic clicks: implications for the clinical and echocardiographic diagnosis of mitral valve prolapse. Author(s): Weis AJ, Salcedo EE, Stewart WJ, Lever HM, Klein AL, Thomas JD. Source: American Heart Journal. 1995 February; 129(2): 314-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7832105&dopt=Abstract

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Angiotensin II type 1 receptor gene adenine/cytosine1166 polymorphism is not associated with mitral valve prolapse syndrome in Taiwan Chinese. Author(s): Chou HT, Shi YR, Wu JY, Tsai FJ. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2002 February; 66(2): 163-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999641&dopt=Abstract

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Anomaly of the origin of the left coronary artery in children: presentation as mitral valve prolapse with mitral insufficiency and normal left ventricular function. Author(s): Zalzstein E, Zucker N, Levitas A, Berant M, Zeevi B. Source: Isr Med Assoc J. 2003 February; 5(2): 127-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674666&dopt=Abstract

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Antibiotic prophylaxis against infective endocarditis in mitral valve prolapse. Author(s): Guntheroth W. Source: Journal of the American College of Cardiology. 1996 February; 27(2): 515. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8557931&dopt=Abstract

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Arrhythmias in mitral valve prolapse: relation to anterior mitral leaflet thickening, clinical variables, and color Doppler echocardiographic parameters. Author(s): Zuppiroli A, Mori F, Favilli S, Barchielli A, Corti G, Montereggi A, Dolara A. Source: American Heart Journal. 1994 November; 128(5): 919-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7942485&dopt=Abstract

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Assessment of left ventricular systolic function in patients with idiopathic mitral valve prolapse using dobutamine stress echocardiography. Author(s): Tikiz H, Balbay Y, Kural T, Goksel S. Source: Clin Cardiol. 2000 October; 23(10): 781-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11061058&dopt=Abstract

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Association between angiotensin I-converting enzyme gene insertion/deletion polymorphism and mitral valve prolapse syndrome. Author(s): Chou HT, Chen YT, Shi YR, Tsai FJ. Source: American Heart Journal. 2003 January; 145(1): 169-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514670&dopt=Abstract

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Association between angiotensinogen gene M235T polymorphism and mitral valve prolapse syndrome in Taiwan Chinese. Author(s): Chou HT, Hung JS, Chen YT, Shi YR, Tsai FJ. Source: J Heart Valve Dis. 2002 November; 11(6): 830-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479284&dopt=Abstract

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Association between idiopathic mitral valve prolapse and panic disorder. Author(s): Tamam L, Ozpoyraz N, San M, Bozkurt A. Source: Croatian Medical Journal. 2000 December; 41(4): 410-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11063765&dopt=Abstract

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Atrial natriuretic factor and mitral valve prolapse syndrome. Author(s): Di Salvo G, Pergola V, Ratti G, Tedesco MA, Giordano C, Scialdone A, Iacono A. Source: Minerva Cardioangiol. 2001 October; 49(5): 317-25. Review. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11533551&dopt=Abstract

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Attenuation of the circadian ST depression with propranolol in mitral valve prolapse. Author(s): Abinader EG, Sharif D, Goldhammer E. Source: The American Journal of Cardiology. 1994 May 1; 73(12): 914-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8184825&dopt=Abstract

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Auscultation for mitral valve prolapse. Author(s): Sandler DA. Source: Lancet. 1995 January 21; 345(8943): 202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7823705&dopt=Abstract

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Auscultation for mitral valve prolapse. Author(s): Hegde BM. Source: Lancet. 1994 November 19; 344(8934): 1446. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7968113&dopt=Abstract

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Autonomic tone in patients with supraventricular arrhythmia associated with mitral valve prolapse in young men. Author(s): Terechtchenko L, Doronina SA, Pochinok EM, Riftine A. Source: Pacing and Clinical Electrophysiology : Pace. 2003 January; 26(1 Pt 2): 444-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12687863&dopt=Abstract

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Bacterial endocarditis after Hurst bougienage in a patient with a benign esophageal stricture and mitral valve prolapse. Author(s): Niv Y, Bat L, Motro M. Source: Gastrointestinal Endoscopy. 1985 August; 31(4): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4029575&dopt=Abstract

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Bacterial endocarditis in a patient with mitral valve prolapse. Author(s): Weinstein AJ, McHenry MC. Source: Archives of Internal Medicine. 1979 October; 139(10): 1191-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=485760&dopt=Abstract

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Bacterial endocarditis: mitral valve prolapse syndrome. Author(s): Yang CP. Source: J Kans Med Soc. 1979 February; 80(2): 60-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=762455&dopt=Abstract

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Bartter's syndrome, supraventricular tachycardia, mitral valve prolapse, and asthma: a therapeutic challenge. Author(s): Rodriguez DF, Kokko JP, Sands JM. Source: The American Journal of the Medical Sciences. 1997 February; 313(2): 114-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9030679&dopt=Abstract

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Behcet's disease (silk route disease) and mitral valve prolapse. Author(s): Cheng TO. Source: The Western Journal of Medicine. 1989 January; 150(1): 91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2735028&dopt=Abstract

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Behcet's disease ('Silk Route disease') and mitral valve prolapse. Author(s): Cheng TO. Source: Cardiology. 1998 May; 89(4): 306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9643280&dopt=Abstract

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Bicoronary-pulmonary fistulae with coexistent mitral valve prolapse: a case report and literature review of coronary-pulmonary fistula. Author(s): Ashraf SS, Shaukat N, Fisher M, Clarke B, Keenan DJ. Source: European Heart Journal. 1994 April; 15(4): 571-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8070486&dopt=Abstract

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Bilateral retinal artery occlusion due to mitral valve prolapse. Author(s): van Rhee F, Blecher TE, DeLepeleire KA, Galloway NR. Source: The British Journal of Ophthalmology. 1991 July; 75(7): 436-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1854701&dopt=Abstract

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Biological markers in panic states: lactate-induced panic and mitral valve prolapse. Author(s): Dager SR, Cowley DS, Dunner DL. Source: Biological Psychiatry. 1987 March; 22(3): 339-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2880610&dopt=Abstract

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Bodily habitus and mitral valve prolapse. Author(s): March LM, Webb J. Source: Aust N Z J Med. 1986 February; 16(1): 81-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3458452&dopt=Abstract

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Bodily habitus and mitral valve prolapse. Author(s): Hickey AJ, Narunsky L, Wilcken DE. Source: Aust N Z J Med. 1985 June; 15(3): 326-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3864424&dopt=Abstract

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Brachydactyly, mesomelia, mental retardation, aortic dilatation, mitral valve prolapse, and characteristic face. Author(s): Stratton RF, Garcia PR, Young RS, Jorgenson RJ. Source: American Journal of Medical Genetics. 1993 April 15; 46(2): 138-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8484398&dopt=Abstract

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Bradyarrhythmia in mitral valve prolapse treated with a pacemaker. Author(s): Gelfand ML, Kloth H. Source: Bull N Y Acad Med. 1978 October; 54(9): 889-99. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=280398&dopt=Abstract

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Bradycardia with mitral valve prolapse: a potential mechanism of sudden death. Author(s): Leichtman D, Nelson R, Gobel FL, Alexander CS, Cohn JN. Source: Annals of Internal Medicine. 1976 October; 85(4): 453-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=970771&dopt=Abstract

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Brain events associated with mitral valve prolapse. Author(s): Hanson MR, Conomy JP, Hodgman JR. Source: Stroke; a Journal of Cerebral Circulation. 1980 September-October; 11(5): 499506. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7423582&dopt=Abstract

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Bupivacaine cardiotoxicity in a pregnant patient with mitral valve prolapse. Author(s): Conklin KA, Ziadlou-Rad F. Source: Anesthesiology. 1983 June; 58(6): 596. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6859605&dopt=Abstract

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Bupivacaine cardiotoxicity in a pregnant patient with mitral valve prolapse: an example of improperly administered epidural block. Author(s): Batra MS, Bridenbaugh LD, Caldwell CB, Crawford RD, Hecker BR, Moors DC, Mulroy MF, Thompson G. Source: Anesthesiology. 1984 February; 60(2): 170-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6696247&dopt=Abstract

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Cardiovascular reactivity of mitral valve prolapse patients during experimental stress exposure: evidence for a functional nature of cardiovascular symptoms. Author(s): Delle Chiaie R, Baciarello G, Villani M, Iannucci G, Regine F, Didonna A, Talamonti F, Pancheri P. Source: Acta Psychiatrica Scandinavica. 1996 June; 93(6): 434-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8831859&dopt=Abstract

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Cerebral ischemic events after diagnosis of mitral valve prolapse: a community-based study of incidence and predictive factors. Author(s): Avierinos JF, Brown RD, Foley DA, Nkomo V, Petty GW, Scott C, EnriquezSarano M. Source: Stroke; a Journal of Cerebral Circulation. 2003 June; 34(6): 1339-44. Epub 2003 May 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738894&dopt=Abstract

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Changes in effective regurgitant orifice throughout systole in patients with mitral valve prolapse. A clinical study using the proximal isovelocity surface area method. Author(s): Enriquez-Sarano M, Sinak LJ, Tajik AJ, Bailey KR, Seward JB. Source: Circulation. 1995 November 15; 92(10): 2951-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7586265&dopt=Abstract

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Chest pain in mitral valve prolapse. Author(s): Svendsen JH. Source: European Heart Journal. 1995 December; 16(12): 1753-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8681999&dopt=Abstract

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Clinical and echocardiographic assessment of Nigerian patients seen at the Lagos University Teaching Hospital with features of mitral valve prolapse. Author(s): Oke DA, Ajuluchukwu JN, Mbakwem A, Alli O, Omoolaye O, Okolie HI, Bastos A. Source: West Afr J Med. 2000 July-September; 19(3): 200-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126084&dopt=Abstract

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Clinical characteristics of primary mitral valve prolapse syndrome in children. Author(s): Rokicki W, Krzystolik-Ladzinska J, Goc B. Source: Acta Cardiol. 1995; 50(2): 147-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7610738&dopt=Abstract

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Clinical features of subjects with mitral valve prolapse: a study with 24-hour ambulatory blood pressure monitoring. Author(s): Cassone R, Moroni C, Parlapiano C, Bondanini F, Affricano C. Source: Cardiology. 1996 September-October; 87(5): 374-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8894256&dopt=Abstract

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Clinical snapshot: mitral valve prolapse. Author(s): McGrath D. Source: The American Journal of Nursing. 1997 May; 97(5): 40-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9155795&dopt=Abstract

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Clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation. Author(s): Lichodziejewska B, Klos J, Rezler J, Grudzka K, Dluzniewska M, Budaj A, Ceremuzynski L. Source: The American Journal of Cardiology. 1997 March 15; 79(6): 768-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9070556&dopt=Abstract

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Clinical, echocardiographic, and biomechanical differences in mitral valve prolapse affecting one or both leaflets. Author(s): Mills WR, Barber JE, Skiles JA, Ratliff NB, Cosgrove DM, Vesely I, Griffin BP. Source: The American Journal of Cardiology. 2002 June 15; 89(12): 1394-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12062734&dopt=Abstract

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Coexistence of congenital bicoronary fistulae and mitral valve prolapse. Author(s): Macieira-Coelho E. Source: European Heart Journal. 1995 April; 16(4): 577. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7671908&dopt=Abstract

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Combined mitral valve prolapse and atrial septal aneurysm. A cause for embolic events. Author(s): Mastroroberto P, Chello M, Zofrea S, Zucco D, Borrello G, Marchese AR. Source: The Journal of Cardiovascular Surgery. 1994 December; 35(6): 507-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7698964&dopt=Abstract

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Combined mitral valve repair and the cox maze procedure for mitral valve prolapse and regurgitation and associated atrial fibrillation. Author(s): Cheng TO. Source: The Journal of Thoracic and Cardiovascular Surgery. 2000 March; 119(3): 634. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10694633&dopt=Abstract

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Comment on thyrotropin receptor gene and mitral valve prolapse. Author(s): Koshiyama H, Sellitti DF, Doi SQ, Akamizu T, Nakao K. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 September; 84(9): 3404-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10487723&dopt=Abstract

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Comparison of mitral valve prolapse in dogs and humans. Author(s): Cheng TO. Source: Cardiovascular Research. 2001 January; 49(1): 244-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11199900&dopt=Abstract

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Comparison of repair techniques for mitral valve prolapse. Author(s): Eishi K, Kawazoe K, Sasako Y, Kosakai Y, Kitoh Y, Kawashima Y. Source: J Heart Valve Dis. 1994 July; 3(4): 432-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7952319&dopt=Abstract

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Complications of mitral valve prolapse. Author(s): Jeresaty RM. Source: Adv Cardiol. 2002; 39: 130-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060909&dopt=Abstract

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Coronary flow reserve and ischemic-like electrocardiogram in patients with symptomatic mitral valve prolapse. Author(s): Wu TC, Chen JW, Hsu NW, Chen YH, Lin SJ, Wang SP, Ding YA, Chang MS. Source: Japanese Heart Journal. 1999 September; 40(5): 571-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10888377&dopt=Abstract

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Cost-effectiveness of infective endocarditis prophylaxis for mitral valve prolapse with or without a mitral regurgitant murmur. Author(s): Devereux RB, Frary CJ, Kramer-Fox R, Roberts RB, Ruchlin HS. Source: The American Journal of Cardiology. 1994 November 15; 74(10): 1024-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7977041&dopt=Abstract

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Current management of mitral valve prolapse. Author(s): Bouknight DP, O'Rourke RA. Source: American Family Physician. 2000 June 1; 61(11): 3343-50, 3353-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865929&dopt=Abstract

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Deep T waves and premature beats in mitral valve prolapse. Author(s): Hancock EW. Source: Hosp Pract (Off Ed). 1993 May 15; 28(5): 28-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7684046&dopt=Abstract

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Degenerative mitral valve disease with emphasis on mitral valve prolapse. Author(s): Pellerin D, Brecker S, Veyrat C. Source: Heart (British Cardiac Society). 2002 November; 88 Suppl 4: Iv20-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369588&dopt=Abstract

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Dermatoglyphs in children with mitral valve prolapse. Author(s): Tay JS, Yip WC, Yap HK, Lee BW, Wong HB, Chay SO. Source: Journal of Medical Genetics. 1985 April; 22(2): 135-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3989829&dopt=Abstract

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Detection of dysrhythmia in pediatric patients with mitral valve prolapse. Author(s): Kavey RE, Sondheimer HM, Blackman MS. Source: Circulation. 1980 September; 62(3): 582-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7398019&dopt=Abstract

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Diagnosis and classification of severity of mitral valve prolapse: methodologic, biologic, and prognostic considerations. Author(s): Devereux RB, Kramer-Fox R, Shear MK, Kligfield P, Pini R, Savage DD. Source: American Heart Journal. 1987 May; 113(5): 1265-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3554945&dopt=Abstract

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Diagnosis and classification of the mitral valve prolapse by the ultrasoundcardiotomography and the evaluation of the M-mode technic. Author(s): Inoh T, Maeda K, Oda A. Source: Japanese Circulation Journal. 1979 April; 43(4): 305-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=459078&dopt=Abstract

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Diagnostic precision of echocardiography in mitral valve prolapse. Author(s): Wann LS, Gross CM, Wakefield RJ, Kalbfleisch JH. Source: American Heart Journal. 1985 April; 109(4): 803-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3984834&dopt=Abstract

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Diagnostic reliability of M-mode echocardiography for detecting mitral valve prolapse in 50 consecutive panic patients. Author(s): Dager SR, Comess KA, Saal AK, Sisk EJ, Beach KW, Dunner DL. Source: Comprehensive Psychiatry. 1989 September-October; 30(5): 369-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2791529&dopt=Abstract

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Diastolic click in mitral valve prolapse. Author(s): Cheng TO. Source: Archives of Internal Medicine. 1977 May; 137(5): 695. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=856092&dopt=Abstract

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Diastolic prolapse in the flail mitral valve syndrome: a new observation providing differentiation from the mitral valve prolapse syndrome. Author(s): Cherian G, Tei C, Shah PM, Wong M. Source: American Heart Journal. 1982 June; 103(6): 1074-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7081023&dopt=Abstract

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Diastolic sounds and murmurs associated with mitral valve prolapse. Author(s): Wei JY, Fortuin NJ. Source: Circulation. 1981 March; 63(3): 559-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7460241&dopt=Abstract

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Diminished global fibrinolytic capacity in patients with mitral valve prolapse is associated with transient ischemic attacks. Author(s): Atalar E, Acil T, Aytemir K, Haznedaroglu I, Ozer N, Kilic H, Kuru G, Aksoyek S, Ovunc K, Kes S, Kirazli S, Ozmen F. Source: Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2002 January; 8(1): 41-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991238&dopt=Abstract

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Disappearance of echocardiographic mitral valve prolapse during ventricular pacing with retrograde artial activation. Author(s): Srinivasan V, Berger M, Gallerstein P, Berdoff R, Goldberg E. Source: Chest. 1982 May; 81(5): 650-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7075292&dopt=Abstract

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Dissecting aneurysm of the aorta: an unusual complication of mitral valve prolapse. Author(s): Altieri PI, Martinez J, Banchs H. Source: Bol Asoc Med P R. 1984 August; 76(8): 347-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6593074&dopt=Abstract

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Distinctive anthropometric characteristics of women with mitral valve prolapse. Author(s): Schutte JE, Gaffney FA, Blend L, Blomqvist CG. Source: The American Journal of Medicine. 1981 October; 71(4): 533-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7282740&dopt=Abstract

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Divorce of mitral valve prolapse and neurocirculatory asthenia. Author(s): Mantysaari M, Lansimies E, Peltonen T. Source: The American Journal of Medicine. 1988 January; 84(1): 183-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3337128&dopt=Abstract

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Does “physiologic” mitral valve prolapse occur with acute blood loss? Author(s): Konicek S, Guntheroth WG, Sylvester CE, Mack LA, Reichler RJ. Source: Clin Cardiol. 1987 March; 10(3): 159-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3829487&dopt=Abstract

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Does mitral valve prolapse cause nonspecific symptoms? Author(s): Uretsky BF. Source: International Journal of Cardiology. 1982; 1(5-6): 435-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7118310&dopt=Abstract

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Dysautonomia in mitral valve prolapse. Author(s): Coghlan HC, Phares P, Cowley M, Copley D, James TN. Source: The American Journal of Medicine. 1979 August; 67(2): 236-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=463929&dopt=Abstract

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Dystrophic degeneration of papillary muscle and ventricular myocardium. A basis for mitral valve prolapse in Duchenne's muscular dystrophy. Author(s): Sanyal SK, Johnson WW, Dische MR, Pitner SE, Beard C. Source: Circulation. 1980 August; 62(2): 430-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7397983&dopt=Abstract

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Ebstein's anomaly of the tricuspid valve with associated mitral valve prolapse. Author(s): Khan IA. Source: Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 2001; 28(1): 72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11330750&dopt=Abstract

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Echocardiographic assessment of mitral stenosis and its associated valvular lesions in 205 patients and lack of association with mitral valve prolapse. Author(s): Sagie A, Freitas N, Chen MH, Marshall JE, Weyman AE, Levine RA. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 1997 March; 10(2): 141-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9083969&dopt=Abstract

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Echocardiographic diagnosis of mitral valve prolapse. Author(s): Shah PM. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 1994 May-June; 7(3 Pt 1): 286-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8060645&dopt=Abstract

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Echocardiographic features of extreme mitral valve prolapse vs mitral valve aneurysm. Author(s): Goldberg L, Mekel J, Grigorov V. Source: Cardiovasc J S Afr. 2002 March-April; 13(2): 73-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981583&dopt=Abstract

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Echocardiography for mitral valve prolapse? Author(s): Lavie CJ. Source: Postgraduate Medicine. 1999 January; 105(1): 34, 37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9924490&dopt=Abstract

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Echocardiography for mitral valve prolapse? Author(s): Stack PS. Source: Postgraduate Medicine. 1999 July; 106(1): 35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10418572&dopt=Abstract

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Effect of enalapril therapy on left ventricular mass and volumes in asymptomatic chronic, severe mitral regurgitation secondary to mitral valve prolapse. Author(s): Tischler MD, Rowan M, LeWinter MM. Source: The American Journal of Cardiology. 1998 July 15; 82(2): 242-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9678300&dopt=Abstract

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Effect of ramipril on mitral regurgitation secondary to mitral valve prolapse. Author(s): Host U, Kelbaek H, Hildebrandt P, Skagen K, Aldershvile J. Source: The American Journal of Cardiology. 1997 September 1; 80(5): 655-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9295005&dopt=Abstract

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Effects of exercise on left ventricular performance determined by echocardiography in chronic, severe mitral regurgitation secondary to mitral valve prolapse. Author(s): Tischler MD, Battle RW, Ashikaga T, Niggel J, Rowen M, LeWinter MM. Source: The American Journal of Cardiology. 1996 February 15; 77(5): 397-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8602570&dopt=Abstract

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Effects of hydration on mitral valve prolapse. Author(s): Lax D, Eicher M, Goldberg SJ. Source: American Heart Journal. 1993 August; 126(2): 415-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8338013&dopt=Abstract

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Electrocardiographic abnormalities in mitral valve prolapse. Author(s): Bhutto ZR, Barron JT, Liebson PR, Uretz EF, Parrillo JE. Source: The American Journal of Cardiology. 1992 July 15; 70(2): 265-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1626519&dopt=Abstract

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Epidemiology of symptomatic mitral valve prolapse in black patients. Author(s): Zua MS, Dziegielewski SF. Source: Journal of the National Medical Association. 1995 April; 87(4): 273-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7752279&dopt=Abstract

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Esophageal dysmotility and acid sensitivity in patients with mitral valve prolapse and chest pain. Author(s): Hammett RJ, Hansen RD, Lorang M, Bak YT, Kellow JE. Source: Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E. 2003; 16(2): 73-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823201&dopt=Abstract

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Evaluation of mitral valve prolapse by four-dimensional echocardiography. Author(s): Cheng TO, Xie MX, Wang XF, Li ZA, Hu G. Source: American Heart Journal. 1997 January; 133(1): 120-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9006300&dopt=Abstract

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Evaluation of mitral valve prolapse using newly developed real-time threedimensional echocardiographic system with real-time volume rendering. Author(s): Goktekin O, Matsumura M, Omoto R, Kyo S, Mochizuki T. Source: The International Journal of Cardiovascular Imaging. 2003 February; 19(1): 43-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602481&dopt=Abstract

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Excessive papillary muscle traction and dilated mitral annulus in mitral valve prolapse without mitral regurgitation. Author(s): Lee TM, Su SF, Huang TY, Chen MF, Liau CS, Lee YT. Source: The American Journal of Cardiology. 1996 August 15; 78(4): 482-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8752199&dopt=Abstract

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Exercise-induced mitral regurgitation and antibiotic prophylaxis against infective endocarditis in mitral valve prolapse. Author(s): Cheng TO. Source: Journal of the American College of Cardiology. 1995 September; 26(3): 839. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7642881&dopt=Abstract

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Exercise-induced mitral regurgitation is a predictor of morbid events in subjects with mitral valve prolapse. Author(s): Stoddard MF, Prince CR, Dillon S, Longaker RA, Morris GT, Liddell NE. Source: Journal of the American College of Cardiology. 1995 March 1; 25(3): 693-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7860915&dopt=Abstract

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Exercise-induced regurgitation in mitral valve prolapse: is it a new disease? Author(s): Levine RA. Source: Journal of the American College of Cardiology. 1995 March 1; 25(3): 700-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7860916&dopt=Abstract

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Extensive use of artificial chordae for repairing diffuse mitral valve prolapse. Author(s): Morita S, Yasui H, Harasawa Y, Tomita Y, Tominaga R. Source: The Annals of Thoracic Surgery. 1996 September; 62(3): 878-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784025&dopt=Abstract

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Factors associated with participation in a mitral valve prolapse support group. Author(s): Scordo KA. Source: Heart & Lung : the Journal of Critical Care. 2001 March-April; 30(2): 128-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11248715&dopt=Abstract

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Factors predisposing to false negative M-mode echocardiograms in patients with twodimensional echocardiographic criteria for mitral valve prolapse. Author(s): Alpert MA, Haikal M, Carney RJ. Source: American Heart Journal. 1987 May; 113(5): 1250-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3578024&dopt=Abstract

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Family history in assessing the risk for progression of mitral valve prolapse. Report of a kindred. Author(s): Cooper MJ, Abinader EG. Source: Am J Dis Child. 1981 July; 135(7): 647-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7246493&dopt=Abstract

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Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease--comparison with 201Tl myocardial perfusion scintigraphy. Author(s): Voth E, Schicha H, Tebbe U, Neumann P, Emrich D. Source: Nuklearmedizin. 1987 August; 26(4): 172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3671099&dopt=Abstract

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Fibromuscular dysplasia of small coronary arteries and fibrosis in the basilar ventricular septum in mitral valve prolapse. Author(s): Burke AP, Farb A, Tang A, Smialek J, Virmani R. Source: American Heart Journal. 1997 August; 134(2 Pt 1): 282-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9313609&dopt=Abstract

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Final word (?) for the diagnosis of mitral valve prolapse. Author(s): Cheng TO. Source: The American Journal of Cardiology. 1988 September 1; 62(7): 512. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3414531&dopt=Abstract

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Floppy mitral valve/mitral valve prolapse/mitral valvular regurgitation: effects on the circulation. Author(s): Boudoulas H, Wooley CF. Source: J Cardiol. 2001; 37 Suppl 1: 15-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433820&dopt=Abstract

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Follow-up findings in mitral valve prolapse. Author(s): Cheng TO. Source: Journal of the American College of Cardiology. 1988 May; 11(5): 1139. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3356833&dopt=Abstract

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Follow-up in mitral valve prolapse by phonocardiography, M-mode and twodimensional echocardiography and Doppler echocardiography. Author(s): Deng YB, Takenaka K, Sakamoto T, Hada Y, Suzuki J, Shiota T, Amano W, Igarashi T, Amano K, Takahashi H, et al. Source: The American Journal of Cardiology. 1990 February 1; 65(5): 349-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2301263&dopt=Abstract

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Follow-up observations in patients with mitral valve prolapse. Author(s): Nishimura RA, Tajik AJ. Source: Herz. 1988 October; 13(5): 326-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3053385&dopt=Abstract

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Follow-up of patients with mitral valve prolapse presenting with rhythm disturbances. Author(s): Piwowarska W, Mroczek-Czernecka D. Source: Ann Clin Res. 1988; 20(6): 389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3218909&dopt=Abstract

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Fourier phase analysis of SPECT equilibrium radionuclide angiography in symptomatic patients with mitral valve prolapse without significant mitral regurgitation: assessment of biventricular functional abnormalities suggesting a cardiomyopathy. Author(s): Casset-Senon D, Babuty D, Philippe L, Fauchier L, Eder V, Fauchier JP, Pottier JM, Delhomme C, Cosnay P. Source: Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology. 2000 September-October; 7(5): 471-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11083196&dopt=Abstract

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Fragmentation hemolysis in a patient with hypertrophic obstructive cardiomyopathy and mitral valve prolapse. Author(s): Maeda T, Ashie T, Kikuiri K, Fukuyama S, Yamaguchi Y, Yoshida E, Shimamoto K, Iimura O. Source: Japanese Circulation Journal. 1992 September; 56(9): 970-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1404852&dopt=Abstract

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Frequency of complications of mitral valve prolapse in subjects aged 60 years and older. Author(s): Naggar CZ, Pearson WN, Seljan MP. Source: The American Journal of Cardiology. 1986 December 1; 58(13): 1209-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3788809&dopt=Abstract

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Frequency of HLA antigens in Graves' hyperthyroidism and mitral valve prolapse. Author(s): Kontopoulos A, Harsoulis P, Adam K, Papadopoulos G, Polymenidis Z, Boudoulas H. Source: J Heart Valve Dis. 1996 September; 5(5): 543-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8894996&dopt=Abstract

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Frequency of isolated panic attacks and panic disorder in patients with the mitral valve prolapse syndrome. Author(s): Alpert MA, Sabeti M, Kushner MG, Beitman BD, Russell JL, Thiele JR, Mukerji V. Source: The American Journal of Cardiology. 1992 June 1; 69(17): 1489-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1590243&dopt=Abstract

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Frequency of mitral valve prolapse in systemic lupus erythematosus, progressive systemic sclerosis and mixed connective tissue disease. Author(s): Comens SM, Alpert MA, Sharp GC, Pressly TA, Kelly DL, Hazelwood SE, Mukerji V. Source: The American Journal of Cardiology. 1989 February 1; 63(5): 369-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2913742&dopt=Abstract

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From irritable heart to mitral valve prolapse: systolic clicks, apical murmurs, and the auscultatory connection in the 19th century. Author(s): Wooley CF. Source: American Heart Journal. 1987 February; 113(2 Pt 1): 413-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3544757&dopt=Abstract

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From irritable heart to mitral valve prolapse: World War I. The U.S. experience and the origin of neurocirculatory asthenia. Author(s): Wooley CF. Source: The American Journal of Cardiology. 1987 May 1; 59(12): 1183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3554955&dopt=Abstract

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From irritable heart to mitral valve prolapse: World War I--the U.S. experience and the prevalence of apical systolic murmurs and mitral regurgitation in drafted men compared with present day mitral valve prolapse studies. Author(s): Wooley CF, Boudoulas H. Source: The American Journal of Cardiology. 1988 April 15; 61(11): 895-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3281429&dopt=Abstract

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Gender differences in dehydration-induced mitral valve prolapse. Author(s): Aufderheide S, Lax D, Goldberg SJ. Source: American Heart Journal. 1995 January; 129(1): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7817930&dopt=Abstract

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Gender differences in mitral valve prolapse. Author(s): Devereux RB, Kramer-Fox R. Source: Cardiovasc Clin. 1989; 19(3): 243-58. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2644034&dopt=Abstract

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Genetic evidence that mutations in the COL1A1, COL1A2, COL3A1, or COL5A2 collagen genes are not responsible for mitral valve prolapse. Author(s): Henney AM, Tsipouras P, Schwartz RC, Child AH, Devereux RB, Leech GJ. Source: British Heart Journal. 1989 March; 61(3): 292-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2930668&dopt=Abstract

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Genetic segregation analysis of familial mitral valve prolapse shows no linkage to fibrillar collagen genes. Author(s): Wordsworth P, Ogilvie D, Akhras F, Jackson G, Sykes B. Source: British Heart Journal. 1989 March; 61(3): 300-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2930669&dopt=Abstract

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Genetics of mitral valve prolapse. Author(s): Devereux RB, Brown WT. Source: Prog Med Genet. 1983; 5: 139-61. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6344142&dopt=Abstract

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Giant left atrium associated with mitral valve prolapse. Author(s): Cheng TO. Source: Circulation. 2002 June 11; 105(23): E190; Author Reply E190. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058002&dopt=Abstract

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Gonococcal endocarditis in a patient with mitral valve prolapse: study of host immunology and organism characteristics. Author(s): Sugar AM, Utsinger PD, Santoro J. Source: The American Journal of the Medical Sciences. 1982 May-June; 283(3): 165-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7081290&dopt=Abstract

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Graph of the month. Barlow's syndrome- mitral valve prolapse. Author(s): Piterman L. Source: Aust Fam Physician. 1983 May; 12(5): 379. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6615361&dopt=Abstract

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Haemodynamic and neurohormonal responsiveness to different stress tests in mitral valve prolapse. Author(s): Micieli G, Cavallini A, Melzi d'Eril GV, Tassorelli C, Barzizza F, Verri AP, Richichi I, Nappi G. Source: Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society. 1991 December; 1(4): 323-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1688000&dopt=Abstract

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Haemophilus parainfluenzae endocarditis in a patient with mitral valve prolapse. Author(s): Greene JN, Sandin RL, Villanueva L, Sinnott JT. Source: Ann Clin Lab Sci. 1993 May-June; 23(3): 203-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8323254&dopt=Abstract

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Heart murmurs audible across the room in children with mitral valve prolapse. Author(s): Fiddler GI, Scott O. Source: British Heart Journal. 1980 August; 44(2): 201-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7426173&dopt=Abstract

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Heart rate variability and QT dispersion in mitral valve prolapse. Author(s): Cheng TO. Source: Journal of Electrocardiology. 2001 January; 34(1): 89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11327046&dopt=Abstract

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Heart rate variability of children with mitral valve prolapse. Author(s): Han L, Ho TF, Yip WC, Chan KY. Source: Journal of Electrocardiology. 2000 July; 33(3): 219-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10954374&dopt=Abstract

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Helping your patient cope with mitral valve prolapse syndrome. Author(s): Scordo KA. Source: Nursing. 1992 October; 22(10): 34-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1436787&dopt=Abstract

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Hemodynamic effects of hydralazine in mitral valve prolapse with regurgitation. Author(s): Lin WW, Chang FJ, Hwang JF, Tsai ZH, Lee DY, Chen YT. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1990 November; 46(5): 259-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2178063&dopt=Abstract

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High frequency of mitral valve prolapse and aortic regurgitation among asymptomatic adults with Down's syndrome. Author(s): Goldhaber SZ, Brown WD, Sutton MG. Source: Jama : the Journal of the American Medical Association. 1987 October 2; 258(13): 1793-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2957521&dopt=Abstract

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High occurrence of mitral valve prolapse in cardiac catheterization patients with pure isolated mitral regurgitation. Author(s): Danielsen R, Nordrehaug JE, Vik-Mo H. Source: Acta Med Scand. 1987; 221(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3565083&dopt=Abstract

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High-speed echophonocardiograhic detection of tricuspid valve prolapse in mitral valve prolapse with discrepancy in onset of systolic murmur. Author(s): Doi YL, Sugiura T, Bishop RL, Paladino D, Moreau K, Spodick DH. Source: American Heart Journal. 1982 February; 103(2): 301-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7055064&dopt=Abstract

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Histopathologic evidence for cardiomyopathy in a child with mitral valve prolapse. Author(s): Nakada T, Yonesaka S. Source: Acta Paediatr Jpn. 1993 December; 35(6): 525-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8109232&dopt=Abstract

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Historical beginnings of the mitral valve prolapse syndrome. Author(s): Bartecchi CE. Source: The American Journal of Cardiology. 1984 November 1; 54(8): 1165-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6388301&dopt=Abstract

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HLA antigens in mitral valve prolapse. Author(s): Braun WE, Ronan J, Schacter B, Gardin J, Isner J, Grecek D. Source: Transplantation Proceedings. 1977 December; 9(4): 1869-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=601847&dopt=Abstract

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Hoarseness due to mitral valve prolapse. Author(s): Brownsberger RJ, Morrelli HF. Source: Journal of the American Geriatrics Society. 1988 May; 36(5): 442-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3361045&dopt=Abstract

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Homozygous factor X deficiency associated with familial hypercholesterolemia, mitral valve prolapse, and hypertrophic cardiomyopathy. Author(s): Onat A, Dursunoglu D, Aktuglu G. Source: Acta Haematologica. 1994; 91(2): 66-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8023645&dopt=Abstract

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How important is mitral valve prolapse? Author(s): Segrave-Daly J, Stevens N. Source: The Journal of Family Practice. 1999 October; 48(10): 751-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12224670&dopt=Abstract

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Hypervascular metastatic cardiac tumors: an unknown cause of mitral valve prolapse. Author(s): Oniki T, Hashimoto Y, Fujinuma Y, Maruyama Y, Namba K, Yajima M, Numano F, Maezawa H. Source: Intern Med. 1992 January; 31(1): 78-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1568048&dopt=Abstract

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Hypomagnesemia and mitral valve prolapse in Cavalier King Charles spaniels. Author(s): Pedersen HD, Mow T. Source: Zentralbl Veterinarmed A. 1998 December; 45(10): 607-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9923143&dopt=Abstract

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Images in cardiovascular medicine. Leaflet-dependent spectrum of regurgitant jet in mitral valve prolapse. Author(s): Ansari A, Maron BJ. Source: Circulation. 1998 March 3; 97(8): 805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9498545&dopt=Abstract

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Impact of echocardiography on antibiotic prophylaxis with suspected mitral valve prolapse. Author(s): Cheng TO. Source: The American Journal of Medicine. 1998 May; 104(5): 509-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9626042&dopt=Abstract

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Impact of echocardiography on the management of patients with mitral valve prolapse. Author(s): Olive KE, Grassman ED. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1990 November-December; 5(6): 4703. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1979990&dopt=Abstract

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Implications of mitral valve prolapse in children with rheumatic mitral regurgitation. Author(s): Wu MH, Lue HC, Wang JK, Wu JM. Source: Journal of the American College of Cardiology. 1994 April; 23(5): 1199-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8144789&dopt=Abstract

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In vivo mitral valve morphology and motion in mitral valve prolapse. Author(s): Weissman NJ, Pini R, Roman MJ, Kramer-Fox R, Andersen HS, Devereux RB. Source: The American Journal of Cardiology. 1994 June 1; 73(15): 1080-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8198034&dopt=Abstract

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Incidence and risk factors for mitral valve prolapse in severe adolescent idiopathic scoliosis. Author(s): Dhuper S, Ehlers KH, Fatica NS, Myridakis DJ, Klein AA, Friedman DM, Levine DB. Source: Pediatric Cardiology. 1997 November-December; 18(6): 425-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9326688&dopt=Abstract

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Increased dispersion of refractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Author(s): Cheng TO. Source: British Heart Journal. 1995 July; 74(1): 96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7662468&dopt=Abstract

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Increased dispersion of refractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Author(s): Tieleman RG, Crijns HJ, Wiesfeld AC, Posma J, Hamer HP, Lie KI. Source: British Heart Journal. 1995 January; 73(1): 37-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7888258&dopt=Abstract

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Increased prevalence of atrial septal aneurysm in mitral valve prolapse. Author(s): Rahko PS, Xu QB. Source: The American Journal of Cardiology. 1990 July 15; 66(2): 235-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2091625&dopt=Abstract

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Increased prevalence of mitral valve prolapse associated with an elevated skin type III/III+I collagen ratio in joint hypermobility syndrome. Author(s): Child A, Handler C, Light N, Dorrance D. Source: Agents Actions Suppl. 1986; 18: 125-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3460313&dopt=Abstract

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Increased prevalence of mitral valve prolapse in IDDM. Author(s): Bell DS, Acton RT. Source: Diabetes Care. 1996 June; 19(6): 672. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8725874&dopt=Abstract

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Infective endocarditis associated with mitral valve prolapse. Author(s): Rubin MM. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 1991 October; 49(10): 1106-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1832445&dopt=Abstract

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Infective endocarditis complicating mitral valve prolapse: epidemiologic, clinical, and microbiologic aspects. Author(s): Baddour LM, Bisno AL. Source: Reviews of Infectious Diseases. 1986 January-February; 8(1): 117-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3513283&dopt=Abstract

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Insensitivity of echocardiography in detecting mitral valve prolapse in older patients with chest pain. Author(s): Ruwitch JF Jr, Weiss AN, Fleg JL, McKnight RC, Ludbrook PA. Source: The American Journal of Cardiology. 1977 November; 40(5): 686-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=920606&dopt=Abstract

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Intermittent complete atrioventricular block masquerading as epilepsy in the mitral valve prolapse syndrome. Author(s): Woodley D, Chambers W, Starke H, Dzindzio B, Forker AD. Source: Chest. 1977 September; 72(3): 369-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=891292&dopt=Abstract

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Is anterior leaflet repair always necessary in repair of bileaflet mitral valve prolapse? Author(s): Gillinov AM, Cosgrove DM 3rd, Wahi S, Stewart WJ, Lytle BW, Smedira NG, McCarthy PM, Wierup PN, Sabik JF, Blackstone EH. Source: The Annals of Thoracic Surgery. 1999 September; 68(3): 820-3; Discussion 824. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10509968&dopt=Abstract

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Is mitral valve prolapse a congenital or acquired disease? Author(s): Nascimento R, Freitas A, Teixeira F, Pereira D, Cardoso A, Dinis M, Mendonca I. Source: The American Journal of Cardiology. 1997 January 15; 79(2): 226-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9193034&dopt=Abstract

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Is mitral valve prolapse a manifestation of adolescent growth spurt? Author(s): Kumar PD. Source: Medical Hypotheses. 2000 February; 54(2): 189-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10790750&dopt=Abstract

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Is mitral valve prolapse due to cardiac entrapment in the chest Cavity? A CT view. Author(s): Raggi P, Callister TQ, Lippolis NJ, Russo DJ. Source: Chest. 2000 March; 117(3): 636-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10712985&dopt=Abstract

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Is there increased sympathetic activity in patients with mitral valve prolapse? Author(s): Kochiadakis GE, Parthenakis FI, Zuridakis EG, Rombola AT, Chrysostomakis SI, Vardas PE. Source: Pacing and Clinical Electrophysiology : Pace. 1996 November; 19(11 Pt 2): 18726. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8945059&dopt=Abstract

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John Barlow: mitral valve prolapse. Author(s): Sternbach G, Varon J. Source: The Journal of Emergency Medicine. 1993 July-August; 11(4): 475-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8080481&dopt=Abstract

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Joint hypermobility in primary mitral valve prolapse patients. Author(s): Ondrasik M, Rybar I, Rus V, Bosak V. Source: Clinical Rheumatology. 1988 March; 7(1): 69-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3409646&dopt=Abstract

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Joint mobility and mitral valve prolapse in an Arab population. Author(s): Rajapakse CN, Al-Orainey IO, Al-Harthi SS, Osman A, Smith J. Source: British Journal of Rheumatology. 1987 December; 26(6): 442-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3690139&dopt=Abstract

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Junctional rhythm in a patient with mitral valve prolapse. Author(s): Twersky RS, Kaplan JA. Source: Anesthesia and Analgesia. 1986 September; 65(9): 975-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3740496&dopt=Abstract

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Juvenile autoimmune thyroiditis and mitral valve prolapse. Author(s): Blumberg D, Rutkowski M, Sklar C, Reggiardo D, Friedman D, David R. Source: Pediatric Cardiology. 1992 April; 13(2): 89-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1614925&dopt=Abstract

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Keratoconus and mitral valve prolapse. Author(s): Lichter H, Loya N, Sagie A, Cohen N, Muzmacher L, Yassur Y, Weinberger D. Source: American Journal of Ophthalmology. 2000 May; 129(5): 667-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10844063&dopt=Abstract

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Klinefelter's syndrome and mitral valve prolapse. an echocardiographic study in twenty-two patients. Author(s): Fricke GR, Mattern HJ, Schweikert HU, Schwanitz G. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 1984; 38(2): 88-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6743777&dopt=Abstract

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Lack of association between acute myocardial infarction and mitral valve prolapse. Author(s): Peller OG, Devereux RB, Schreiber TL, McNulty A. Source: The American Journal of Cardiology. 1988 December 1; 62(17): 1297. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3195489&dopt=Abstract

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Lack of association between keratoconus, mitral valve prolapse, and joint hypermobility. Author(s): Street DA, Vinokur ET, Waring GO 3rd, Pollak SJ, Clements SD, Perkins JV. Source: Ophthalmology. 1991 February; 98(2): 170-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2008274&dopt=Abstract

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Lack of association between mitral valve prolapse and history of rheumatic fever. Author(s): Zuppiroli A, Roman MJ, O'Grady M, Devereux RB. Source: American Heart Journal. 1996 March; 131(3): 525-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8604633&dopt=Abstract

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Lack of association between thyroid function and mitral valve prolapse in Graves' disease. Author(s): Alvarado A, Ribeiro JP, Freitas FM, Gross JL. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 1990; 23(2): 133-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2207441&dopt=Abstract

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Lack of association between transforming growth factor-beta1 gene polymorphisms and mitral valve prolapse in Taiwan Chinese. Author(s): Chou HT, Shi YR, Hsu Y, Tsai FJ. Source: J Heart Valve Dis. 2002 July; 11(4): 478-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150293&dopt=Abstract

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Lack of association of genetic polymorphisms in the interleukin-1beta, interleukin-1 receptor antagonist, interleukin-4 and interleukin-10 genes with mitral valve prolapse in Taiwan Chinese. Author(s): Chou HT, Shi YR, Hsu Y, Tsai FJ. Source: J Heart Valve Dis. 2003 January; 12(1): 38-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578333&dopt=Abstract

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Lacunar infarction in a puerpera with mitral valve prolapse. Author(s): Anzalone N, Landi G. Source: Italian Journal of Neurological Sciences. 1988 October; 9(5): 515-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3215753&dopt=Abstract

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Late potentials in mitral valve prolapse. Author(s): Jabi H, Burger AJ, Orawiec B, Touchon RC. Source: American Heart Journal. 1991 November; 122(5): 1340-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1950998&dopt=Abstract

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Leber's optic neuropathy and mitral valve prolapse. Author(s): Banerjee AK, MacSweeney JE, Hykin PG, Sanders MD. Source: Journal of the Royal Society of Medicine. 1990 January; 83(1): 55-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2304059&dopt=Abstract

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Left ventricular diastolic filling alterations in subjects with mitral valve prolapse: a Doppler echocardiographic study. Author(s): Corrao S, Scaglione R, Arnone S, Licata G. Source: European Heart Journal. 1993 March; 14(3): 369-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8458357&dopt=Abstract

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Left ventricular dysfunction in symptomatic mitral valve prolapse. Author(s): Dorn GW 2nd, Gertler AS, Gordon L, Usher BW, Hendrix GH. Source: Chest. 1989 February; 95(2): 370-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2914489&dopt=Abstract

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Lifetime risk for patients with mitral valve prolapse of developing severe valve regurgitation requiring surgery. Author(s): Wilcken DE, Hickey AJ. Source: Circulation. 1988 July; 78(1): 10-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3383395&dopt=Abstract

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Limitations of the echocardiogram in diagnosing valvular vegetations in patients with mitral valve prolapse. Author(s): Chandraratna PA, Langevin E. Source: Circulation. 1977 September; 56(3): 436-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=884798&dopt=Abstract

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Living with mitral valve prolapse. Author(s): Cheng TO. Source: The American Journal of Cardiology. 1990 August 15; 66(4): 528. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2386129&dopt=Abstract

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Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. Author(s): Duren DR, Becker AE, Dunning AJ. Source: Journal of the American College of Cardiology. 1988 January; 11(1): 42-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3335704&dopt=Abstract

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Long-term follow-up of mitral valve prolapse and latent tetany. Preliminary data. Author(s): Frances Y, Collet F, Luccioni R. Source: Magnesium. 1986; 5(3-4): 175-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2873272&dopt=Abstract

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Long-term results of artificial chordae implantation in patients with mitral valve prolapse. Author(s): Eishi K, Kawazoe K, Nakano K, Kosakai Y, Sasako Y, Kobayashi J. Source: J Heart Valve Dis. 1997 November; 6(6): 594-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9427126&dopt=Abstract

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Long-term results of surgery for mitral regurgitation due to mitral valve prolapse: a comparison of valve replacement and annuloplasty. Author(s): Shigenobu M, Senoo Y, Teramoto S. Source: Acta Medica Okayama. 1992 December; 46(6): 465-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1485541&dopt=Abstract

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Long-term site-related differences in the progression and regression of the idiopathic mitral valve prolapse syndrome. Author(s): Kamei F, Nakahara N, Yuda S, Kobayashi N, Tsuchihashi K, Shimamoto K. Source: Cardiology. 1999; 91(3): 161-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10516409&dopt=Abstract

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Low frequency of clinically silent circulating emboli in patients with mitral valve prolapse or patent foramen ovale detected by bigated transcranial Doppler ultrasound. Author(s): Droste DW, Schlossberg R, Mitusch R, Kaps M. Source: Neurological Research. 1998 September; 20(6): 499-503. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9713839&dopt=Abstract

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Mental retardation, mitral valve prolapse, and characteristic face: another report? Author(s): Fryer A. Source: American Journal of Medical Genetics. 1994 July 1; 51(3): 277-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8074158&dopt=Abstract

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Mitral valve prolapse and infective endocarditis. Author(s): Bisno AL. Source: Archives of Internal Medicine. 1993 June 28; 153(12): 1506. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8512442&dopt=Abstract

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Mitral valve prolapse and its effects: a programme of inquiry within Orem's Self-Care Deficit Theory of Nursing. Author(s): Utz SW, Ramos MC. Source: Journal of Advanced Nursing. 1993 May; 18(5): 742-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8514929&dopt=Abstract

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Mitral valve prolapse and the risk of stroke after initial cerebral ischemia. Author(s): Orencia AJ, Petty GW, Khandheria BK, O'Fallon WM, Whisnant JP. Source: Neurology. 1995 June; 45(6): 1083-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7783867&dopt=Abstract

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Mitral valve prolapse causing severe mitral regurgitation in a patient with absent right pulmonary artery. Author(s): Yip AS, Chow WH, Lee DF, Cheung KL. Source: Clin Cardiol. 1995 July; 18(7): 424-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7554550&dopt=Abstract

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Mitral valve prolapse in a case of Marfan syndrome with congenital cardiac disease, chronic obstructive pulmonary disease and schizophrenia. Author(s): Melissari M, Giordano G, Crafa P, Martella EM, Ricci R. Source: Pathologica. 1995 February; 87(1): 78-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7567172&dopt=Abstract

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Mitral valve prolapse in patients with paroxysmal supraventricular tachycardia. Author(s): Chiou CW, Chen SA, Chiang CE, Tsai DS, Cheng CC, Wu TJ, Tai CT, Lee SH, Hsu TL, Chen CY, et al. Source: The American Journal of Cardiology. 1995 January 15; 75(2): 186-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7810502&dopt=Abstract

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Mitral valve prolapse in systemic lupus erythematosus patients: clinical and immunological aspects. Author(s): Evangelopoulos ME, Alevizaki M, Toumanidis S, Sotou D, Evangelopoulos CD, Koutras DA, Stamatelopoulos SF, Mavrikakis M. Source: Lupus. 2003; 12(4): 308-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729055&dopt=Abstract

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Mitral valve prolapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study. Author(s): Freed LA, Benjamin EJ, Levy D, Larson MG, Evans JC, Fuller DL, Lehman B, Levine RA. Source: Journal of the American College of Cardiology. 2002 October 2; 40(7): 1298-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383578&dopt=Abstract

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Mitral valve prolapse prevalence and complications: an ongoing dialogue. Author(s): St John Sutton M, Weyman AE. Source: Circulation. 2002 September 10; 106(11): 1305-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221042&dopt=Abstract

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Mitral valve prolapse simulating a mitral tumor or vegetation. Author(s): Oki T, Fukuda N, Iuchi A, Tabata T, Manabe K, Kageji Y, Sasaki M, Ito S. Source: American Heart Journal. 1995 July; 130(1): 191-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7611116&dopt=Abstract

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Mitral valve prolapse. Author(s): Devereux RB. Source: J Am Med Womens Assoc. 1994 November-December; 49(6): 192-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7829819&dopt=Abstract

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Mitral valve prolapse. Author(s): Zua MS. Source: Journal of the National Medical Association. 1996 April; 88(4): 201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8648654&dopt=Abstract

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Mitral valve prolapse. Author(s): Cheng TO. Source: American Heart Journal. 1995 December; 130(6): 1315. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7484800&dopt=Abstract

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Mitral valve prolapse. Author(s): Cheng TO. Source: Journal of the National Medical Association. 1995 November; 87(11): 785. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8907809&dopt=Abstract

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Mitral valve prolapse. Author(s): Tait MJ. Source: N Z Med J. 1993 June 23; 106(958): 261. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332302&dopt=Abstract

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Mitral valve prolapse: old beliefs yield to new knowledge. Author(s): Hayek E, Griffin B. Source: Cleve Clin J Med. 2002 November; 69(11): 889-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12430974&dopt=Abstract

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Mitral valve prolapse: time for a fresh look. Author(s): Playford D, Weyman AE. Source: Reviews in Cardiovascular Medicine. 2001 Spring; 2(2): 73-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439384&dopt=Abstract

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Monomorphic right ventricular tachycardia in a patient with mitral valve prolapse. Author(s): Kosmas CE, Dalessandro DA, Langieri G, Rubin AM, Rials SJ, Marinchak RA, Kowey PR. Source: Pacing and Clinical Electrophysiology : Pace. 1996 April; 19(4 Pt 1): 509-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8848403&dopt=Abstract

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Multiplane transesophageal echocardiography performed according to the guidelines of the American Society of Echocardiography in patients with mitral valve prolapse, flail, and endocarditis: diagnostic accuracy in the identification of mitral regurgitant defects by correlation with surgical findings. Author(s): Agricola E, Oppizzi M, De Bonis M, Maisano F, Toracca L, Bove T, Alfieri O; American Society of Echocardiography. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2003 January; 16(1): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514636&dopt=Abstract

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Natural history of asymptomatic mitral valve prolapse in the community. Author(s): Avierinos JF, Gersh BJ, Melton LJ 3rd, Bailey KR, Shub C, Nishimura RA, Tajik AJ, Enriquez-Sarano M. Source: Circulation. 2002 September 10; 106(11): 1355-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221052&dopt=Abstract

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Natural history of mitral valve prolapse. Author(s): Zuppiroli A, Rinaldi M, Kramer-Fox R, Favilli S, Roman MJ, Devereux RB. Source: The American Journal of Cardiology. 1995 May 15; 75(15): 1028-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7747683&dopt=Abstract

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Natural history of the asymptomatic/minimally symptomatic patient with severe mitral regurgitation secondary to mitral valve prolapse and normal right and left ventricular performance. Author(s): Rosen SE, Borer JS, Hochreiter C, Supino P, Roman MJ, Devereux RB, Kligfield P, Bucek J. Source: The American Journal of Cardiology. 1994 August 15; 74(4): 374-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8059701&dopt=Abstract

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Neuroendocrine changes in Dachshunds with mitral valve prolapse examined under different study conditions. Author(s): Pedersen HD, Olsen LH, Mow T, Christensen NJ. Source: Research in Veterinary Science. 1999 February; 66(1): 11-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10088706&dopt=Abstract

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Neurologic aspects of mitral valve prolapse. Author(s): Heck AF. Source: Angiology. 1989 August; 40(8): 743-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2667405&dopt=Abstract

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Neurological and ophthalmological complications of mitral valve prolapse. Author(s): Shapiro SK, Warshawsky R, Shapiro I, See CE. Source: Minn Med. 1981 April; 64(4): 197-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7231383&dopt=Abstract

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Neuropathology of mitral valve prolapse in man and cardiopulmonary bypass (CPB) surgery in adolescent Yorkshire pigs. Author(s): Sparks DL, Gross DR, Hunsaker JC. Source: Neurobiology of Aging. 2000 March-April; 21(2): 363-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10867222&dopt=Abstract

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New guidelines for the clinical diagnosis of mitral valve prolapse. Author(s): Perloff JK, Child JS, Edwards JE. Source: The American Journal of Cardiology. 1986 May 1; 57(13): 1124-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3706164&dopt=Abstract

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No mitral valve prolapse in Korean patients with panic attacks. Author(s): Min SK, Lee HY. Source: The American Journal of Psychiatry. 1986 July; 143(7): 943-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3717453&dopt=Abstract

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Nonbacterial thrombotic endocarditis complicating mitral valve prolapse presenting as Parinaud's syndrome--a case report. Author(s): Cook DJ, Tanser PH. Source: Angiology. 1989 May; 40(5): 494-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2705652&dopt=Abstract

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Noncardiac chest pain in adolescents and children with mitral valve prolapse. Author(s): Woolf PK, Gewitz MH, Berezin S, Medow MS, Stewart JM, Fish BG, Glassman MS, Newman LJ. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1991 May; 12(3): 247-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2054366&dopt=Abstract

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Normal coronary flow reserve in patients with mitral valve prolapse, a positive exercise test and normal coronary arteries. Author(s): Tentolouris C, Petropoulakis P, Kyriakidis M, Karas S, Triposkiadis F, Gialafos J, Toutouzas P. Source: European Heart Journal. 1995 December; 16(12): 1960-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8682033&dopt=Abstract

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Normal sympathetic neural activity in patients with mitral valve prolapse. Author(s): Lenders JW, Fast JH, Blankers J, de Boo T, Lemmens WA, Thien T. Source: Clin Cardiol. 1986 May; 9(5): 177-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3708943&dopt=Abstract

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Not life threatening: mitral valve prolapse syndrome. Author(s): Cash JT, Grissett G. Source: Focus Crit Care. 1985 December; 12(6): 54-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3852750&dopt=Abstract

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Nurse practitioner clinical update: mitral valve prolapse. Author(s): Daly TM. Source: Journal of the American Academy of Nurse Practitioners. 1996 September; 8(9): 437-41; Quiz 442-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9305044&dopt=Abstract

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Observer variation in the angiocardiographic diagnosis of mitral valve prolapse. Author(s): Kennett JD, Rust PF, Martin RH, Parker BM, Watson LE. Source: Chest. 1981 February; 79(2): 146-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7460643&dopt=Abstract

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Observer variation in the echocardiographic diagnosis of mitral valve prolapse. Author(s): Alpert MA, Carney RJ, Munuswamy K, Ruder MA, Kapoor AS, Webel RR, Sanfelippo JF, Haikal M, Perkins SK, Kelly DL. Source: American Heart Journal. 1986 June; 111(6): 1123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3716988&dopt=Abstract

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Occurrence of mitral valve prolapse in nonsmoker spontaneous pneumothorax patients. Author(s): Bense L, Edhag O, Eklund G, Karlberg KE. Source: Chest. 1991 March; 99(3): 791-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1995256&dopt=Abstract

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Occurrence of mitral valve prolapse in nonsmoking patients with spontaneous pneumothorax. Author(s): Cheng TO. Source: Chest. 1992 January; 101(1): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1729101&dopt=Abstract

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Occurrence of mitral valve prolapse in patent ductus arteriosus after surgery-comparison between pre- and post-operative conditions. Author(s): Watari T, Awa S, Yanagawa Y, Hishi T, Akagi M, Dodo H, Ishii T, Oho S, Lin YF, Nakamura G. Source: Acta Paediatr Jpn. 1988 June; 30(3): 352-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3150221&dopt=Abstract

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Ocular findings in mitral valve prolapse syndrome. Author(s): Traboulsi EI, Aswad MI, Jalkh AE, Malouf JF. Source: Ann Ophthalmol. 1987 September; 19(9): 354-7, 359. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3662324&dopt=Abstract

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Opening snap in mitral valve prolapse-click syndrome. Author(s): Aintablian A, Hamby RI, Pulerwitz L, Franklin W. Source: N Y State J Med. 1978 September; 78(11): 1764-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=279818&dopt=Abstract

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Orthostatic hypotension, catecholamines, and alpha-adrenergic receptors in mitral valve prolapse. Author(s): Schatz IJ, Ramanathan S, Villagomez R, MacLean C. Source: The Western Journal of Medicine. 1990 January; 152(1): 37-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2155518&dopt=Abstract

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Orthostatic hypotension: a commonly unrecognized cause of symptoms in mitral valve prolapse. Author(s): Santos AD, Mathew PK, Hilal A, Wallace WA. Source: The American Journal of Medicine. 1981 November; 71(5): 746-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7304644&dopt=Abstract

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Ortner's syndrome in association with mitral valve prolapse. Author(s): Kishan CV, Wongpraparut N, Adeleke K, Frechie P, Kotler MN. Source: Clin Cardiol. 2000 April; 23(4): 295-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10763081&dopt=Abstract

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Predisposing factors for severe mitral regurgitation in idiopathic mitral valve prolapse. Author(s): Fukuda N, Oki T, Iuchi A, Tabata T, Manabe K, Kageji Y, Sasaki M, Yamada H, Ito S. Source: The American Journal of Cardiology. 1995 September 1; 76(7): 503-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7653453&dopt=Abstract

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Pregnancy outcome and mitral valve prolapse. Author(s): Chia YT, Yeoh SC, Lim MC, Viegas OA, Ratnam SS. Source: Asia Oceania J Obstet Gynaecol. 1994 December; 20(4): 383-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7832670&dopt=Abstract

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Prevalence of mitral valve prolapse and thick mitral valve in a non-selected outpatient population. Author(s): Karavidas AI, Lazaros GA, Zampoulakis JD, Matsakas EP, Panou FK, Zacharoulis AA. Source: Cardiology. 2002; 98(3): 165-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417818&dopt=Abstract

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Prevalence of mitral valve prolapse in healthy adult Nigerians as diagnosed by echocardiography. Author(s): Oladapo OO, Falase AO. Source: Afr J Med Med Sci. 2001 March-June; 30(1-2): 13-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14510142&dopt=Abstract

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Prevalence of mitral valve prolapse in Stickler syndrome. Author(s): Ahmad N, Richards AJ, Murfett HC, Shapiro L, Scott JD, Yates JR, Norton J, Snead MP. Source: American Journal of Medical Genetics. 2003 January 30; 116A(3): 234-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503098&dopt=Abstract

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Prevalence of mitral valve prolapse in the Framingham Heart Study. Author(s): Cheng TO. Source: The American Journal of Cardiology. 2002 December 15; 90(12): 1425; Author Reply 1425-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480067&dopt=Abstract

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Prevalence of myxomatous mitral valve prolapse in patients with lymphocytic thyroiditis. Author(s): Kahaly G, Mohr-Kahaly S, Beyer J, Meyer J. Source: The American Journal of Cardiology. 1995 December 15; 76(17): 1309-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7503017&dopt=Abstract

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Primary mitral valve prolapse: a clinical form of primary magnesium deficit. Author(s): Durlach J. Source: Magnes Res. 1994 December; 7(3-4): 339-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7786696&dopt=Abstract

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Pseudoaneurysm of gastroduodenal artery associated with mitral valve prolapse presenting as haemobilia. Author(s): Chetri K, Choudhuri G, Gogoi R, Baijal SS, Sikora SS. Source: Trop Gastroenterol. 2001 October-December; 22(4): 211-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11963328&dopt=Abstract

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P-wave signal-averaged electrocardiogram in patients with idiopathic mitral valve prolapse syndrome and supraventricular arrhythmias. Author(s): Banasiak W, Pajak I, Ponikowski P, Lacheta W, Wiech K, Piepoli M, Telichowski C. Source: International Journal of Cardiology. 1995 June 30; 50(2): 175-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7591329&dopt=Abstract

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QT dispersion in mitral valve prolapse. Author(s): Cheng TO. Source: International Journal of Cardiology. 1998 April 1; 64(2): 219. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9688444&dopt=Abstract

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QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness. Author(s): Zouridakis EG, Parthenakis FI, Kochiadakis GE, Kanoupakis EM, Vardas PE. Source: Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology. 2001 October; 3(4): 292-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11678387&dopt=Abstract

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QT interval prolongation and increased plasma catecholamine levels in patients with mitral valve prolapse. Author(s): Puddu PE, Pasternac A, Tubau JF, Krol R, Farley L, de Champlain J. Source: American Heart Journal. 1983 March; 105(3): 422-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6131602&dopt=Abstract

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Quantitation and significance of systolic mitral leaflet displacement in mitral valve prolapse. Author(s): Sanfilippo AJ, Abdollah H, Burggraf GW. Source: The American Journal of Cardiology. 1989 December 1; 64(19): 1349-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2589202&dopt=Abstract

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Quantitative frame by frame analysis of regional contraction and lengthening on left ventricular cineangiograms: application to the study of normal left ventricles and left ventricles with mitral valve prolapse. Author(s): Colle JP, Le Goff G, Ohayon J, Bonnet J, Bricaud H, Besse P. Source: Clin Cardiol. 1986 February; 9(2): 43-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3948440&dopt=Abstract

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Radiology in diagnosis of mitral valve prolapse. Study in 105 patients. Author(s): Bjork L. Source: Ann Radiol (Paris). 1981 June-July; 24(5): 327-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7332216&dopt=Abstract

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Radionuclide esophageal transit test to detect esophageal disorders in patients with mitral valve prolapse. Author(s): Kao CH, Tsai SC, Hsieh JF, Ho YJ, Ding HJ. Source: Nuklearmedizin. 2000; 39(4): 92-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10919158&dopt=Abstract

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Recent developments in the diagnosis and management of mitral valve prolapse. Author(s): Devereux RB. Source: Current Opinion in Cardiology. 1995 March; 10(2): 107-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7787275&dopt=Abstract

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Relation between QT dispersion and ventricular arrhythmias in uncomplicated isolated mitral valve prolapse. Author(s): Ulgen MS, Biyik I, Karadede A, Temamogullari AV, Alan S, Toprak N. Source: Japanese Circulation Journal. 1999 December; 63(12): 929-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10614836&dopt=Abstract

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Relationship between IFN-gamma production by blood lymphocytes and constitutional personality features of patients with idiopathic mitral valve prolapse. Author(s): Surkina ID, Yu Sokolov O, Gabaeva MV, Gurevich KG, Alfimova MV, Akatova EV, Pak LS. Source: Bulletin of Experimental Biology and Medicine. 2001 April; 131(4): 389-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11550034&dopt=Abstract

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Relationship between severity of mitral regurgitation and prognosis of mitral valve prolapse: echocardiographic follow-up study. Author(s): Kim S, Kuroda T, Nishinaga M, Yamasawa M, Watanabe S, Mitsuhashi T, Ueda S, Shimada K. Source: American Heart Journal. 1996 August; 132(2 Pt 1): 348-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8701897&dopt=Abstract

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Renin-aldosterone regulation during upright posture in young men with mitral valve prolapse syndrome. Author(s): Zdrojewski TR, Wyrzykowski B, Krupa-Wojciechowska B. Source: J Heart Valve Dis. 1995 May; 4(3): 236-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7655681&dopt=Abstract

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Repair of anterior leaflet mitral valve prolapse: chordal replacement versus chordal shortening. Author(s): Phillips MR, Daly RC, Schaff HV, Dearani JA, Mullany CJ, Orszulak TA. Source: The Annals of Thoracic Surgery. 2000 January; 69(1): 25-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10654480&dopt=Abstract

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Risk of stroke with mitral valve prolapse in population-based cohort study. Author(s): Orencia AJ, Petty GW, Khandheria BK, Annegers JF, Ballard DJ, Sicks JD, O'Fallon WM, Whisnant JP. Source: Stroke; a Journal of Cerebral Circulation. 1995 January; 26(1): 7-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7839400&dopt=Abstract

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Ruptured mitral chordae tendineae may be a frequent and insignificant complication in the mitral valve prolapse syndrome. Author(s): Grenadier E, Keidar S, Sahn DJ, Alpan G, Goldberg SJ, Valdez Cruz LM, Lima CO, Barron JV, Allen HD, Palant A. Source: European Heart Journal. 1985 December; 6(12): 1006-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3830706&dopt=Abstract

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Severe mitral regurgitation due to mitral valve prolapse associated with Bland-WhiteGarland syndrome. Author(s): Chau EM, Cheng LC, Lee JW. Source: Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine. 2001 September; 7(3): 307-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11590275&dopt=Abstract

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Severe mitral regurgitation due to mitral valve prolapse: risk factors for development, progression, and need for mitral valve surgery. Author(s): Singh RG, Cappucci R, Kramer-Fox R, Roman MJ, Kligfield P, Borer JS, Hochreiter C, Isom OW, Devereux RB. Source: The American Journal of Cardiology. 2000 January 15; 85(2): 193-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10955376&dopt=Abstract

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Single-photon emission computed tomographic myocardial perfusion imaging in patients with mitral valve prolapse. Author(s): Ozkan M, Kaymaz C, Dinckal H, Kirma C, Ozdemir N, Akdemir I, Sonmez K, Mutlu B, Sansoy V, Onsel C. Source: The American Journal of Cardiology. 2000 February 15; 85(4): 516-8, A11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10728965&dopt=Abstract

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Spectrum of regurgitation jets in mitral valve prolapse. Author(s): Ansari A, Maron BJ. Source: Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 1995; 22(4): 349. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8605441&dopt=Abstract

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Stroke in a young patient with mitral valve prolapse. Author(s): Dasgupta R, Chakraborti A, Bardhan S, Sen SK. Source: J Indian Med Assoc. 1995 July; 93(7): 278, 277. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8576595&dopt=Abstract

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Successful surgical ablation of sustained ventricular tachycardia associated with mitral valve prolapse guided by a multielectrode basket catheter. Author(s): Van Dessel PF, Van Hemel NM, Van Swieten HA, De Bakker JM, Jessurun ER. Source: Pacing and Clinical Electrophysiology : Pace. 2001 June; 24(6): 1029-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11449580&dopt=Abstract

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Sudden death in mitral valve prolapse and severe mitral regurgitation. Is chordal rupture an indication to early surgery? Author(s): Ciancamerla F, Paglia I, Catuzzo B, Morello M, Mangiardi L. Source: The Journal of Cardiovascular Surgery. 2003 April; 44(2): 283-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813402&dopt=Abstract

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Sudden death in mitral valve prolapse with Holter monitoring-documented ventricular fibrillation: evidence of coexisting arrhythmogenic right ventricular cardiomyopathy. Author(s): Martini B, Basso C, Thiene G. Source: International Journal of Cardiology. 1995 May; 49(3): 274-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7649675&dopt=Abstract

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Sudden death in young people with apparently isolated mitral valve prolapse. Author(s): Corrado D, Basso C, Nava A, Rossi L, Thiene G. Source: G Ital Cardiol. 1997 November; 27(11): 1097-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9419819&dopt=Abstract

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Supernumerary nipple as a cutaneous marker of mitral valve prolapse in Asian Indians. Author(s): Rajaratnam K, Kumar PD, Sahasranam KV. Source: The American Journal of Cardiology. 2000 September 15; 86(6): 695-7, A9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10980229&dopt=Abstract

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The long-term outcome of mitral valve repair for mitral valve prolapse. Author(s): Mohty D, Enriquez-Sarano M. Source: Current Cardiology Reports. 2002 March; 4(2): 104-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11827632&dopt=Abstract

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The polymorphisms of codon 727 and 52 of thyroid-stimulating hormone receptor gene are not associated with mitral valve prolapse syndrome in Taiwan Chinese. Author(s): Chou HT, Shi YR, Chang CT, Tsai FJ. Source: Japanese Heart Journal. 2002 November; 43(6): 655-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12558129&dopt=Abstract

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The prevalence of mitral valve prolapse in children with anxiety disorders. Author(s): Toren P, Eldar S, Cendorf D, Wolmer L, Weizman R, Zubadi R, Koren S, Laor N. Source: Journal of Psychiatric Research. 1999 July-August; 33(4): 357-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10404474&dopt=Abstract

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The site of mitral valve prolapse is a predictor of atrial fibrillation. Author(s): Ohki R, Yamamoto K, Okayama M, Nonaka M, Suzuki C, Ikeda U, Shimada K. Source: The American Journal of Cardiology. 2001 October 1; 88(7): 811-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589858&dopt=Abstract

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The treatment of mitral valve prolapse syndrome in a nurse-managed outpatient mitral valve prolapse clinic. Author(s): Scordo KA. Source: Nurs Clin North Am. 2000 December; 35(4): 1005-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11072285&dopt=Abstract

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Three-dimensional transesophageal echocardiography in the diagnosis of mitral valve prolapse. Author(s): Cheng TO, Wang XF, Zheng LH, Li ZA, Lu P. Source: American Heart Journal. 1994 December; 128(6 Pt 1): 1218-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7985604&dopt=Abstract

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Toward an understanding of the cause of mitral valve prolapse. Author(s): Towbin JA. Source: American Journal of Human Genetics. 1999 November; 65(5): 1238-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10521288&dopt=Abstract

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Transesophageal echocardiographic assessment of systolic mitral leaflet displacement among patients with mitral valve prolapse. Author(s): Langholz D, Mackin WJ, Wallis DE, Jacobs WR, Scanlon PJ, Louie EK. Source: American Heart Journal. 1998 February; 135(2 Pt 1): 197-206. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9489965&dopt=Abstract

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Transformation of mitral valve prolapse to dynamic left ventricular outflow tract obstruction and back again in a patient with acute transient myocardial depression. Author(s): Fisher SD, Eichelberger JP, Pomerantz R, Delehanty J. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2000 April; 13(4): 319-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10756251&dopt=Abstract

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Treatment of mitral valve prolapse and panic disorder with metoprolol. Author(s): Zwanzger P, Baghai T, Schule C, Rupprecht R. Source: World J Biol Psychiatry. 2000 April; 1(2): 124-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607209&dopt=Abstract

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Understanding mitral valve prolapse (MVP). Author(s): Schatz IJ. Source: Herz. 1988 August; 13(4): 235-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3049286&dopt=Abstract

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Unsuspected infrahepatic interruption of inferior vena cava associated with floppy mitral valve, mitral valve prolapse, and severe mitral regurgitation. Author(s): Dellavalle A, Ribichini F, Steffenino G. Source: Chest. 1994 November; 106(5): 1626-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7956440&dopt=Abstract

•

Update: mitral valve prolapse syndrome. Author(s): Crase D. Source: The Journal of School Health. 1982 August; 52(8): 354-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6922312&dopt=Abstract

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•

Upright paradoxical posterior wall movement in mitral valve prolapse. Author(s): Krafchek J, Shaw M, Kisslo J. Source: The American Journal of Cardiology. 1985 November 1; 56(12): 804-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4061308&dopt=Abstract

•

Urinary catecholamines and mitral valve prolapse in panic-anxiety patients. Author(s): Nesse RM, Cameron OG, Buda AJ, McCann DS, Curtis GC, Huber-Smith MJ. Source: Psychiatry Research. 1985 January; 14(1): 67-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3857649&dopt=Abstract

•

Usefulness of echocardiographically determined mitral leaflet motion for diagnosis of mitral valve prolapse in 17- and 18-year-old men. Author(s): Kriwisky M, Froom P, Gross M, Ribak J, Lewis BS. Source: The American Journal of Cardiology. 1987 May 1; 59(12): 1149-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3578057&dopt=Abstract

•

Usefulness of three-dimensional echocardiography for the evaluation of mitral valve prolapse: an intraoperative study. Author(s): Chauvel C, Bogino E, Clerc P, Fernandez G, Vernhet JC, Becat A, Dehant P. Source: J Heart Valve Dis. 2000 May; 9(3): 341-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10888088&dopt=Abstract

•

Usefulness of transesophageal echocardiography for diagnosis of mitral valve prolapse. Author(s): Zamorano J, Erbel R, Mackowski T, Alfonso F, Meyer J. Source: The American Journal of Cardiology. 1992 February 1; 69(4): 419-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1734661&dopt=Abstract

•

Usually benign, but always frightening--that's mitral valve prolapse. Author(s): Kovalesky A. Source: Nursing. 1981 April; 11(4): 58-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6907787&dopt=Abstract

•

Utility of echocardiography in patients with suspected mitral valve prolapse. Author(s): Hershman WY, Moskowitz MA, Marton KI, Balady GJ. Source: The American Journal of Medicine. 1989 October; 87(4): 371-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2801727&dopt=Abstract

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Mitral Valve Prolapse

•

Value of acceleration flows and regurgitant jet direction by color Doppler flow mapping in the evaluation of mitral valve prolapse. Author(s): Yoshida K, Yoshikawa J, Yamaura Y, Hozumi T, Shakudo M, Akasaka T, Kato H. Source: Circulation. 1990 March; 81(3): 879-85. Erratum In: Circulation 1990 October; 82(4): 1547. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2306838&dopt=Abstract

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Ventricular arrhythmia factors in mitral valve prolapse. Author(s): Babuty D, Cosnay P, Breuillac JC, Charniot JC, Delhomme C, Fauchier L, Fauchier JP. Source: Pacing and Clinical Electrophysiology : Pace. 1994 June; 17(6): 1090-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7521034&dopt=Abstract

•

Ventricular arrhythmias and mitral valve prolapse. Author(s): Levy S. Source: Acta Cardiol. 1992; 47(2): 125-34. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1615738&dopt=Abstract

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Ventricular arrhythmias and the autonomic tone in patients with mitral valve prolapse. Author(s): Sniezek-Maciejewska M, Dubiel JP, Piwowarska W, Mroczek-Czernecka D, Mazurek S, Jaskiewicz J, Kitlinski M. Source: Clin Cardiol. 1992 October; 15(10): 720-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1395181&dopt=Abstract

•

Ventricular arrhythmias in patients with mitral valve prolapse. Author(s): Schaal SF. Source: Cardiovasc Clin. 1992; 22(1): 307-16. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1728433&dopt=Abstract

•

Ventricular buckling: a factor in the abnormal ventriculogram and peculiar hemodynamics associated with mitral valve prolapse. Author(s): Cobbs BW Jr, King SB 3rd. Source: American Heart Journal. 1977 June; 93(6): 741-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=871101&dopt=Abstract

•

Ventricular fibrillation during anesthetic induction in a child with undiagnosed mitral valve prolapse. Author(s): Moritz HA, Parnass SM, Mitchell JS. Source: Anesthesia and Analgesia. 1997 July; 85(1): 59-61. Erratum In: Anesth Analg 1997 September; 85(3): 482. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9212123&dopt=Abstract

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Ventricular premature beat localization in mitral valve prolapse syndrome. Author(s): Klein MD, Feldman CL. Source: American Heart Journal. 1981 July; 102(1): 138-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6166188&dopt=Abstract

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Vertical left ventricular angulation assessed by thallium 201 myocardial perfusion imaging in patients with mitral valve prolapse. Author(s): Arora RR, Horowitz SF, Machac J, Goldman ME. Source: Catheterization and Cardiovascular Diagnosis. 1986; 12(4): 240-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3757024&dopt=Abstract

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Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Author(s): Mohty D, Orszulak TA, Schaff HV, Avierinos JF, Tajik JA, Enriquez-Sarano M. Source: Circulation. 2001 September 18; 104(12 Suppl 1): I1-I7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11568020&dopt=Abstract

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CHAPTER 2. NUTRITION AND MITRAL VALVE PROLAPSE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and mitral valve prolapse.

Finding Nutrition Studies on Mitral Valve Prolapse 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 “mitral valve prolapse” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

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

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Mitral Valve Prolapse

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

Clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation. Author(s): Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland. Source: Lichodziejewska, B Klos, J Rezler, J Grudzka, K Dluzniewska, M Budaj, A Ceremuzynski, L Am-J-Cardiol. 1997 March 15; 79(6): 768-72 0002-9149

•

Combined mitral valve prolapse and atrial septal aneurysm. A cause for embolic events. Author(s): Chair of Cardiac Surgery, Medical School of Catanzaro, University of Reggio Calabria, Italy. Source: Mastroroberto, P Chello, M Zofrea, S Zucco, D Borrello, G Marchese, A R JCardiovasc-Surg-(Torino). 1994 December; 35(6): 507-9 0021-9509

•

Erythrocyte magnesium in symptomatic patients with primary mitral valve prolapse: relationship to symptoms, mitral leaflet thickness, joint hypermobility and autonomic regulation. Author(s): Department of Medicine, University of Alabama, Birmingham. Source: Coghlan, H C Natello, G Magnes-Trace-Elem. 1991-92; 10(2-4): 205-14 1015-3845

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Hypomagnesemia and mitral valve prolapse in Cavalier King Charles spaniels. Author(s): Department of Anatomy and Physiology, Royal Veterinary and Agricultural University, Frederiksberg, Denmark. Source: Pedersen, H D Mow, T Zentralbl-Veterinarmed-A. 1998 December; 45(10): 60714 0514-7158

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Mitral valve prolapse syndrome. Nonpharmacologic management. Author(s): Wright State University-Miami Valley College of Nursing and Health, Dayton, Ohio, USA. Source: Scordo, K A Crit-Care-Nurs-Clin-North-Am. 1997 December; 9(4): 555-64 08995885

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Neuroendocrine changes in Dachshunds with mitral valve prolapse examined under different study conditions. Author(s): Department of Anatomy and Physiology, Royal Veterinary and Agricultural University, Frederiksberg C, Denmark. [email protected] Source: Pedersen, H D Olsen, L H Mow, T Christensen, N J Res-Vet-Sci. 1999 February; 66(1): 11-7 0034-5288

•

Recent data on mitral valve prolapse and magnesium deficit. Author(s): Medical Clinic, Emergency Hospital Bucharest, Romania. Source: Zeana, C D Magnes-Res. 1988 December; 1(3-4): 203-11 0953-1424

•

Ventricular fibrillation in a patient with 'silent' mitral valve prolapse. Author(s): Electrophysiology Unit, Massada Center for Heart Diseases, Beilinson Medical Center, Petah Tikva, Israel. Source: Strasberg, B Caspi, A Kusniec, J Lewin, R F Sclarovsky, S Agmon, J Cardiology. 1988; 75(2): 149-53 0008-6312

Nutrition

57

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

•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The following is a specific Web list relating to mitral valve prolapse; 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: •

Minerals L-carnitine Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Prima Communications, Inc.www.personalhealthzone.com

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

Clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation. Author(s): Lichodziejewska B, Klos J, Rezler J, Grudzka K, Dluzniewska M, Budaj A, Ceremuzynski L. Source: The American Journal of Cardiology. 1997 March 15; 79(6): 768-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9070556&dopt=Abstract

•

Complex arrhythmias in mitral regurgitation with and without mitral valve prolapse: contrast to arrhythmias in mitral valve prolapse without mitral regurgitation. Author(s): Kligfield P, Hochreiter C, Kramer H, Devereux RB, Niles N, Kramer-Fox R, Borer JS. Source: The American Journal of Cardiology. 1985 June 1; 55(13 Pt 1): 1545-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4003297&dopt=Abstract

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•

Factors associated with participation in a mitral valve prolapse support group. Author(s): Scordo KA. Source: Heart & Lung : the Journal of Critical Care. 2001 March-April; 30(2): 128-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11248715&dopt=Abstract

•

Hyperventilation syndrome and the assessment of treatment for functional cardiac symptoms. Author(s): DeGuire S, Gevirtz R, Kawahara Y, Maguire W. Source: The American Journal of Cardiology. 1992 September 1; 70(6): 673-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1510019&dopt=Abstract

•

Management of the headache patient with medical illness. Author(s): Solomon GD. Source: The Clinical Journal of Pain. 1989; 5(1): 95-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2520392&dopt=Abstract

•

Migraine treatment. Author(s): Young WB, Silberstein SD, Dayno JM. Source: Seminars in Neurology. 1997; 17(4): 325-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9474712&dopt=Abstract

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Mitral valve prolapse syndrome and anxiety neurosis/panic disorder. Author(s): Pariser SF, Pinta ER, Jones BA. Source: The American Journal of Psychiatry. 1978 February; 135(2): 246-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=341727&dopt=Abstract

•

Mitral valve prolapse syndrome. Nonpharmacologic management. Author(s): Scordo KA. Source: Critical Care Nursing Clinics of North America. 1997 December; 9(4): 555-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9444178&dopt=Abstract

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Mitral valve prolapse syndrome: interventions for symptom control. Author(s): Scordo KA. Source: Dimensions of Critical Care Nursing : Dccn. 1998 July-August; 17(4): 177-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9883120&dopt=Abstract

•

Psychoneuroimmunology and its relationship to the differential diagnosis of temporomandibular disorders. Author(s): Auvenshine RC.

Alternative Medicine 61

Source: Dent Clin North Am. 1997 April; 41(2): 279-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9142484&dopt=Abstract •

Symptomatic mitral valve prolapse in children and adolescents: catecholamines, anxiety, and biofeedback. Author(s): Smith MS, Doroshow C, Womack WM, Tenckhoff L, Stamm S, Pertik M. Source: Pediatrics. 1989 August; 84(2): 290-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2664696&dopt=Abstract

•

The sauna and the heart. Author(s): Cheng TO. Source: Journal of Internal Medicine. 1993 July; 234(1): 101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8326282&dopt=Abstract

•

Upper limb ischemia induced by chronic licorice ingestion. Author(s): Lozano P, Flores D, Martinez S, Artigues I, Rimbau EM, Gomez F. Source: The Journal of Cardiovascular Surgery. 2000 August; 41(4): 631-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052297&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The following is a specific Web list relating to mitral valve prolapse; 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 Cardiovascular Disease Overview Source: Healthnotes, Inc.; www.healthnotes.com Mitral Valve Prolapse Source: Healthnotes, Inc.; www.healthnotes.com Pulmonary Hypertension Source: Integrative Medicine Communications; www.drkoop.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. PROLAPSE

DISSERTATIONS

ON

MITRAL

VALVE

Overview In this chapter, we will give you a bibliography on recent dissertations relating to mitral valve prolapse. 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 “mitral valve prolapse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on mitral valve prolapse, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Mitral Valve Prolapse 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 mitral valve prolapse. 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: •

Multimodal Treatment of Women with Mitral Valve Prolapse Syndrome by Nevin, Doris Eileen Jacobs, PhD from Ball State University, 1997, 382 pages http://wwwlib.umi.com/dissertations/fullcit/9738301

•

The Relationship of Selected Personality Characteristics and Personal Belief Systems to Mitral Valve Prolapse Syndrome by Gebhart, James Edward, PhD from The Ohio State University, 1982, 202 pages http://wwwlib.umi.com/dissertations/fullcit/8300252

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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. BOOKS ON MITRAL VALVE PROLAPSE Overview This chapter provides bibliographic book references relating to mitral valve prolapse. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on mitral valve prolapse 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 “mitral valve prolapse” (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 mitral valve prolapse: •

Family and ADPKD: A Guide for Children and Parents Source: Kansas City, MO: Polycystic Kidney Research Foundation. 1997. 48 p. Contact: Polycystic Kidney Research (PKR) Foundation. 4901 Main Street, Suite 200, Kansas City, MO 64112-2674. (800) 753-2873 or (816) 931-2600. Fax (816) 931-8655. Email: [email protected]. Website: http://www.kumc.edu/pkrf/. PRICE: $10 for members, $15 for nonmembers. ISBN: 0961456752. Summary: In this book, two physicians provide answers to the questions most commonly asked by children and parents about autosomal dominant polycystic kidney disease (ADPKD). The book is divided into two sections: one for children and one for parents. For the convenience of the reader, the questions are organized into topics. In the children's section, the topics include general information, inheritance, diagnosis, and self care. The parents' section contains information about diagnosis and prognosis, taking

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care of the child, and family issues. Topics include the physiology and functions of the kidney, polycystic kidneys, deciding about screening tests, good habits that can prevent further damage to cystic kidneys, nutritional considerations. Other topics include participating in sports, drug therapy, hypertension (high blood pressure), relatives with ADPKD, dialysis, kidney transplantation, organ donation, ethical guidelines for disclosing information to a child, the natural course of the disease, and complications that can occur in children with ADPKD (including hypertension, kidney infection, blood in the urine, mitral valve prolapse, hernias). The authors also discuss establishing a routine of medical care and monitoring, how to know when to consult a health care provider for a child who has ADPKD and contracts a typical childhood illness, contraceptive use in teenagers with ADPKD, telling children about a parent's illness, psychosocial issues, and how readers can help with current research efforts, including those sponsored by the Polycystic Kidney Research Foundation. The authors explain complicated medical terms often associated with genetic diseases and replace them with common language. A brief subject index is included. 4 figures.

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

Confronting Mitral Valve Prolapse Syndrome by Lyn Frederickson (Author) (1992); ISBN: 0446394076; http://www.amazon.com/exec/obidos/ASIN/0446394076/icongroupinterna

•

Confronting Mitral Valve Prolapse: The Mysterious Heart Condition of the Young and Healthy by Lyn Fredrickson, Lyn Frederickson; ISBN: 0932238459; http://www.amazon.com/exec/obidos/ASIN/0932238459/icongroupinterna

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Coping With Mitral Valve Prolapse: A Guide to Living With Mvp for You and Your Family by Robert H. Phillips (1993); ISBN: 0895295148; http://www.amazon.com/exec/obidos/ASIN/0895295148/icongroupinterna

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Mitral Valve Prolapse by Nancy Tkaczuk (1986); ISBN: 0939838206; http://www.amazon.com/exec/obidos/ASIN/0939838206/icongroupinterna

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Mitral Valve Prolapse; ISBN: 0969430205; http://www.amazon.com/exec/obidos/ASIN/0969430205/icongroupinterna

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Mitral Valve Prolapse by Robert M. Jeresaty; ISBN: 0890042306; http://www.amazon.com/exec/obidos/ASIN/0890042306/icongroupinterna

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Mitral Valve Prolapse and the Marfan Syndrome by Richard B. Devereux; ISBN: 0781701996; http://www.amazon.com/exec/obidos/ASIN/0781701996/icongroupinterna

Books

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•

Mitral Valve Prolapse and the Mitral Valve Prolapse Syndrome by Harisios Boudoulas, Charles F. Wooley (1988); ISBN: 0879933194; http://www.amazon.com/exec/obidos/ASIN/0879933194/icongroupinterna

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Mitral Valve Prolapse Syndrome: A Patient's Perspective by Lorelei J. Logsdon; ISBN: 0972429409; http://www.amazon.com/exec/obidos/ASIN/0972429409/icongroupinterna

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Mitral Valve Prolapse: Benign Syndrome? by Sharon Anderson (1999); ISBN: 0759229643; http://www.amazon.com/exec/obidos/ASIN/0759229643/icongroupinterna

•

Mitral Valve: Floppy Mitral Valve, Mitral Valve Prolapse, Mitral Valvular Regurgitation by Harisios Boudoulas M.D. Ph.D. (Editor), M.D., Charles Wooley (Editor); ISBN: 0879934484; http://www.amazon.com/exec/obidos/ASIN/0879934484/icongroupinterna

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Natural Therapies for Mitral Valve Prolapse by Ronald L. Hoffman; ISBN: 0879837659; http://www.amazon.com/exec/obidos/ASIN/0879837659/icongroupinterna

•

Taking Control: Living With the Mitral Valve Prolapse Syndrome by Kristine A. Bludau-Scordo, Kristine A. Scordo (1996); ISBN: 0965068900; http://www.amazon.com/exec/obidos/ASIN/0965068900/icongroupinterna

•

The Mitral Valve Prolapse Syndrome/Dysautonomia Survival Guide by James F. Durante, et al (2002); ISBN: 1572243031; http://www.amazon.com/exec/obidos/ASIN/1572243031/icongroupinterna

•

Women and Mitral Valve Prolapse: A Comprehensive Guide to Living and Coping With M.V.P. and Its Symptoms by Victoria Gotti; ISBN: 188559190X; http://www.amazon.com/exec/obidos/ASIN/188559190X/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 “mitral valve prolapse” (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:8 •

8

Mitral stenosis after closed commissurotomy: a clinical and echocardiographic longterm follow-up study Author: Eskilsson, Jan.; Year: 1961; Lund: [s.n.]; Stockholm, Sweden: Distributed by Almqvist; Wiksell Periodical Co., 1982

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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•

Surgical treatment of mitral stenosis; a handbook for physicians. Edited by A. N. Bakulev. Moscow, Medgiz, 1958. Author: Bakulev, A. N. (Aleksandr Nikolaevich),; Year: 1958; [Jerusalem, Israel Program for Scientific Translations, 1960]

•

The floppy mitral valve Author: Lucas, Russell V.; Year: 1968; Chicago: Year Book Medical Publishers, c1982

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

Marfan Syndrome, The Source: in Coggins, C.H.; Hancock, E.W.; Levitt, L.J., eds. Annual Review of Medicine, Volume 51, 2000. Palo Alto, CA: Annual Reviews, Inc. 2000. p. 481-510. Contact: Available from Annual Reviews. 4139 El Camino Way, P.O. Box 10139, Palo Alto, CA 94303-0139. (650) 493-4400. E-mail: [email protected]. Website: www.AnnualReviews.org. Summary: This chapter provides health professionals with information on the historical evolution, classification, clinical features, diagnosis, and pathogenesis of Marfan syndrome (MFS). This heritable disorder of connective tissue was initially described just over 100 years ago and was among the first conditions classified as a heritable disorder of connective tissue. MFS lies at one end of a phenotypic continuum, with people in the general population who have one or another of the features of MFS at the other end, and those with a variety of other conditions in between. Diagnosis of MFS and these other conditions is based on clinical features. Mutations in FBN1, the gene that encodes fibrillin-1, are responsible for MFS and, in a few patients, other disorders in the continuum. Differential diagnosis of MFS is hampered by the range of FBN1 mutations in MFS and related conditions, the considerable prevalence of many phenotypic manifestations in the general population and in other connective tissue disorders, and the existence of phenotypic continua. In addition to skeletal, ocular, and cardiovascular features, patients with MFS have involvement of the skin, integument, lungs, and muscle tissue. Related disorders include MASS phenotype, familial mitral valve prolapse, familial aortic aneurysm and dissection, familial ectopia lentis, familial tall stature, contractural arachnodactyly, and Shprintzen-Goldberg syndrome. Over the past 30 years, evolution of aggressive medical and surgical management of the cardiovascular problems, especially mitral valve prolapse, aortic dilatation, and aortic dissection, has resulted in considerable improvement in life expectancy. 5 tables and 131 references. (AA-M).

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CHAPTER 6. MULTIMEDIA ON MITRAL VALVE PROLAPSE Overview In this chapter, we show you how to keep current on multimedia sources of information on mitral valve prolapse. 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.

Bibliography: Multimedia on Mitral Valve Prolapse 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 mitral valve prolapse (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 mitral valve prolapse: •

Aortic and mitral stenosis [videorecording] Source: presented by Department of Medicine, Emory University, School of Medicine; Year: 1982; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Network, 1982

•

Auscultation of the heart [motion picture]: (mitral stenosis) Source: [presented by] Eli Lilly and Company; by Abe Ravin; produced by Thos. J. Barbre Productions; Year: 1967; Format: Motion picture; United States: Lilly, [1967]

•

Development of medical thought [videorecording]: from irritable heart to mitral valve prolapse Source: presented by Department of Medicine, Emory University, School of Medicine; Year: 1981; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Netork, 1981

•

Medical and surgical treatment of mitral stenosis [videorecording] Source: presented by the Department of Medicine, Emory University, School of Medicine; Year: 1986; Format: Videorecording; Atlanta, Ga.: The University, 1986

•

Mitral prolapse (Barlow's syndrome) [videorecording] Source: presented by Department of Pediatrics, Emory Univ., School of Medicine; Year: 1981; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Network, 1981

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•

Mitral stenosis [slide] Source: Michael V. Herman; Year: 1979; Format: Slide; Westport, Conn.: Medical Education Programs, c1979

•

Mitral stenosis [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; Houston, TX: The Institute, 1982

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Mitral stenosis and regurgitation [videorecording] Source: Medi-Cine Ltd; Year: 1976; Format: Videorecording; London: Medi-Cine; [Philadelphia: for loan and sale by Lippincott], c1976

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Mitral stenosis with floating left atrial thrombus [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; Houston, TX: The Institute, 1982

•

Mitral valve prolapse [slide]: is this a variant of health or disease Source: Dept. of Medical Education, Millard Fillmore Hospital, Buffalo, New York, in cooperation with the School of Medicine, State University of New York at Buffalo; Year: 1976; Format: Slide; Buffalo: Communications in Learning, 1976

•

Mitral valve prolapse [sound recording] Source: Charles Naggar; S. Alexander, ed; Year: 1978; Format: Sound recording; [Park Ridge, Ill.]: ASCME, p1978

•

Mitral valve prolapse [videorecording] Source: presented by Department of Medicine, Emory University, School of Medicine; Year: 1982; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Network, 1982

•

Mitral valve prolapse [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; Houston, TX: The Institute, 1982

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Mitral valve prolapse [videorecording]. Year: 1982; Format: Videorecording; Houston, TX: Texas Heart Institute, 1982

•

Mitral valve prolapse, the problem arrhythmias [videorecording] Source: presented by Department of Medicine, Emory University, School of Medicine; Year: 1982; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Network, 1982

•

Pure mitral stenosis [videorecording] Source: Medi-Cine Ltd; Year: 1976; Format: Videorecording; London: Medi-Cine; [Philadelphia: for loan and sale by Lippincott] c1976

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CHAPTER 7. PERIODICALS AND NEWS ON MITRAL VALVE PROLAPSE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover mitral valve prolapse.

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

ACE polymorphisms linked to mitral valve prolapse Source: Reuters Medical News Date: February 11, 2003

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•

Mitral valve prolapse in general population more benign than thought Source: Reuters Medical News Date: October 28, 2002

•

Mitral valve prolapse may be caused by small chest cavity Source: Reuters Medical News Date: March 27, 2000

•

Mitral Valve Prolapse And History Of Rheumatic Fever Appear To Be Unrelated Source: Reuters Medical News Date: March 22, 1996 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 “mitral valve prolapse” (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 “mitral valve prolapse” (or synonyms). If you know the name of a company that is relevant to mitral valve prolapse, 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 “mitral valve prolapse” (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 “mitral valve prolapse” (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 mitral valve prolapse: •

Treatment Complexities of the Turner's Syndrome Patient Source: Oral-B Case Studies in Dental Hygiene. 1(1): 1-4,6-8. Summer 2003. Contact: Available from Oral-B Case Studies in Dental Hygiene, Professional Audience Communications, Inc. P.O. Box 243, Yardley, PA 19067. (800) 446-7252. Website: www.oralb.com/dentalpros. Summary: Effective patient assessment is critical to the delivery of high quality dental hygiene care. This article helps dental hygienists understand the treatment complexities of working with patients with Turner's syndrome, a complex medical condition characterized by oral, physical, and psychological features. Common physical characteristics of Turner's syndrome patients include short stature, webbed neck, and hypoplastic pinna (underdeveloped outer ears), underdeveloped or shield chest with wide-spaced nipples, and edema of the hands and feet. Oral features associated with Turner's syndrome include high arched and narrow palate, occurrence of cleft palate at higher-than-normal frequency, significantly smaller mesio-distal dimensions of the teeth, bifurcated roots and reduced root length, particularly in the maxilla (upper jaw), premature tooth eruption, increased molarization of premolars, and the presence of hypoplasia. The article then describes a case of the management of a patient diagnosed with Turner's syndrome. The young woman (age 21 years) presented with severe retrognathia, posterior open bite, crossbite on the right side, generalized enamel hypoplasia, shortened roots, thin dentin, compromised dexterity, osteoporosis, mitral valve prolapse, and low self-esteem. The dentist and dental hygienist provided this patient with comprehensive care in consultation with the patient's physician and other dental specialists. A posttest with which readers can obtain continuing education credit is appended to the article. 5 figures. 2 tables. 29 references.

Academic Periodicals covering Mitral Valve Prolapse Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to mitral valve prolapse. In addition to these sources, you can search for articles covering mitral valve prolapse that

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

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to mitral valve prolapse: Caffeine •

Systemic - U.S. Brands: Cafcit; Caffedrine Caplets; Dexitac Stay Alert Stimulant; Enerjets; Keep Alert; Maximum Strength SnapBack Stimulant Powders; NoDoz Maximum Strength Caplets; Pep-Back; Quick Pep; Ultra Pep-Back; Vivarin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html

Nicotine •

Systemic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html

•

Systemic - U.S. Brands: Habitrol; Nicorette; Nicotrol; Prostep http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202407.html

Tiagabine •

Systemic - U.S. Brands: Gabitril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203392.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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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 Institute9: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

9

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/

•

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

•

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/

•

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.10 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:11 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

10

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

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•

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

•

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

The NLM Gateway12 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.13 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “mitral valve prolapse” (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 4137 45 444 3 1 4630

HSTAT14 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.15 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.16 Simply search by “mitral valve prolapse” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

12

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

13

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). 14 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 15 16

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

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

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Coffee Break: Tutorials for Biologists17 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.18 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.19 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

17 Adapted 18

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 19 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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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 mitral valve prolapse 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 mitral valve prolapse. 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 mitral valve prolapse. 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 “mitral valve prolapse”:

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•

Guides on mitral valve prolapse Mitral Valve Prolapse http://www.nlm.nih.gov/medlineplus/mitralvalveprolapse.html Mitral Valve Prolapse http://www.nlm.nih.gov/medlineplus/tutorials/mitralvalveprolapseloader.html

•

Other guides Arrhythmia http://www.nlm.nih.gov/medlineplus/arrhythmia.html Asperger's Syndrome http://www.nlm.nih.gov/medlineplus/aspergerssyndrome.html Congenital Heart Disease http://www.nlm.nih.gov/medlineplus/congenitalheartdisease.html Connective Tissue Disorders http://www.nlm.nih.gov/medlineplus/connectivetissuedisorders.html Heart Diseases http://www.nlm.nih.gov/medlineplus/heartdiseases.html Heart Failure http://www.nlm.nih.gov/medlineplus/heartfailure.html Heart Valve Diseases http://www.nlm.nih.gov/medlineplus/heartvalvediseases.html Kidney Diseases http://www.nlm.nih.gov/medlineplus/kidneydiseases.html Marfan Syndrome http://www.nlm.nih.gov/medlineplus/marfansyndrome.html Tourette Syndrome http://www.nlm.nih.gov/medlineplus/tourettesyndrome.html

Within the health topic page dedicated to mitral valve prolapse, the following was listed: •

General/Overviews Mitral Valve Prolapse http://www.nlm.nih.gov/medlineplus/tutorials/mitralvalveprolapseloader.html Mitral Valve Prolapse: What You Should Know Source: American Academy of Family Physicians http://familydoctor.org/598.xml

•

Diagnosis/Symptoms Echocardiogram Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HB00012

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Treatment Mitral Valve Repair Source: Society of Thoracic Surgeons http://www.sts.org/doc/4107 Mitral Valve Replacement Source: Society of Thoracic Surgeons http://www.sts.org/doc/4101

•

Specific Conditions/Aspects Dental Care and Heart Disease Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4548

•

From the National Institutes of Health Facts About Mitral-Valve Prolapse Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/heart/other/mvp/mvp_fs.htm

•

Men Mitral Valve Prolapse Source: Women's Heart Foundation http://www.womensheartfoundation.org/content/HeartDisease/mitral_valve_pro lapse.asp Mitral Valve Prolapse and Pregnancy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01106

•

Organizations American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=1200000 National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/ Society of Thoracic Surgeons http://www.sts.org/section/stspatientinfo/

•

Women Mitral Valve Prolapse Source: Women's Heart Foundation http://www.womensheartfoundation.org/content/HeartDisease/mitral_valve_pro lapse.asp Mitral Valve Prolapse and Pregnancy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01106

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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 mitral valve prolapse. 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: •

Pediatric Concerns Source: Port Washington, NY: National Marfan Foundation. 2000. [4 p.]. Contact: Available from National Marfan Foundation. 382 Main Street, Port Washington, NY 11050. (800) 862-7326 or (516) 883-8712. Fax (516) 883-8040. E-mail: [email protected]. Website: www.marfan.org. PRICE: Single copy free. Summary: Marfan syndrome is a medical condition that is classified as a heritable disorder of connective tissue. Connective tissue is the glue and scaffolding of the body, and is also important in development before birth, growth after birth, cushioning of joints, and enabling passage of light through the eye. All organs contain connective tissues and the manifestations of the Marfan syndrome appear in many parts of the body. Early diagnosis and management of the Marfan syndrome can save lives. This brochure familiarizes pediatricians with the manifestations of the disorder so that children suspected of having Marfan syndrome can be evaluated in a timely fashion and enrolled in an appropriate treatment plant. Topics include a definition, the causes of Marfan (genetic), the challenges of diagnosing Marfan syndrome in children, diagnostic criteria for Marfan syndrome, related diagnoses (emerging Marfan syndrome, isolated skeletal features, mitral valve prolapse syndrome, MASS phenotype, familial ectopia lentis, familial aortic aneurysm), the principles of follow up and effective management, and the other special needs of children diagnosed with Marfan syndrome, including school issues, physical activity, and social issues. The brochure concludes with a description of the National Marfan Foundation, a nonprofit voluntary health organization dedicated to saving lives and improving the quality of life for people and families affected by the Marfan syndrome and related disorders.

•

Review of PXE for the Pediatrician and Family Practitioner Source: Sharon, MA: PXE International, Inc. 1998. 3 p. Contact: Available from PXE International, Inc. 23 Mountain Street, Sharon, MA 02067. (781) 784-3817. E-mail: [email protected]. Website: www.pxe.org. PRICE: Single copy free. Summary: This fact sheet for health professionals presents a review of pseudoxanthoma elasticum (PXE), a rare, heterogeneous, inherited disorder of elastic fibers in the

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dermatological, ophthalmological, cardiovascular, and gastrointestinal systems. Although the prevalence of PXE is believed to be about 1 in 50,000, it is probably more common because many patients are undiagnosed. Equal numbers of men and women are affected, and the disease is often diagnosed between the ages of 30 and 50. Skin manifestations are usually the most prominent and visible symptoms, and many patients report having had unrecognized symptoms for 10 years or more. Primary PXE lesions are 1-5 millimeter yellow-orange papules of varying shapes. Lesions may form groups and usually progress downward from the neck. Although skin manifestations are the most prominent feature, the ophthalmologic, cardiovascular, and gastrointestinal manifestations are medically more significant. Ocular changes usually occur in adults and include angioid streaks, retinal hemorrhage, and loss of central vision. Cardiovascular problems include coronary artery disease, peripheral artery disease with intermittent claudication, easy fatigability, mitral valve prolapse, and hypertension. Gastrointestinal bleeding is sometimes seen in younger children. The fact sheet also discusses genetic aspects and offers suggestions on caring for patients with PXE and preventing complications. •

Your Child and PXE Source: Sharon, MA: PXE International, Inc. 1998. 4 p. Contact: Available from PXE International, Inc. 23 Mountain Street, Sharon, MA 02067. (781) 784-3817. E-mail: [email protected]. Website: www.pxe.org. PRICE: Single copy free. Summary: This fact sheet for parents of a child with pseudoxanthoma elasticum (PXE) presents an overview of this rare, heterogeneous, inherited disorder that causes calcification of the connective tissue. The skin, retina, and cardiovascular and gastrointestinal systems are most commonly affected. Skin manifestations are usually the most prominent and visible. Primary PXE lesions are 1-5 millimeter yellow-orange papules of varying shapes. Lesions may form groups and usually progress downward from the neck. Although skin manifestations are its most prominent feature, ophthalmologic, cardiovascular, and gastrointestinal manifestations are medically more significant. Ocular changes usually occur in adults and include peau d'orange, angioid streaks, retinal hemorrhage, and loss of central vision. Cardiovascular problems, which are usually not present in children, either include coronary artery disease, peripheral artery disease with intermittent claudication, easy fatigability, mitral valve prolapse, and hypertension. Gastrointestinal bleeding is sometimes seen in younger children, however. The fact sheet also discusses the genetic aspects of PXE, offers suggestions for caring for a child with the disease, and addresses the emotional issues raised when a child is diagnosed. 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 mitral valve prolapse. 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.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to mitral valve prolapse. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with mitral valve prolapse. 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 mitral valve prolapse. 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 “mitral valve prolapse” (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

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the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “mitral valve prolapse”. 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 “mitral valve prolapse” (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 “mitral valve prolapse” (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.20

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

20

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)21: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

21

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

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

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

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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 mitral valve prolapse: •

Basic Guidelines for Mitral Valve Prolapse Marfan syndrome Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000418.htm Mitral stenosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000175.htm Mitral valve prolapse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000180.htm Sle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000435.htm

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Signs & Symptoms for Mitral Valve Prolapse Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm

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Chest discomfort Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Cough Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm Difficulty breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Dyspnea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Hemoptysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003073.htm Irregular heartbeat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Low blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Orthopnea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003076.htm Palpitations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Pectus excavatum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003320.htm Shortness of breath Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Swelling of feet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003104.htm Syncope Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm

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Diagnostics and Tests for Mitral Valve Prolapse Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Chest MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003794.htm Chest X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm Chest X-rays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm Contraction Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003405.htm CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003330.htm CT scan of the chest Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003788.htm Doppler ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003775.htm ECG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm Echocardiogram Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm Echocardiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm Heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003335.htm Nuclear ventriculography (MUGA or RNV) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003822.htm Right heart catheterization Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003870.htm Stress test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003878.htm Ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003336.htm

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X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm •

Surgery and Procedures for Mitral Valve Prolapse Heart valve surgery Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002954.htm Valve replacement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002954.htm

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Background Topics for Mitral Valve Prolapse Benign Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002236.htm Blood clots Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Clot Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Emboli Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Heart disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Heart diseases Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Invasive Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002384.htm Palpation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002284.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm Symptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002293.htm

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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

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

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

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

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MITRAL VALVE PROLAPSE 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] Ablation: The removal of an organ by surgery. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [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] Adenine: A purine base and a fundamental unit of adenine nucleotides. [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] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [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] 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] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure

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and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Alprenolol: 1-((1-Methylethyl)amino)-3-(2-(2-propenyl)phenoxy)-2-propanol. Adrenergic beta-blocker used as an antihypertensive, anti-anginal, and anti-arrhythmic agent. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] 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] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH]

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Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angioid Streaks: Small breaks in the elastin-filled tissue of the retina. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Angulation: Deviation from the normal long axis, as in a fractured bone healed out of line. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [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] 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] 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] Antihypertensive: An agent that reduces high blood pressure. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH]

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Arrhythmogenic: Producing or promoting arrhythmia. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]

Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuated: Strain with weakened or reduced virulence. [NIH] Auscultation: Act of listening for sounds within the body. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Avian: A plasmodial infection in birds. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] 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] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bilateral: Affecting both the right and left side of body. [NIH] 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

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clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] 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] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents,

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and in the relaxation of uterine spasms. [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] Cardiac: Having to do with the heart. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiotoxicity: Toxicity that affects the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] 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] Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and

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secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [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] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell 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] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Central retinal artery: The blood vessel that carries blood into eye; supplies nutrition to the retina. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] 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] Chest cavity: Space in body surrounding the lungs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chordae Tendineae: The tendinous cords that connect each cusp of the two atrioventricular valves to appropriate papillary muscles in the heart ventricles, preventing the valves from reversing themselves when the ventricles contract. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH]

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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 Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [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] Claudication: Limping or lameness. [EU] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clindamycin: An antibacterial agent that is a semisynthetic analog of lincomycin. [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] 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] Codon: A set of three nucleotides in a protein coding sequence that specifies individual amino acids or a termination signal (codon, terminator). Most codons are universal, but some organisms do not produce the transfer RNAs (RNA, transfer) complementary to all codons. These codons are referred to as unassigned codons (codons, nonsense). [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH]

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Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH]

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Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone 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] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]

Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] 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] Criterion: A standard by which something may be judged. [EU] 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] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] 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] Dental Hygienists: Persons trained in an accredited school or dental college and licensed by

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the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Dexterity: Ability to move the hands easily and skillfully. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] 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] Diuresis: Increased excretion of urine. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dobutamine: A beta-2 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery. [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] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Ductus Arteriosus: A fetal blood vessel connecting the pulmonary artery with the descending aorta. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Ectopia Lentis: Congenital displacement of the lens resulting from defective zonule

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formation. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [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] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrocardiograph: Apparatus which, by means of currents produced by contractions of the cardiac muscle, records heart movements as electro-cardiograms. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat hypertension. [NIH]

Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.

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[NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] 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] Epidural block: An injection of an anesthetic drug into the space between the wall of the spinal canal and the covering of the spinal cord. [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] 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 Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [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 Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.

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[NIH]

Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Fibril: Most bacterial viruses have a hollow tail with specialized fibrils at its tip. The tail fibers attach to the cell wall of the host. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] 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] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [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] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genotype: The genetic constitution of the individual; the characterization of the genes. [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] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [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;

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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] Heart Catheterization: Procedure which includes placement of catheter, recording of intracardiac and intravascular pressure, obtaining blood samples for chemical analysis, and cardiac output measurement, etc. Specific angiographic injection techniques are also involved. [NIH] Heart Murmurs: Abnormal heart sounds heard during auscultation caused by alterations in the flow of blood into a chamber, through a valve, or by a valve opening or closing abnormally. They are classified by the time of occurrence during the cardiac cycle, the duration, and the intensity of the sound on a scale of I to V. [NIH] Heart Sounds: The sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of systole and is heard as a "lubb" sound; the second is produced by the closing of the aortic and pulmonary valves and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the atria; and the fourth is produced by atrial contraction and ventricular filling but is rarely audible in the normal heart. The physiological concept of heart sounds is differentiated from the pathological heart murmurs. [NIH]

Heartbeat: One complete contraction of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] 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] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin

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help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydralazine: A direct-acting vasodilator that is used as an antihypertensive agent. [NIH] Hydration: Combining with water. [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] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [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] Hypertrophic cardiomyopathy: Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypotension: Abnormally low blood pressure. [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] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [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] Immunology: The study of the body's immune system. [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] Incision: A cut made in the body during surgery. [NIH]

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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 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] 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]

Inferior vena cava: A large vein that empties into the heart. It carries blood from the legs and feet, and from organs in the abdomen and pelvis. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [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-10: Factor that is a coregulator of mast cell growth. It is produced by T-cells and B-cells and shows extensive homology with the Epstein-Barr virus BCRFI gene. [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] Interleukin-4: Soluble factor produced by activated T-lymphocytes that causes proliferation and differentiation of B-cells. Interleukin-4 induces the expression of class II major histocompatibility complex and Fc receptors on B-cells. It also acts on T-lymphocytes, mast cell lines, and several other hematopoietic lineage cells including granulocyte, megakaryocyte, and erythroid precursors, as well as macrophages. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

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Involuntary: Reaction occurring without intention or volition. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratoconus: A disorder characterized by an irregular corneal surface (cone-shaped) resulting in blurred and distorted images. [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 Transplantation: The transference of a kidney from one human or animal to another. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [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] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Lincomycin: (2S-trans)-Methyl 6,8-dideoxy-6-(((1-methyl-4-propyl-2pyrrolidinyl)carbonyl)amino)-1-thio-D-erythro-alpha-D-galacto-octopyranoside. An antibiotic produced by Streptomyces lincolnensis var. lincolnensis. It has been used in the treatment of staphylococcal, streptococcal, and Bacteroides fragilis infections. [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a

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factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [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] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Lordosis: The anterior concavity in the curvature of the lumbar and cervical spine as viewed from the side. The term usually refers to abnormally increased curvature (hollow back, saddle back, swayback). It does not include lordosis as normal mating posture in certain animals ( = posture + sex behavior, animal). [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

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] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [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] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU]

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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] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] 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] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metoprolol: Adrenergic beta-1-blocking agent with no stimulatory action. It is less bound to plasma albumin than alprenolol and may be useful in angina pectoris, hypertension, or cardiac arrhythmias. [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] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microfibrils: Components of the extracellular matrix consisting primarily of fibrillin. They are essential for the integrity of elastic fibers. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mitral Valve Prolapse: Abnormal protrusion of one or both of the leaflets of the mitral valve into the left atrium during systole. This may be accompanied by mitral regurgitation, systolic murmur, nonejection click, or cardiac arrhythmia. [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] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the

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body. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [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] Muscle Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] 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] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis,

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as the neutral arch. [EU] Neurocirculatory Asthenia: A clinical syndrome characterized by palpitation, shortness of breath, labored breathing, subjective complaints of effort and discomfort, all following slight exertion. Other symptoms may be dizziness, tremulousness, sweating, and insomnia. Neurocirculatory asthenia is most typically seen as a form of anxiety disorder. [NIH] Neurologic: Having to do with nerves or 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] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Nipples: The conic organs which usually give outlet to milk from the mammary glands. [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] 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] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ophthalmic: Pertaining to the eye. [EU] Ophthalmic Artery: Artery originating from the internal carotid artery and distributing to the eye, orbit and adjacent facial structures. [NIH] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] 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] Opsin: A visual pigment protein found in the retinal rods. It combines with retinaldehyde to form rhodopsin. [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] Orderly: A male hospital attendant. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outer ear: The pinna and external meatus of the ear. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH]

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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]

Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpitation: A subjective sensation of an unduly rapid or irregular heart beat. [EU] Pancreatic: Having to do with the pancreas. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Papillary Muscles: Conical muscular projections from the walls of the cardiac ventricles, attached to the cusps of the atrioventricular valves by the chordae tendineae. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patent ductus arteriosus: Abnormal persistence of the opening in the arterial duct that connects the pulmonary artery to the descending aorta; this opening normally closes within 24 hours of birth. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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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] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peau d'orange: A dimpled condition of the skin of the breast, resembling the skin of an orange, sometimes found in inflammatory breast cancer. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [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]

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] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] Phonocardiography: Graphic registration of the heart sounds picked up as vibrations and transformed by a piezoelectric crystal microphone into a varying electrical output according to the stresses imposed by the sound waves. The electrical output is amplified by a stethograph amplifier and recorded by a device incorporated into the electrocardiograph or by a multichannel recording machine. [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] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of

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organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumothorax: Accumulation of air or gas in the space between the lung and chest wall, resulting in partial or complete collapse of the lung. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] 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] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [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] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH]

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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] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [NIH]

Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] 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] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]

Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Pseudoxanthoma Elasticum: A rare, progressive inherited disorder resulting from extensive basophilic degeneration of elastic tissue, usually presenting after puberty and involving the skin, eye, and cardiovascular system. Characteristic manifestations are small, circumscribed yellowish patches at sites of considerable movement of the skin, angioid streaks in the retina, and a tendency towards hemorrhage and arterial insufficiency. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH]

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Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

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] 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]

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] 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] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radioisotope Renography: Graphic tracing over a time period of radioactivity measured externally over the kidneys following intravenous injection of a radionuclide which is taken up and excreted by the kidneys. [NIH] Radionuclide Angiography: The measurement of visualization by radiation of any organ after a radionuclide has been injected into its blood supply. It is used to diagnose heart, liver, lung, and other diseases and to measure the function of those organs, except renography, for which radioisotope renography is available. [NIH] Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [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] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression

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(see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]

Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [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] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Artery: Central retinal artery and its branches. It arises from the ophthalmic artery, pierces the optic nerve and runs through its center, enters the eye through the porus opticus and branches to supply the retina. [NIH] Retinal Artery Occlusion: Occlusion or closure of the central retinal artery causing sudden, usually nearly complete, loss of vision in one eye. Occlusion of the branch retinal artery causes sudden visual loss in only a portion of the visual field. [NIH] Retinal Hemorrhage: Bleeding from the vessels of the retina. [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] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Ribonuclease: RNA-digesting enzyme. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rods: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide side vision and the ability to see objects in dim light (night vision). [NIH]

Dictionary 135

Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scoliosis: A lateral curvature of the spine. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seasonal Affective Disorder: A syndrome characterized by depressions that recur annually at the same time each year, usually during the winter months. Other symptoms include anxiety, irritability, decreased energy, increased appetite (carbohydrate cravings), increased duration of sleep, and weight gain. SAD (seasonal affective disorder) can be treated by daily exposure to bright artificial lights (phototherapy), during the season of recurrence. [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] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [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] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] 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] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septum: A dividing wall or partition; a general term for such a structure. The term is often used alone to refer to the septal area or to the septum pellucidum. [EU] Septum Pellucidum: A triangular double membrane separating the anterior horns of the lateral ventricles of the brain. It is situated in the median plane and bounded by the corpus callosum and the body and columns of the fornix. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Behavior: Sexual activities of humans. [NIH]

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Sex Behavior, Animal: Sexual activities of animals. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] 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] Skin Manifestations: Dermatologic disorders attendant upon non-dermatologic disease or injury. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [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] 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] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] 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] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH]

Dictionary 137

Standardize: To compare with or conform to a standard; to establish standards. [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]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stridor: The loud, harsh, vibrating sound produced by partial obstruction of the larynx or trachea. [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] 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]

Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire 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] Systole: Period of contraction of the heart, especially of the ventricles. [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] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of

138 Mitral Valve Prolapse

extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [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] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroiditis: Inflammation of the thyroid gland. [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] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tonicity: The normal state of muscular tension. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH]

Dictionary 139

Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transient Ischemic Attacks: Focal neurologic abnormalities of sudden onset and brief duration that reflect dysfunction in the distribution of the internal carotid-middle cerebral or the vertebrobasilar arterial system. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Tricuspid Valve: The valve consisting of three cusps situated between the right atrium and right ventricle of the heart. [NIH] Tricuspid Valve Prolapse: Abnormal protrusion of one or more of the leaflets of the tricuspid valve into the right atrium during systole. [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] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [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] 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] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [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] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a

140 Mitral Valve Prolapse

decreased functionality. [NIH] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] 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] Vivo: Outside of or removed from the body of a living organism. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

141

INDEX A Abdominal, 107, 129 Ablation, 48, 107 Abscess, 107, 135 Acceptor, 107, 129 Adenine, 11, 107 Adenosine, 107, 111, 130 Adrenal Cortex, 107, 108 Adrenal Medulla, 107, 112, 119, 128 Adrenergic, 43, 107, 108, 109, 119, 126, 132 Adverse Effect, 107, 136 Aerobic, 107, 119 Affinity, 107, 136 Agonist, 107, 117 Albumin, 107, 126 Aldosterone, 47, 108 Alertness, 108, 111 Algorithms, 108, 111 Alkaline, 108, 111, 138 Alkalosis, 108, 138 Alprenolol, 108, 126 Alternative medicine, 59, 62, 72, 108, 115 Amino Acid Sequence, 108, 109 Amino Acids, 108, 109, 114, 119, 130, 131, 132, 139 Amoxicillin, 5, 108 Ampicillin, 108 Anaesthesia, 108, 123 Analog, 108, 114 Anatomical, 9, 108, 110, 118, 122, 135 Anemia, 6, 108 Anesthesia, 5, 34, 52, 108, 109 Aneurysm, 17, 20, 21, 32, 56, 68, 90, 108, 109 Angina, 108, 109, 126, 132 Angina Pectoris, 109, 126, 132 Angioid Streaks, 91, 109, 132 Angiotensinogen, 12, 109, 134 Angulation, 53, 109 Antagonism, 109, 111 Anti-Anxiety Agents, 109, 131 Antibacterial, 109, 114, 136 Antibiotic, 3, 4, 5, 12, 23, 31, 108, 109, 111, 119, 124, 130, 131, 136 Antibiotic Prophylaxis, 4, 23, 31, 109, 131 Antibodies, 8, 109, 121, 126, 131 Antibody, 107, 109, 115, 121, 122, 123 Antigen, 107, 109, 115, 121, 123, 126

Antihypertensive, 108, 109, 122 Anxiety, 5, 9, 49, 51, 60, 61, 101, 109, 128, 129, 131, 132, 135 Anxiety Disorders, 49, 109, 129 Aorta, 20, 109, 112, 117, 129, 139 Aortic Aneurysm, 68, 90, 109 Arrhythmia, 13, 52, 88, 109, 110, 126 Arrhythmogenic, 48, 110 Arterial, 110, 122, 129, 132, 137, 139 Arteries, 24, 42, 109, 110, 111, 116, 124, 126, 127 Arteriosus, 110, 117, 133 Asthenia, 20, 27, 110, 128 Asymptomatic, 22, 29, 40, 110 Atrial, 8, 13, 17, 32, 49, 56, 70, 110, 121 Atrial Fibrillation, 17, 49, 110 Atrioventricular, 11, 32, 110, 113, 129, 137 Atrioventricular Node, 110, 137 Atrium, 28, 110, 112, 126, 137, 139 Attenuated, 17, 56, 59, 110 Auscultation, 13, 69, 110, 121 Autonomic, 13, 28, 52, 56, 110, 128 Avian, 7, 110 B Bacteremia, 5, 110 Bacteria, 109, 110, 118, 121, 136 Bacteriostatic, 110, 119 Base, 107, 108, 110, 124 Basement Membrane, 110, 119 Benign, 13, 38, 51, 67, 72, 104, 110, 120 Bilateral, 7, 14, 110 Biotechnology, 10, 67, 72, 83, 110 Bladder, 4, 111, 139 Blood Coagulation, 111 Blood Glucose, 6, 111, 121 Blood pressure, 16, 66, 102, 103, 109, 111, 122, 127, 136 Blood vessel, 111, 112, 113, 117, 124, 130, 136, 137, 138, 139 Body Fluids, 108, 111, 117, 136 Body Mass Index, 111, 128 Branch, 99, 111, 118, 126, 128, 130, 134, 136, 138 Broad-spectrum, 108, 111 Bronchitis, 111, 114 C Caffeine, 6, 9, 76, 111 Calcification, 8, 91, 111

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Calcium, 9, 111, 115, 126, 138 Calcium channel blocker, 9, 111 Calcium Channel Blockers, 9, 111 Carbohydrate, 112, 135 Cardiac, 4, 5, 8, 18, 29, 30, 33, 38, 45, 56, 60, 110, 111, 112, 117, 118, 119, 121, 126, 127, 129, 137 Cardiac catheterization, 29, 112 Cardiac Output, 112, 121 Cardiomyopathy, 25, 26, 29, 30, 48, 112, 122 Cardiopulmonary, 41, 112 Cardiopulmonary Bypass, 41, 112 Cardioselective, 112, 132 Cardiotonic, 112, 117 Cardiotoxicity, 15, 112 Cardiovascular, 7, 15, 17, 23, 30, 39, 48, 53, 61, 62, 68, 91, 112, 119, 132 Cardiovascular System, 112, 132 Carnitine, 58, 112 Carotene, 112, 134 Case report, 14, 41, 112, 114 Case series, 112, 114 Case-Control Studies, 8, 112 Catecholamine, 45, 112, 117 Catheterization, 29, 53, 103, 112, 113, 121 Caudal, 113, 131 Causal, 113, 121 Cell, 7, 107, 110, 111, 113, 114, 115, 119, 120, 123, 125, 127, 130, 131, 133, 134, 135, 140 Cell Division, 110, 113, 130, 135 Cell membrane, 111, 113 Central Nervous System, 111, 113, 121, 128 Central Nervous System Infections, 113, 121 Central retinal artery, 113, 134 Cerebral, 15, 16, 38, 47, 113, 119, 120, 139 Cerebrovascular, 111, 113 Cerebrum, 113 Cervical, 6, 113, 125 Cervix, 113 Chest cavity, 72, 113 Chest Pain, 6, 9, 23, 32, 41, 113 Chest wall, 6, 113, 131 Cholesterol, 113, 122 Chordae Tendineae, 47, 113, 129 Choroid, 113, 116, 134 Chromosome, 11, 114, 125, 135 Chronic, 4, 5, 6, 22, 38, 61, 114, 118, 123, 124, 131, 135, 137

Chronic Fatigue Syndrome, 5, 114 Chronic Obstructive Pulmonary Disease, 38, 114 Chronic renal, 114, 131 Circadian, 13, 114 CIS, 114, 134 Claudication, 91, 114 Cleft Palate, 73, 114 Clindamycin, 5, 114 Clinical study, 16, 114 Clinical trial, 7, 83, 114, 133 Cloning, 111, 114 Coagulation, 111, 114, 138 Codon, 49, 114 Cofactor, 114, 132 Collagen, 27, 32, 110, 114, 132 Collapse, 115, 131 Complement, 115, 125 Complementary and alternative medicine, 59, 62, 115 Complementary medicine, 59, 115 Computational Biology, 83, 115 Conception, 115, 116 Conduction, 10, 110, 115 Cone, 115, 124 Connective Tissue, 7, 26, 68, 88, 90, 91, 114, 115, 116, 120, 125, 126, 137 Connective Tissue Cells, 115, 116 Constitutional, 46, 116 Constriction, 116, 124, 139 Consultation, 8, 73, 116 Consumption, 6, 116, 119, 129, 134 Continuum, 68, 116 Contraceptive, 66, 116 Contractility, 116, 118 Contraindications, ii, 116 Conus, 116, 133 Coronary, 12, 14, 18, 24, 42, 91, 109, 110, 116, 126, 127 Coronary Thrombosis, 116, 126, 127 Cranial, 116, 120, 128 Craniocerebral Trauma, 116, 121 Criterion, 4, 116 Curative, 116, 138 Cutaneous, 49, 116, 125 Cyclic, 111, 116 D Data Collection, 8, 116 Databases, Bibliographic, 83, 116 Dehydration, 4, 6, 27, 116 Deletion, 12, 116 Dental Hygienists, 73, 116

Index 143

Dentists, 4, 117 Depersonalization, 117, 129 Derealization, 117, 129 Dexterity, 73, 117 Diagnostic procedure, 72, 117 Diastole, 117 Diastolic, 19, 20, 36, 117, 122 Dilatation, 7, 15, 68, 108, 117 Direct, iii, 75, 117, 122, 126, 133 Dissection, 68, 117 Distal, 73, 117, 132 Diuresis, 111, 117 Dizziness, 9, 117, 128, 129 Dobutamine, 12, 117 Dorsal, 7, 117, 131 Dorsum, 117 Drug Interactions, 76, 117 Duct, 113, 117, 129, 135 Ductus Arteriosus, 43, 117, 129 Duodenum, 117, 120, 137 Dysplasia, 24, 117 Dyspnea, 102, 117, 129 Dystrophy, 21, 117 E Echocardiography, 8, 11, 12, 19, 21, 22, 23, 25, 31, 32, 40, 44, 49, 50, 51, 103, 117 Ectopia Lentis, 68, 90, 117 Edema, 73, 118 Efficacy, 4, 118 Ejection fraction, 8, 118 Elastin, 109, 114, 118 Electrocardiogram, 18, 45, 118 Electrocardiograph, 118, 130 Electrolyte, 108, 118, 131, 136 Electrons, 110, 118, 129, 133 Electrophysiological, 118, 140 Emboli, 37, 104, 118 Embolus, 118, 123 Embryo, 8, 118, 123 Emphysema, 114, 118 Enalapril, 22, 118 Enamel, 73, 118 Endocarditis, 4, 5, 12, 13, 18, 23, 28, 32, 37, 40, 41, 118 Endocardium, 118 End-stage renal, 114, 118, 131 Environmental Health, 82, 84, 118 Enzymatic, 111, 112, 115, 119, 120, 134 Enzyme, 12, 118, 119, 133, 134 Epidermal, 119, 126 Epidural, 15, 119 Epidural block, 15, 119

Epinephrine, 107, 119, 128 Erythrocytes, 108, 119, 121 Erythromycin, 5, 119 Esophageal, 13, 23, 46, 119 Esophageal Stricture, 13, 119 Esophagus, 23, 119, 121, 137 Exercise Test, 42, 119 Extracellular, 7, 115, 119, 126, 136, 138 Extracellular Matrix, 7, 115, 119, 126 Extracellular Space, 119 F Family Planning, 83, 119 Fat, 112, 118, 119, 128 Fatigue, 4, 5, 9, 102, 114, 119 Femoral, 112, 120 Femoral Artery, 112, 120 Fibril, 8, 120 Fibrillation, 17, 48, 49, 52, 56, 110, 120, 140 Fibrin, 111, 120, 138 Fibrinolytic, 20, 120 Fibrosis, 24, 120, 135 Fissure, 114, 120 Fistula, 14, 120 Foramen, 8, 37, 120, 126 Forearm, 111, 120 G Gas, 120, 122, 131 Gastric, 108, 112, 120, 121 Gastric Acid, 108, 120 Gastrin, 120, 121 Gastroduodenal, 45, 120 Gastrointestinal, 13, 91, 119, 120, 137 Gene, 11, 12, 17, 35, 49, 67, 68, 111, 120, 123, 135 Genotype, 120, 130 Gland, 7, 107, 120, 122, 125, 129, 135, 138 Governing Board, 120, 131 Graft, 120, 122 Grafting, 120, 122 Growth, 8, 33, 35, 90, 109, 110, 120, 123, 130, 138, 139 H Headache, 4, 60, 111, 120, 121 Headache Disorders, 121 Heart Catheterization, 103, 121 Heart Murmurs, 3, 121 Heart Sounds, 121, 130 Heartbeat, 102, 121, 137, 140 Heartburn, 4, 121 Hemodynamics, 52, 121 Hemoglobin, 108, 119, 121 Hemolysis, 26, 121

144 Mitral Valve Prolapse

Hemorrhage, 91, 116, 120, 121, 132, 134, 137 Heredity, 120, 121 Homogeneous, 116, 121 Homologous, 121, 135 Hormone, 49, 108, 119, 120, 121, 138 Host, 4, 22, 28, 120, 122, 140 Hydralazine, 29, 122 Hydration, 22, 122 Hydrogen, 107, 110, 112, 122, 127, 129, 130 Hydroxylysine, 114, 122 Hydroxyproline, 114, 122 Hypercholesterolemia, 30, 122 Hypertension, 62, 66, 91, 111, 118, 121, 122, 126, 132 Hyperthyroidism, 26, 122, 132 Hypertrophic cardiomyopathy, 30, 122 Hypertrophy, 8, 122 Hypoplasia, 73, 122 Hypotension, 43, 122 Hypothyroidism, 6, 122 I Id, 57, 61, 88, 89, 92, 98, 100, 122 Idiopathic, 6, 12, 31, 36, 37, 44, 45, 46, 122 Immune system, 122, 125, 140 Immunofluorescence, 122, 126 Immunology, 28, 107, 122 Impairment, 122, 126 Implantation, 37, 115, 122 Incision, 122, 123 Indicative, 66, 123, 130, 139 Induction, 52, 123 Infarction, 8, 34, 35, 116, 117, 123, 126, 127, 132 Infection, 6, 66, 107, 110, 123, 125, 128, 130, 137, 140 Inferior vena cava, 50, 123 Inflammation, 108, 111, 120, 123, 137, 138 Ingestion, 61, 123, 138 Insomnia, 123, 128 Interleukin-1, 35, 123 Interleukin-10, 35, 123 Interleukin-2, 123 Interleukin-4, 35, 123 Intermittent, 32, 91, 123 Intestines, 107, 120, 123, 135 Intracellular, 111, 123, 131 Intravascular, 121, 123 Intravenous, 4, 123, 133 Invasive, 5, 104, 123 Involuntary, 120, 124, 127, 136 Ischemia, 38, 61, 109, 124

Ischemic stroke, 8, 124 J Joint, 4, 32, 33, 34, 56, 124, 137 K Kb, 82, 124 Keratoconus, 34, 124 Kidney Disease, 65, 82, 88, 124 Kidney Transplantation, 66, 124 L Latent, 36, 124 Least-Squares Analysis, 124, 133 Lens, 117, 124, 140 Lesion, 124, 125 Lethargy, 122, 124 Library Services, 98, 124 Life Expectancy, 68, 124 Ligaments, 116, 124 Likelihood Functions, 124, 134 Lincomycin, 114, 124 Linear Models, 124, 133 Linkage, 27, 125 Liver, 107, 108, 112, 125, 133 Localization, 53, 125 Localized, 123, 125, 130, 135 Logistic Models, 125, 134 Lordosis, 6, 125 Lumbar, 6, 125 Lupus, 26, 38, 125, 126, 137 Lymph, 113, 125 Lymph node, 113, 125 Lymphatic, 123, 125 Lymphocytic, 44, 125 Lymphoid, 109, 125 M Macrophage, 123, 125 Major Histocompatibility Complex, 123, 125 Mammary, 125, 128 Mammogram, 111, 125, 126 Manifest, 7, 125 Meatus, 126, 128 Medical Records, 4, 126 MEDLINE, 83, 126 Membrane, 110, 113, 115, 119, 126, 134, 135, 140 Menopause, 126, 131, 132 Mental Retardation, 15, 126 Metabolite, 126, 131, 133 Metastasis, 126 Metastatic, 30, 126 Metoprolol, 50, 126 MI, 43, 105, 126

Index 145

Microcalcifications, 111, 126 Microfibrils, 7, 126 Microscopy, 7, 110, 126 Millimeter, 91, 126 Mixed Connective Tissue Disease, 126 Mobility, 34, 126 Mobilization, 6, 126 Modification, 8, 127, 133 Molecular, 83, 85, 111, 115, 127 Molecule, 109, 110, 115, 127, 129, 133 Monitor, 7, 8, 127, 128 Monocytes, 123, 127 Mood Disorders, 6, 127 Morphogenesis, 7, 127 Morphological, 118, 127 Morphology, 31, 127 Muscle Tonus, 6, 127 Muscular Dystrophies, 117, 127 Myocardial infarction, 8, 34, 116, 117, 126, 127, 132 Myocardium, 21, 109, 126, 127 N Nausea, 127, 129 Necrosis, 123, 126, 127 Need, 3, 47, 65, 68, 73, 93, 107, 114, 127 Neonatal, 7, 127 Nephropathy, 124, 127 Nerve, 107, 108, 127, 128, 134, 135 Nervous System, 111, 113, 121, 127, 128, 137 Neural, 42, 127 Neurocirculatory Asthenia, 20, 27, 128 Neurologic, 41, 109, 128, 139 Neuropathy, 35, 128 Neurosis, 60, 128 Nipples, 73, 128 Norepinephrine, 107, 128 Nuclear, 25, 103, 118, 126, 127, 128 O Ocular, 7, 43, 68, 91, 128 Ophthalmic, 128, 134 Ophthalmic Artery, 128, 134 Ophthalmologic, 91, 128 Ophthalmology, 14, 34, 128 Opsin, 128, 134 Optic Nerve, 128, 134 Orderly, 8, 128 Osteoporosis, 73, 128 Outer ear, 73, 128 Outpatient, 44, 49, 128 Overweight, 4, 57, 128 Oxidation, 6, 107, 129

Oxygen Consumption, 119, 129, 134 Oxygenator, 112, 129 P Pacemaker, 15, 129 Palate, 73, 114, 129 Palliative, 129, 138 Palpitation, 128, 129 Pancreatic, 112, 129 Panic, 5, 9, 12, 14, 19, 26, 41, 50, 51, 60, 129 Panic Disorder, 5, 12, 26, 50, 60, 129 Papilla, 129 Papillary, 21, 23, 113, 129 Papillary Muscles, 113, 129 Parathyroid, 129, 138 Paresthesias, 129 Paroxysmal, 38, 109, 121, 129 Patent ductus arteriosus, 43, 129 Pathogenesis, 68, 129 Pathologic, 116, 130, 139 Patient Education, 90, 96, 98, 105, 130 Peau d'orange, 91, 130 Penicillin, 5, 108, 109, 130 Peptide, 130, 131, 132, 138 Perforation, 120, 130 Perfusion, 24, 48, 53, 130 Pericardium, 130, 137 PH, 41, 48, 130 Pharmacologic, 108, 130, 138 Phenotype, 68, 90, 130 Phonocardiography, 25, 130 Phosphorus, 111, 130 Phototherapy, 130, 135 Physical Examination, 3, 130 Physiologic, 20, 107, 130, 133 Physiology, 7, 56, 66, 112, 118, 130 Pigments, 112, 130, 134 Plants, 127, 128, 130, 138 Plasma, 45, 107, 109, 113, 121, 126, 131, 134 Plasma cells, 109, 131 Platelets, 131, 138 Pneumothorax, 42, 43, 131 Polycystic, 65, 131 Polymorphism, 11, 12, 131 Polypeptide, 108, 114, 131 Posterior, 51, 73, 110, 113, 117, 129, 131 Postmenopausal, 128, 131 Potassium, 108, 131 Potentiates, 123, 131 Practice Guidelines, 84, 131 Precursor, 109, 119, 128, 131, 139 Predictive factor, 16, 131

146 Mitral Valve Prolapse

Premedication, 4, 131 Prenatal, 118, 131 Prevalence, 8, 27, 32, 38, 44, 49, 68, 91, 131 Prodrug, 131, 133 Progression, 8, 24, 37, 47, 132 Progressive, 26, 114, 120, 127, 132 Proline, 114, 122, 132 Prophylaxis, 4, 5, 12, 18, 23, 31, 109, 117, 131, 132 Proportional, 9, 132 Propranolol, 13, 132 Prospective study, 8, 36, 132 Protective Agents, 111, 132 Protein C, 108, 114, 132 Protein S, 67, 111, 119, 132 Proteins, 7, 108, 109, 113, 114, 115, 119, 123, 127, 130, 131, 132, 135, 138 Proximal, 16, 117, 132, 135 Pseudoxanthoma, 90, 91, 132 Pseudoxanthoma Elasticum, 90, 91, 132 Psychiatric, 5, 49, 132 Psychiatry, 14, 19, 41, 50, 51, 60, 132 Psychic, 128, 132, 135 Puberty, 132 Public Policy, 83, 132 Publishing, 5, 10, 133 Pulmonary, 6, 14, 38, 62, 111, 114, 116, 117, 119, 121, 129, 133, 139 Pulmonary Artery, 38, 111, 117, 129, 133, 139 Pulse, 127, 133 Q Quality of Life, 90, 133 R Race, 8, 133 Radiation, 109, 133 Radioactive, 122, 128, 133 Radioisotope, 133 Radioisotope Renography, 133 Radionuclide Angiography, 25, 133 Ramipril, 22, 133 Randomized, 118, 133 Receptor, 11, 17, 35, 49, 109, 115, 133 Recur, 133, 135 Recurrence, 133, 135 Refer, 1, 115, 117, 125, 133, 135 Refraction, 133, 136 Regimen, 118, 133 Regression Analysis, 9, 133 Regurgitation, 17, 22, 23, 25, 27, 29, 31, 36, 37, 38, 40, 44, 46, 47, 48, 50, 59, 67, 70, 121, 126, 134

Reliability, 3, 19, 134 Renin, 47, 109, 134 Respiration, 127, 134 Retina, 91, 109, 113, 116, 124, 128, 132, 134, 140 Retinal, 14, 91, 113, 115, 128, 134 Retinal Artery, 14, 113, 134 Retinal Artery Occlusion, 14, 134 Retinal Hemorrhage, 91, 134 Retinol, 134 Retrograde, 20, 134 Ribonuclease, 126, 134 Risk factor, 4, 8, 11, 31, 47, 125, 132, 134 Rods, 128, 134 S Saline, 126, 135 Saliva, 135 Salivary, 7, 135 Schizophrenia, 38, 135 Scleroderma, 126, 135 Sclerosis, 26, 135 Scoliosis, 6, 31, 135 Screening, 66, 114, 135 Seasonal Affective Disorder, 6, 135 Secretion, 122, 135 Sedentary, 6, 135 Segmental, 8, 135 Segmentation, 135 Segregation, 27, 135 Seizures, 129, 135 Self Care, 65, 135 Semisynthetic, 108, 114, 135 Senile, 128, 135 Septal, 17, 32, 56, 135 Septum, 24, 110, 135 Septum Pellucidum, 135 Serum, 107, 108, 115, 126, 135 Sex Behavior, 125, 135, 136 Sex Behavior, Animal, 125, 136 Side effect, 5, 75, 107, 136, 138 Skeletal, 7, 68, 90, 127, 136 Skeleton, 124, 136 Skin Manifestations, 91, 136 Small intestine, 117, 122, 123, 136 Smooth muscle, 111, 116, 136, 137 Social Environment, 133, 136 Social Support, 9, 136 Sodium, 9, 108, 136 Sound wave, 115, 130, 136 Spasm, 136, 138 Spatial disorientation, 117, 136 Specialist, 92, 136

Index 147

Species, 119, 133, 136, 139, 140 Spectrum, 30, 48, 108, 111, 136 Sperm, 114, 136 Spinal cord, 113, 119, 127, 128, 136 Standardize, 4, 137 Stimulant, 76, 111, 117, 137 Stomach, 107, 119, 120, 122, 123, 127, 136, 137 Stress, 5, 6, 7, 12, 15, 28, 102, 103, 113, 127, 137 Stridor, 137, 138 Stroke, 8, 11, 15, 16, 38, 47, 48, 82, 112, 124, 137 Subacute, 123, 137 Subarachnoid, 120, 137 Subclinical, 8, 123, 135, 137 Subcutaneous, 118, 137 Substance P, 119, 126, 135, 137 Sudden death, 15, 48, 137 Supplementation, 17, 56, 59, 137 Support group, 24, 60, 137 Supraventricular, 13, 14, 38, 45, 137 Symptomatic, 18, 22, 24, 25, 36, 40, 56, 61, 104, 109, 137 Systemic, 26, 38, 76, 109, 111, 119, 121, 123, 126, 135, 137 Systemic lupus erythematosus, 26, 38, 126, 137 Systole, 16, 121, 126, 137, 139 Systolic, 11, 12, 26, 27, 29, 45, 50, 122, 126, 137 T Tachycardia, 14, 38, 40, 48, 110, 117, 137 Tachypnea, 110, 137 Terminator, 114, 137 Tetany, 36, 129, 137 Therapeutics, 76, 138 Thoracic, 6, 17, 24, 33, 47, 89, 138, 140 Thorax, 125, 138 Threshold, 122, 138 Thrombosis, 20, 116, 126, 127, 132, 137, 138 Thrombus, 70, 116, 123, 124, 138 Thyroid, 35, 49, 122, 129, 138 Thyroid Gland, 122, 129, 138 Thyroid Hormones, 138 Thyroiditis, 34, 44, 138 Thyrotropin, 17, 122, 138 Thyroxine, 108, 138 Tonicity, 121, 138

Torsion, 123, 138 Toxic, iv, 128, 138 Toxicity, 112, 117, 138 Toxicology, 84, 138 Toxins, 109, 123, 138 Trachea, 137, 138 Traction, 6, 23, 138 Transfection, 111, 139 Transient Ischemic Attacks, 20, 139 Translation, 119, 139 Translocation, 119, 139 Tricuspid Valve, 10, 21, 29, 139 Tricuspid Valve Prolapse, 29, 139 Tryptophan, 114, 139 Tuberculosis, 116, 125, 139 U Unconscious, 122, 139 Ureters, 139 Urethra, 139 Urinary, 7, 51, 139 Urinary tract, 7, 139 Urine, 66, 111, 117, 139 Uterus, 113, 139 V Valves, 113, 121, 129, 139 Vascular, 8, 111, 113, 121, 123, 138, 139 Vasoconstriction, 117, 119, 139 Vasodilator, 122, 139 Vein, 108, 123, 128, 139 Vena, 50, 123, 139 Venous, 132, 139 Ventricle, 110, 126, 133, 137, 139 Ventricular, 8, 12, 20, 21, 22, 24, 31, 36, 40, 46, 48, 50, 52, 53, 56, 118, 121, 139, 140 Ventricular Dysfunction, 36, 118, 139 Ventricular fibrillation, 48, 52, 56, 140 Ventricular Function, 12, 140 Veterinary Medicine, 83, 140 Virulence, 110, 138, 140 Virus, 113, 123, 140 Visual field, 134, 140 Vitreous Body, 134, 140 Vivo, 31, 140 W Weight Gain, 6, 135, 140 White blood cell, 109, 125, 131, 140 Windpipe, 138, 140 Y Yeasts, 130, 140

148 Mitral Valve Prolapse

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